A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Arts (Counselling Psychology) in the Department of Psychology in the Faculty of Arts at the University Of Zululand, South Africa, 2012. / The overarching aim of this study was to explore the use of mental health services in UMhlathuze district. A further aim was to explore the experiences and opinions of mental health users. Sixty mental health users participated in the study. The mental health needs of the predominantly poor, black population and people in rural areas are consequently left unmet. For mental health services to be improved and stay effective, constant evaluation is necessary. This will allow the use of mental health services as well as delivery to build upon its strengths as well as respond to short comings and new emerging needs indicated by research participants. This study investigated the use of mental health service in certain parts of UMhlathuze district. It records valuable aspects of the mental health services usage and identifies experiences and opinions for improvement. Findings in this study were guided by mental health service users from different service providers. The procedure for data collection involved direct conversations in which participants reflected on their experiences when mental health services are offered to them. A convenient sample was used in that the criterion of inclusion of participants in the sample was based on people consulting at health care facilities for mental health services, for example mental health users from psychology clinic, district hospital and NGOs. The opinions given were speaking back to the experiences thus participants came up with suggestions on how mental health services can be improved. Participants' experiences of the mental health service delivery were generally positive and negative on the other hand. The experiences of mental health users mainly appreciated for the essential services provided to the community and the fact that it also easy to access services because of providing psychological services at affordable rates. / National Research Foundation

In KwaZulu-Natal, South Africa, many of those who search for solace from mental illness draw on one or more of the three vigorous therapeutic traditions of healing to which the region is heir. Western psychiatry and its formal institutions have a long history in this region: in 1868, the Colony of Natal passed southern Africa's first 'lunacy legislation'; and in 1880, the Natal Government Asylum was opened on the Town Hill, Pietermaritzburg. Although founded on the precepts of nineteenth century liberalism, by 1910, the Pietermaritzburg Mental Hospital (as it was now known) increasingly reflected a national concern with a racialised 'mental science' and Natal psychiatry became somewhat marginalized within a broader network of national asylum administration. During World War 1, too, the white citizens of Pietermaritzburg sought to have future expansion of the asylum halted, and its inmates hidden from public view. Although the story of Western psychiatry in Natal and Zululand is important for any history of mental illness in South Africa, in the nineteenth and early twentieth centuries, colonial psychiatry had relatively limited significance for the majority of people. Since the nineteenth century, African understandings of and treatments for illness have proved especially resilient, interacting with and at times adopting - and adapting - elements of Western biomedicine, as well aspects of healing strategies whose origins lie in Indian concepts of health and medicine first brought with indentured workers from the 1860s. For whites, as well as for Africans and Indians, committal to the asylum came, most typically, at the end of a lengthy quest to find a cure for mental illness. Throughout the nineteenth and early twentieth centuries, other sectors of healing proved to be remarkably flexible, offering new explanations for apparently new forms of illness - including insanity - that accompanied the political, economic and social upheavals of the time, as well as producing new therapies, strategies, and specialists to meet them. It is this variety of responses to mental illness, and ways of attempting to negotiate a path to a state of mind that might be termed 'mental health', that this dissertation traces. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.

This qualitative study explores the experiences of adult mental health service users as well as their families upon discharge of service users, to their families in the Durban area, from Ekuhlengeni Care Centre (ECC) during May 1999 to December 2001. In so doing, the aim was to ascertain the nature of mental health service users' adjustment to living in the community, their impact on the home environment, to identify gaps in community care and to provide suggestions on resolving these gaps. The study was guided by a qualitative research paradigm and utilized an exploratory descriptive research design. Availability sampling was used. Unstructured face-to-face, in-depth interviews were conducted with four mental health service users (MHSUs) and six family members. The results of the study reveal the many dilemmas that both MHSUs and their relatives experience because of the lack of support and services available in the community. There is overwhelming evidence to suggest that the environment is ill suited at all levels to meeting the needs of MHSUs and their relatives. This study examines the challenges experienced by MHSUs and their relatives and makes recommendations for practice and policy that can contribute to improved service delivery. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

This research presents a consumer evaluation of the delivery and aspects of services provided at three community run mental health centres. The purpose of this research is to describe the satisfaction levels of consumers with mental health service delivery in Durban, with a view to using this information to improve the services in future for quality assurance. The current investigation takes a look at how a comprehensive community mental health centre is perceived by its consumers. The subjects totalling one hundred and eleven clients who were attending psychiatric community health clinics during the study period. Using client self report questionnaires, the study investigates clients' perceptions of several aspects of their clinical care in community mental health service. In addition to assessing the clients' level of overall satisfaction and degree of acceptability of the services to the clients, the researcher was also interested in determining the expectation of consumers and how the clients perceived the effectiveness of health care service delivery. Additional information provided was the clients' views of the quality and outcome oftherapy. As further measures of the clinic's effectiveness and client satisfaction, questions relative to other help seeking actions, future behaviour in similar situations and recommendations ofthe clinic to others were asked. In addition to asking a wide variety of satisfaction-related questions, sociodemographic detail (i.e. age, gender, race, educational level, employment status, length of visits to the clinic) were asked. Most participants were unemployed men. Analysis of findings indicated that most participants were satisfied with the health service provided. Recommendations were, however, further made for improving quality of care and towards additional studies in other settings to include appropriate proportions of all racial groups in South Africa. / Thesis (M.Cur.)-University of Natal, Durban, 2002.

The understanding of the pathways that clients take prior to admission to a mental health institution, is a vital factor in planning to reduce delays in seeking treatment. Studying the pathways may also help in the identification of sources of delays in the receiving of care and suggest possible improvements. Although western medicine plays an important role in the control of disease, traditional medicine continues to play an important role in the health care of black African communities. They, therefore possess unique attitudes, values and beliefs, about health and illness, which integrally infiuence their health behaviour. This study aims to increase the understanding by health professionals of pathways to care taken by clients before they are admitted to a mental health institution, so as to enhance heath service planning. It also aims to determine the socio-cultural and economic factors, as well as satisfaction with different service providers. The sample in this study consisted of 15 clients, who were between the ages of ten and fifty-nine years. These clients were males and females who were admitted for the first time in a mental health institution (MHI) (TownHill Hospital, Pietermaritzburg). The interview questionnaire, was administered, by the researcher.This study has demonstrated that, Africans still believe in traditional and faith healers as their first port of call when they are mentally ill. Their help seeking behaviour is determined by their cultural beliefs and values. The study also demonstrated the high involvement of the South African Police Services (SAPS) in the pathway to mental health institution by intervening to protect family or public and also transporting the client to a mental health institution. The Primary Health Care (PHC) is very seldom used Economic factors like unemployment strongly infiuence the mental health of people and also affect their social functioning, as it is shown by the high levels of unemployment in the sample. Some of these clients resort to living on the streets, because they cannot find employment and are homeless. The study has also shown the importance of education and training of health professionals in PHC, in identifying the first signs of mental illness when clients present themselves and making available the psychotropic drugs at the PHCC as this is the first port of call for clients. Psycho education of traditional healers, spiritual healers, SAPS and community should be implemented on when and how to refer clients, how to handle mentally ill clients. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

Aim To explore Mental Health Care Practitioners and a Mental Health Care Directors perceptions of mental health care nurses obtaining prescription authority in eThekwini District KwaZulu-Natal. Methodology A qualitative design was used to gather data through individual interviews and a focus group interview. Purposive sampling was used to select the study setting (five (5) Out Patient Departments, two (2) Community Health Centres, one (1) tertiary educational institution, and one district office), potential participants were not sampled. Participants included; twenty six mental health care nurses (n=26), one (1) psychiatrist (n=1), four (4) medical officers (n=4) and one (n=1) mental health care director. Thematic analysis using the steps outlined by Braun and Clark (2006) was used to analyse the data. Results The majority of participants were not aware of policies or legislation allowing nurses to prescribe medication. Participating mental health care nurses from an education setting were more knowledgeable than other participants about current legislation and policy. Study findings indicate that nurses’ obtaining prescriptive authority is not on the provincial department of health agenda. In addition, participating ppsychiatrists and medical officers expressed reservations about nurses obtaining prescriptive authority, specifically independent prescriptive authority. Participating mental health nurses displayed ambivalence related to the pursuit of prescriptive authority. Conclusion and Recommendations The challenge for mental health nurses is suggested to be the achievement of a collaborative working relationship within the discipline of nursing, and between the discipline of nursing and medicine / psychiatry. It is suggested mental health care directors, and the SANC, be proactive, look to the future in advising the health minister about access and barriers to mental health care treatment. In addition, the SANC champion the nurse, specifically the mental health care nurse in obtaining prescriptive authority for schedule 5-6 psychotropic medications. Further research is required to generate more in-depth data, specifically research that explores mental health care nurses’ reluctance to pursue prescriptive authority. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2014.