Caregivers’ perception regarding mental health disorders, living conditions and access to psychiatric programs: a case study of KwaXimba, eThekwini Municipality, KwaZulu-Natal, South Africa.

Abstract

In rural clinics within developing countries MHC is limited to medication. Taking medication without psychiatric evaluation and the necessary rehabilitation leads to continuing impairments in patients, implying a continued need for assistance from caregivers. The lack or absentia of any of these critical components increases the burden of caregiving for caregivers and their households, without the possibility of patients being rehabilitated and reintegrated into their communities. Educating communities about MHDs has been identified as a key part of destigmatising MHD, improving adherence to medication, leading to a decreased burden on caregivers and their households. This research aims to explore the awareness, knowledge and perceptions about MHDs, the challenges, and opportunities available for rural caregivers and to analyse accessibility and availability of MHC services for patients with MHDs and their caregivers in rural communities of KwaXimba. This research adopted a case study approach utilising a descriptive research design. Also, this study utilised triangulation. Quantitative questionnaires were administered to 35 purposively and snowball sampled caregivers in KwaXimba. Data collected from questionnaires was processed through Statistical Package for Social Science version 28, presented, and analysed descriptively. The key informant was purposively sampled for the qualitative interview and data from the interview was analysed thematically. The results of this study indicated that witchcraft was perceived to be the most common cause of MHDs (89%). Majority of patients (80%) sought traditional methods as the first choice for treating the MHD. Strong common beliefs about MHDs exist and influence treatment routes preferred by caregivers. Stigma and discrimination were common affecting patients (60%) and caregivers (60%) respectively. Lack of awareness about MHDs was predominantly influenced by instilled traditional beliefs about MHDs (71%). The nearest clinic was 6-10 km away and the nearest hospital 55-60 km away from KwaXimba. There were no rehabilitation or facilities for the disabled. Only 3% of patients had accessed and engaged with a rehabilitation program in the nearest town, Pietermaritzburg. Social grants were the most available social service for patients and caregivers. Psychiatric medication was the only available MHC service available in the local clinic. There are no other MHC services that were available. Mental health literacy needs to be improved to enable timeous seeking of medical assistance, adherence to medication, empowerment of patients and caregivers as well as decrease stigma. Collaboration between traditional and medical care needs to be introduced, where traditional leaders, caregivers, patients, health care personnel, non-governmental organisations and communities are informed about the rehabilitation of patients.