MCur / Department of Advanced Nursing Science / Background- Family support is the most important milieu for the treatment and rehabilitation for mental health care users. However, there are cases that are reported where mental health care users are rejected by their family members worldwide. Vhembe District is no exception. Purpose-The study determined factors affecting family members’ support of their state patients in Hayani hospital, Vhembe District, Limpopo Province. Methodology- The study adopted a qualitative design which was explorative, descriptive and contextual in nature. Non-probability purposive sampling method was used to sample 09 family members with state patients at Hayani Hospital from the entire population. Data was collected through in-depth individual interviews and analysed through Techs method of coding. Ethical considerations and measures to ensure trustworthiness were followed throughout the study. Results- Data revealed two themes from namely, psychological factors and sociological factors affecting family members’ support. Recommendations- This study recommends on developing a model of support for family members’ with state patients at Hayani hospital. This study also recommends that department of health should consider meetings with family members. / NRF

Magister Scientiae (Occupational Therapy) - MSc(OT) / Return to work is a recognised goal of rehabilitation by the occupational therapy discipline that is addressed through vocational rehabilitation as a key feature of work practice. Programmes that fall under the umbrella of vocational rehabilitation include work preparation and training, work hardening and supported employment. In the case of mental health care users (MHCU), meaningful employment contributes to their sense of identity and the prevention of relapse. Vocational rehabilitation is thus important in preparing MHCU for self-employment or employment in the community after they are discharged from the hospital. There is however a dearth of literature pertaining to how vocational rehabilitation programmes particularly in a rural setting, is experienced by MHCU in South Africa. Therefore, the aim of this study was to explore the experiences and perceptions of MHCU regarding the usefulness of the vocational rehabilitation programme at a rural hospital in enhancing their worker roles. A qualitative research approach and exploratory descriptive research design was utilised. Purposive sampling was used to select participants for the study. Semi-structured interviews were conducted with ten MHCU participants as well as two focus groups. Semi-structured interviews were furthermore conducted with two key informants. All interviews and the focus group discussion were audio-recorded, transcribed verbatim and analysed through thematic data analysis. Strategies implemented to ensure trustworthiness included member checking and peer review. Ethics clearance was obtained from the UWC Research Committee and permission to conduct the study at the hospital was requested from the Mpumalanga Provincial Health Ethics Committee and hospital management. Three themes originated from the findings of this study. Theme one describes the barriers experienced by people with mental illness while returning to work. Theme two describes the programme factors that influence return to work in respect of work habits, work skills, and community re-integration. Theme three captures the value of participating in the work programme as experienced by the participants. The findings of the study is related to the Model of The Ecology of Human Performance (EHP) to show how the vocational rehabilitation programme effected the MHCU’s return to work. The findings show that the context as well as the person’s skills and abilities are very important factors in reintegrating the user back to work. The study illuminated recommendations for the further development of the vocational rehabilitation programme.

Magister Curationis - MCur / The provision of mental health care, treatment and rehabilitation of the acutely ill mental health care users (MHCUS) poses a major challenge to the nurses working in acute units. Nurses spend long hours ensuring that acutely ill psychiatric patients receive quality patient care in acute admission units in different psychiatric hospitals in South Africa. With few studies showing a rise in the prevalence of mental disorders in the South Africa and the Western Cape Province, acute psychiatric inpatient units across the province have experienced intense pressure and persistent rise in the number of acute patient admissions. Dealing with this group of patients is a difficult task particularly for nurses who spent prolonged hours caring for them. Despite the continuing provision of care to MHCUS by nurses in acute admission units, very little is known about the lived experiences of nurses in acute admission units. The aim of this study was to explore and describe the lived experiences of nurses who care for the acutely ill MHCUS in an acute male admission unit at a psychiatric hospital in the Western Cape. Acutely ill MHCUS in acute psychiatric units show severely disturbed behaviour at times, aggression, hostility, acute psychotic symptoms and many other symptoms related to psychiatric illness. Methods: a qualitative, descriptive phenomenological research design was used to explore and describe the lived experiences of nurses who care for acutely ill patients in an acute admission unit. A purposive sample of eight nurses was selected. Individual, semi structured phenomenological interviews were used to collect data from nurses caring for MHCUS in an acute admission unit. Data saturation was reached after carrying out the eight interviews. These interviews were audio taped and transcribed verbatim and Collaizi’s (1978) seven steps method of qualitative data was applied to analyse the collected data. Findings: The study found that nurses in the acute admission unit experienced several challenges while caring for MHCUs. Nurses reported both negative and positive experiences. Positive experiences included MHCUs recovery, teamwork and passion for caring while negative experiences were feeling unappreciated and unsupported by authorities. Furthermore, they reported physical assault by MHCUs which led to fear. Challenges experienced included shortage of staff and increased workload which led to burnout amongst nurses in acute admission units.

The aim of this thesis is to analyze mental health care in Australia from a social justice and human rights perspective, in order to demonstrate that social justice as a philosophical manifestation of justice and fairness, is an essential ingredient in the theory and practice of mental health care. It is contended that the needs of the mentally ill would be most appropriately answered by the utilization of a Natural Law model, based on Finnis’s Natural Law theory. The Scope of the Thesis.The needs and care of the mentally ill are discussed, together with the treatment meted out to these vulnerable members of society since, approximately, the year 1800. Neither the criminally insane, nor the intellectually disabled are included in this discourse. Each group of people merits a thesis on its own: criminal insanity requires a debate to include the history, psychiatric and legal approaches to the subject, and current management of the insane. The intellectually disabled are not mentally ill; their ability to function as all round, naturally competent individuals is diminished by an inadequacy and/or impairment of their intellectual capacities. The needs of these two groups are far too broad and demanding to be included within the current thesis. Rationale for the Timeframe The timeframe, 1800 until 2004, has been established because it approximates to the transition from the end of the Classical through the Modern Age to the Post Modern Age, together with the predominance of Enlightenment philosophical theories, and the development of a scientific approach to medicine. Further, many politico-economic and social changes were taking place, associated with the Industrial Revolution. All are shown to have affected the introduction of asylumdom, and the institutionalization of those unable to participate actively in the industrial workforce. Of significant importance to the development of institutionalization for such marginal groups is the philosophy of Jeremy Bentham. Bentham espoused Classical Utilitarianism which will be shown to believe that the ultimate standard of utility is not the individual’s happiness but the greatest amount of happiness altogether. The thesis will demonstrate that this philosophical view prevailed from the beginning of the Industrial Revolution, with Benthamism influencing the sequestration of the unemployable into institutional life. Development of the Thesis.The thesis is developed against a background of prevailing philosophical, and other changes as stated above, including the medicalization of mental illness and the development of psychiatry as a branch of medicine. There is manifestation of many social injustices to those incarcerated in the asylum in all three countries under consideration: England, USA, and Australia. It is demonstrated that social justice and human rights of their work forces were disregarded by many employers at the time of the Industrial Revolution. Such values were, therefore, unlikely to prevail with regard to the mentally ill. Asylumdom continued with few changes in its practices until after World War II. It is shown that the predominance of post Enlightenment theories, together with further politico-economic, social and pharmaceutical revolutionary change followed the Second World War. Encouraged also by the founding of the United Nations and World Health Organizations as well as provision of the Declaration of Human Rights, circumstances led to the process of de-institutionalization of the mentally ill. The latter were decanted with apparently unseemly haste into a community ill prepared for such a change, and with little evidence of infra- structure to support the move. Need to conduct a National Inquiry. There was, then, a need to investigate what was now an overt issue of mental health care. The two subsequent inquiries by the Australian Health Ministers Advisory Council, (AHMAC) and the Burdekin Report, both focused on social justice issues, and addressed epidemiological, economic, sociological and justice considerations. Within the thesis, both investigations are critiqued against a Natural Law model, using Finnis’s Natural Law theory. It is demonstrated that contrary to Enlightenment principles of social justice as described by Miller, such a theory is eminently practical, and answers the needs of all members of the community, providing not merely ‘the greatest happiness for the greatest number’ but the common good of all Conclusion. Evidence shows that such a Natural Law theory is required to give a firm foundation to the needs of the mentally ill, especially at a time when relativism, economic rationalism and negative aspects of globalization prevail. Without such a basis the mentally ill are left insecure, uncertain and adrift in a world uncaring of their plight, while all the earnest exhortations espoused by Reports remain platitudes, subject to the whims of whatever government is in power. Our responsibilities to all our fellow human beings demand better from us than this.

Thesis (M.S.W.)--University of Hong Kong, 1976. / Includes bibliographical references (leaves 56-59) Also available in print.

Older adults have historically utilized mental health services at substantially low rates. Unfortunately, though professional, policy, and other recent developments portend an increase in service use, there has been scant empirical attention devoted to the current or recent utilization of mental health treatment by the elderly, and almost nothing is known about the correlates of mental health need and service use among older adults. Accordingly, the present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65+) and younger (18- 64) adults throughout the United States, and the extent to which various factors predict mental health need and the use and magnitude of mental health treatment. In addition, the study examined factors related to unmet need, as well as age group differences in perceived benefit from treatment. The findings reveal that older adults were three times less likely than their younger counterparts to receive any outpatient mental health treatment. Only 2.5% of older individuals utilized any outpatient mental health service in the past year, versus 7.0% of younger adults. The results indicate that the low rate of utilization by older adults may be partly a function of limited subjective mental health need. Prevalence estimates for SMI and all specific mental health syndromes, with the exception of agoraphobia, were markedly lower in the older than the younger cohort. Importantly, though mental health problems appear to be significantly undertreated in older and younger age groups, the study also reveals that those older and younger adults that make it into services typically benefit considerably from treatment. It is hoped that the knowledge yielded by the current study will promote efforts to enhance mental health care access and reduce the long neglected mental health needs of the nation’s elderly population. Several factors related to mental health need and service use were identified in the study that may assist policy, planning, and outreach efforts aimed at increasing service access.

Thesis (Ph. D.)--University of Texas at Austin, 1998. / Vita. Includes bibliographical references (leaves 193-206). Available also in a digital version from Dissertation Abstracts.

Background: A serious problem in the work environment are threats and violence. This is a growing problem in health care. Workplaces providing mental health care is one of the workplaces that is at risk of exposure. Nurses may suffer from severe psychological and physical consequences afterwards. Aim: The aim of the study was to describe nurses' experiences of threats and violence in the field of mental health care. Method: The study was conducted at a hospital in southern Sweden. Ten nurses were interviewed for 30-60 minutes. The interviews were recorded in order to be written down later. The material was subjected to qualitative content analysis. Results: The processed material was subdivided into four categories: The view on threats and violence, approach to threats and violence over time, reactions on threats and violence and safety-creating factors. Everyone in the study had been exposed to threats and violence at work. Nurses described that with growing work experience, their approach to meet threats and violence changed. They were not as much affected as they were in the beginning of their work, and rather stood back instead of entering into confrontation with the patients. Experienced staff, education and secure premises are some of the factors to increase safety to staff. Conclusion: Working within psychiatric in-patient care department inevitably entails coming into contact with threats and / or violence at some point. Patients with a variety of psychiatric disorders may have difficulties expressing their needs in an appropriate manner. One last resort, when a patient is lacking a feeling of being understood, can be to communicate his needs through threats and violence. Linking a patient's behavior to his illness often helps nurses to gain a better understanding of why the patient is acting out.

Due to the global push for deinstitutionalisation, the care of psychiatric patients has been transferred to their family members. Evidence worldwide however suggests that the rate of deinstitutionalisation has not been matched with the sufficient increase of community resources to support both the caregiver and the patient in the community where they reside (Lippi, 2016:1). The conducted study undertook to explore and describe the experiences of caregivers of Mental Health Care Users (MHCUs) with a diagnosis of Schizophrenia in the southern- western parts of Johannesburg. The goal of the present study was to explore the experiences of the caregivers of MHCUs with schizophrenia in the southern- western parts of Johannesburg. A qualitative research approach was utilised to conduct the study. The researcher made use of purposive sampling and semi-structured, face to face interviews were utilised to collect data. Ten interviews were conducted with caregivers of MHCUs in Lenasia South. The researcher however reports on 9 of the 10 interviews due to the fact that the recording device was stolen in the home of the researcher before the recording could be backed up. The findings of the study indicate that the caregivers of MHCUs often do not know the name of the diagnosis and do not understand the diagnosis. Many of the caregivers held the belief that the MHCU was bewitched. The social lives, health and finances of caregivers were negatively affected by the task of caregiving. The study found that caregivers are reluctant to leave the MHCU alone or in the care of other people, because they are constantly worried about their well-being. The study found that caregivers were stigmatised together with the MHCU in their communities. Community resources to support the caregiver and provide psychoeducation are non-existent in the experience of these caregivers. The study found that caregivers had minimal to no experience at all of receiving support from a social worker. The study concludes that the experiences of caregivers are difficult because of the lack of understanding of the illness, a lack of support and psycho-education and a lack of community resources that can aid the caregiver. Recommendations in the study include making a referral to be seen by a social worker mandatory for each case, social workers facilitating the start-up of peer support groups for the caregivers and being intentional about psycho-educating caregivers. / Mini Dissertation (MSW)--University of Pretoria, 2019. / Social Work and Criminology / MSW / Unrestricted

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