Risk factors and strategies for relapse prevention among individuals living with serious mental illness in South Africa: Qualitative inquiry from patients' and caregivers' perspectives.

Journal: PloS one

Volume: 19

Issue: 8

Year of Publication: 2024

Affiliated Institutions:  Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa. Discipline of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa. Discipline of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Private Practice, Durban, South Africa. Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa. School of Social Work, University of Connecticut, Hartford, Connecticut, United States of America. KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Abstract summary 

Relapse among individuals with serious mental illnesses in resource-limited contexts, including South Africa, is a significant concern. To date, the risks for relapse among this population is well documented, but little is known about prevention strategies to reduce its occurrence in these resource-limited settings. Therefore, this qualitative study explores the risk factors and strategies for relapse prevention from the patients' and caregivers' perspectives.We conducted audio-recorded face-to-face in-depth interviews to capture the lived experience of relapse of inpatient study participants with serious mental illness (N = 24) at a public specialized psychiatry hospital in South Africa and their caregivers (N = 6). We conducted an inductive thematic analysis with two pre-specified themes (risk factors for relapse and strategies for prevention), with the codes devised from the data.Six sub-themes were identified from the analysis within the two pre-specified themes(Risk factors and strategies for relapse prevention): personal-related, family-related, and health system-related risk factors and strategies for preventing relapse, respectively. To highlight some essential findings, the importance of motivation for drug adherence, family involvement, and availability of anti-psychotic drugs in public health care were noted. More importantly, this study identified important cultural complexities where traditional healers play a significant role in some cultural understanding and treatment of mental illness, affecting medication adherence.This study calls for people-centered mental health care delivery in a public health system that listens to the voice of concern, including cultural challenges, and implements meaningful support that matters most to the patient and their family/caregivers.

Authors & Co-authors:  Mlay Joyce Protas JP Naidu Thirusha T Ramlall Suvira S Mhlungu Sbusisiwe Sandra SS Zondi Makhosazane M Lessells Richard R Manuel Jennifer I JI Tomita Andrew A

Study Outcome 

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Statistics
Citations :  Jääskeläinen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, et al.. A systematic review and meta-analysis of recovery in schizophrenia. Schizophrenia bulletin. 2013. Nov 20;39(6):1296–306. doi: 10.1093/schbul/sbs130
Authors :  8
Identifiers
Doi : e0309238
SSN : 1932-6203
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Study Design
Study Approach
Qualitative
Country of Study
South Africa
Publication Country
United States