Thesis (MA (Psychology))--University of Stellenbosch, 2006. / An immense burden is placed on families caring for a member with a mental disorder as a result of deinstitutionalisation in South Africa. The aim of present study was to identify resilience factors in families living with and caring for a member with a mental disorder. The focus was on families living in an underprivileged, semi-rural area; caring for a patient using the state-sponsored psychiatric services. Using a cross-sectional survey design, interviews were conducted with 34 family representatives. During these interviews, qualitative and quantitative data was gathered by means of a biographical questionnaire, an open-ended question and set of self-report questionnaires. The results yielded from the data analysis are in keeping with findings from international and South African family resilience studies. After content analysis of the qualitative data, three themes related to resilience factors emerged: internal factors within the home, external factors outside of the home and factors related to the member with a mental disorder. The most commonly mentioned resilience factors cited by the family representative were religion and spirituality, characteristics of individual family members (excluding the patient), family characteristics, and social support. Spearman’s correlations and best subsets multiple regression analysis were performed on the data to ascertain which factors are significantly correlated or associated with family adaptation. In both statistical analyses, communication styles of the family unit were the most important. Spearman’s correlations further revealed that in addition to family communication, the ability of the family to work together, and communication between the marital couple had the strongest correlation with adaptation. Passive acceptance of problematic issues in the family has a negative correlation with family adaptation. The two most significant predictor variables of family adaptation are the family’s style of family communication during crises and the family’s use of passive appraisal as a coping style.

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The topic of perinatal depression (i.e. depression during and after pregnancy) remains a subject of continued research interest, as a broad literature body reports that a large proportion of women suffering from this mental disorder do not receive appropriate treatment. This is worrisome, firstly, because mental health treatment is often readily available to the public and at no cost. Secondly, untreated perinatal depression not only holds dangerous consequences for the mother but also for the infant and the rest of the family. It is therefore important to identify those factors that act as barriers to mental health care utilization for perinatal depression. Although this is a persistent problem within the South African context, to date, little is known about the barriers to the utilization of available mental health services experienced among pregnant South African women. For this reason, the Perinatal Mental Health Project (PMHP) aims to provide mental health services at the same location where women receive obstetric services. However, despite their efforts, the number of women who decline available treatment is still of great concern. The present study offers a unique perspective on counselling for perinatal depression appointment-keeping barriers as it provides a holistic view of these barriers that exist not only within the women but also in their multi-levelled environments. Secondly, it addresses the problem of nonattendance to mental health care treatment offered by the PMHP and consequently also addresses the gap in South African research on the topic. The sample for this study was selected from PMHP files of those patients who failed to attend scheduled counselling appointments. The participants included in this study were selected by means of purposeful sampling to participate in face-to-face and telephonic semi-structured interviews. Participants were assured of confidentiality and anonymity. The semi-structured interviews were audio-recorded and transcribed after which transcriptions were entered into MS Word for textual analysis. Transcriptions were thematically analysed. The main themes that emerged from the present study included individual-related barriers, social-related barriers, institution-related barriers, community-related barriers and poverty-related barriers. The results of the present study reflect the motivations for depressive pregnant women to decline available and free mental health services provided by the PMHP, according to five main themes. These themes were then discussed according to Bronfenbrenner’s (1977; 1979) Ecological Systems Theory, which categorised the main themes identified according to the different systems operating within the patient’s environment, i.e. the individual-, micro-, meso-, exo-, and macrosystem. The individual system comprised the individual-related barriers, which included poor mental health, and ambivalent feelings toward the pregnancy. The microsystem comprised the social-related barriers, which included low social support and self-help strategies. Community-related barriers were considered within the mesosystem of the patient’s ecological environment, with stigma and pity as sub-barrier. The exosystem comprised the institution-related barriers, including referral protocol barriers, lack of information provided by the nurses, and nurses’ attitudes as experienced by participants. Lastly, poverty-related barriers were considered within the macrosystem, with financial life hardship, constant child-care demands, and transportation barriers as sub-barriers. The significance of this study lies in the original perspective offered on mental health care appointment-keeping behaviour within the South African context. Future research could, in addition to conducting interviews with hospital patients, include health care professionals and focus groups as this will allow for triangulation of the perspectives of all significant players. Also, having identified the problems and concerns with regards to attending counselling appointments, future research direction may be aimed at creating interventions designed to reduce the identified barriers to mental health care service use. / AFRIKAANSE OPSOMMING: Perinatale depressie (d.w.s. depressie voor en na swangerskap) bly ʼn onderwerp van voortdurende navorsings belang, aangesien ʼn breë navorsingsveld aandui dat ʼn groot proporsie van vroue wat aan hierdie geestesversteuring lei, nie die gepaste behandeling ontvang nie. Dit is kommerwekkend, eerstens, aangesien behandeling vir geestesgesondheid meestal openlik verkrygbaar is aan almal sonder enige koste. Tweedens, onbehandelde perinatale depressie hou nie slegs gevaarlike gevolge vir die moeder in nie, maar ook vir die baba en die res van die gesin. Dit is daarom belangrik om daardie faktore te identifiseer wat as hindernisse optree tot geestesgesondheid sorg diensgebruik vir perinatale depressie. Alhoewel dit ʼn voortdurende probleem binne die Suid-Afrikaanse konteks is, is daar tot op hede geen navorsing wat hindernisse tot gebruik van beskikbare geestesgesondheidsdienste bekend gemaak nie, veral wat ervaar word onder swanger Suid-Afrikaanse vroue nie. Vir hierdie rede, beoog die Perinatal Geestesgesondheid Projek (Perinatal Mental Health Project - PMHP) om geestesgesondheidsdienste te lewer by dieselfde plek waar vroue verloskundige dienste kan ontvang. Nietemin, ten spyte van hul pogings, is die getal vroue wat beskikbare behandeling van die hand wys steeds van groot kommer. Dié studie bied ʼn unieke perspektief op hindernisse tot berading vir perinatale depressie afspraak-ooreenkoms gedrag, aangesien dit ʼn algehele uitkyk bied op hindernisse wat nie slegs binne die vroue bestaan nie, maar ook in hul veelvlakkige omgewings bestaan. Tweedens, spreek dit die probleem van nie-bywoning van geestesgesondheidsbehandelingsdienste wat aangebied word deur die PMHP aan en gevolglik ook die gaping wat binne Suid-Afrikaanse navorsing rakende dié onderwerp bestaan. Die steekproef vir die studie was gekies van PMHP lêers van daardie pasiënte wat nie hul geskeduleerde terapie afsprake bygewoon het nie. Die deelnemers ingesluit in die studie is deur middel van doelgerigte-steekproefneming geselekteer om aan aangesig-tot-aangesig of telefoniese semi-gestruktureerde onderhoude deel te neem. Deelnemers is van hul vertroulikheid en anonimiteit van die proses verseker. Die semi-gestruktureerde onderhoude was oudio-opgeneem en transkripsies is daarvan gemaak, waarna die transkripsies in MS Word gelaai is vir tekstuele analise. Transkripsies is tematies geanaliseer. Die hooftemas wat na vore gekom het, sluit in individuele-verwante hindernisse, sosiale-verwante hindernisse, institusie-verwante hindernisse, gemeenskapsverwante hindernisse en armoede-verwante hindernisse. Resultate van dié studie reflekteer die motiverings van depressiewe swanger vroue om beskikbare en gratis geestesgesondheidsdienste wat verskaf is deur die PMHP van die hand te wys, volgens die vyf hooftemas. Hierdie temas is toe volgens Bronfenbrenner (1972) se Ekologiese Sisteemteorie verdeel in die verskillende sisteme teenwoording in die pasiënt se omgewing, naamlik die individuele-, mikro-, meso-, ekso-, en makrosisteem. Die individuele sisteem het die individuele-verwante hindernisse ingesluit, wat swak geestesgesondheid, en teenstrydige gevoelens teenoor die swangerskap omvat het. Die mikrosisteem het die sosiale-verwante hindernisse ingesluit, wat swak sosiale ondersteuning, en self-help strategieë omvat het. Gemeenskapsverwante hindernisse is binne die mesosisteem van die pasiënt se ekologiese omgewing beskou, en het stigma en jammerte as sub-hindernisse ingesluit. Die eksosisteem het die institusie-verwante hindernisse ingesluit, wat verwysing protokol hindernisse, gebrek aan inligting verskaf deur die verpleegsters, en verpleegsters se houdings soos ervaar deur die deelnemers omvat het. Laastens is die armoede-verwante hindernisse binne die makrosisteem beskou, en het finansiële lewens swaarkry, konstante kindersorg eise, en vervoer-verwante struikelblokke as sub-hindernisse ingesluit het. Die belang van dié studie lê in die oorspronklike perspektief van geestesgesondheidsbehandeling dienste afspraak-ooreenkoms gedrag binne die Suid-Afrikaanse konteks, wat aangebied is. Toekomstige navorsing kan, bykomend tot die voer van onderhoude met hospitaal pasiënte, fokus daarop om gesondheidsorg kenners en fokus groepe in te sluit, aangesien dit die triangulasie van perspektiewe moontlik maak van al die belangrike rolspelers. Ook, aangesien die probleem en bekommernisse rakende bywoning van terapie afsprake reeds geïdentifiseer is, mag toekomstige navorsing in die rigting beweeg met die doel om intervensies te omskep wat beoog om die geïdentifiseerde hindernisse tot geestesgesondheidsorg diensgebruik te verminder.

Educational Studies / M. Ed. (Guidance & Counselling)

This study highlighted the distinction between retributive and restorative justice. Diversion and the Journey as a diversion option for youth in South Africa was discussed. Literature indicated that certain family aspects such as family cohesiveness, communication, discipline, and conflict in the home could lead to youth offending. Interviews, focus groups, and questionnaires were used to determine possible problematic family interactions as well as parents' needs of a parent programme. It was found that parents experience feelings like anger, disappointment, shock, helplessness, frustration, and humiliation regarding the child's crime. It was established that dealing with parents' feelings, communication, discipline, conflict resolution, and problem solving should be included in the parent programme. An evaluation of the programme was done and the following aspects showed improvement: communication, mother's involvement with the child, understanding and support in the family, youth's independence, affection, family relations, problem solving and the amount of time spent with family. / Psychology of Education / M. Ed. (Guidance and Counselling)

The South African government has initiated the transformation of health services in the country towards primary health care (PHC) in order to provide comprehensive care to individuals and families. The move to PHC involves an increased need for collaboration between health professionals. It is proposed that for effective team-work to take place, an understanding of the roles and functions of team members is imperative in providing quality mental health care. This study explored health professionals’ perceptions of the role and function of clinical psychologists working as part of a health care team in a community context. Three focus groups and three individual interviews were conducted with social workers, nurses and doctors. The data was then processed and analysed using a grounded theory method. The research highlighted the importance of knowledge, and how this affects referrals, perceptions, inter-professional relations and the perceived usefulness of clinical psychology and clinical psychologists. What is of significance is the potential power that the health professionals have as gatekeepers between the general public and clinical psychologists.

Thesis (M. A. (Clinical Psychology)) -- University of Limpopo, 2020 / The integration of mental health care (MHC) into primary health care (PHC) has been identified as a practical intervention to: increase accessibility to mental health care; reduce stigma and discrimination against people living with mental illnesses; improve the management of chronic mental illness; and, to reduce the burden of comorbidity of mental illnesses with other chronic illnesses. In the South African context, integrating MHC into PHC also seeks to respond to numerous legislative reforms, with the aim of providing comprehensive health care, particularly to previously disadvantaged populations. The aim of the present study was to explore the perceptions of facility managers in the Tshwane District (Gauteng Province) towards the integration of mental health into PHC. Fifteen participants from the Tshwane district facilities participated in the study. The participants were selected through a non-probability purposive sampling method. Data was collected through in-depth interviews using a semi-structured questionnaire, and analysed using the thematic coding approach. Significant findings suggested that the major hindrances to the realisation of the policy objectives may be due to: the lack of rehabilitation and psychotherapeutic services; insufficient skill and knowledge of mental health on the part of staff; insufficient or unsuitable practice space in the facilities; and, poor cooperation between South African Police Services, Emergency Medical Services and Primary Health Care. Inter-facility communication, district implementation support and policy knowledge has notably increased over the years and were deemed to be amongst the biggest enablers.

Thesis (M.A. (Psychology)) -- University of Limpopo, 2022 / Globally, mental disorders are a growing public health problem. The World Health Organisation has urged member states to prioritise efforts to address the growing pandemic of mental illness. One strategy identified by WHO is the promotion of the use of traditional medicines. Similarly, a collaboration between Western and Traditional health care practitioners has been identified as another strategy that could help bridge the gap of shortages of mental health care providers and the cost of professional mental health care services. The present study investigated the Mmotong community’s knowledge of mental disorders and attitudes towards collaboration between Traditional healers and Western-trained practitioners in the treatment of mental disorders. A quantitative study was conducted, with a sample of 200 participants (Female = 131; Male = 69; in the age range of 18 years and older). Participants were selected using convenience sampling. Data was collected using a questionnaire and analysed using the SPSS to draw out the descriptive statistics. A majority (59%) of participants were found to possess knowledge of mental disorders. Attitudinally, most participants favoured Western-oriented mental health care services in terms of effectiveness. Despite this finding, a majority (69%) endorsed the need for collaboration between the two healthcare systems. A gender analysis revealed that more females (71.8%) than males (63.8%) favoured collaboration. While analysed by age, those 18-37 years (63.5%), 38-57 years (75.5%) and over the age of 58 years (75.5%) favoured the collaboration respectively. The present study findings show that in this community, the majority of members possess knowledge of mental illness. The community also favours the collaboration between traditional and medically oriented health care providers in mental health care. The study is concluded by making recommendations to the government, Traditional healers, and Western-oriented health practitioners to work towards the harnessing of collaboration of the two healthcare systems.

South Africa is a country steeped in decades of conflict and animosity. Apartheid and its consequences do not simply die: it has created a society struggling for survival. Against the backdrop of a country and its people still experiencing an extended social crisis, these struggles are socially constructed through various forms of aggressive, traumatic and violent behaviours such as crime victimisation. The resultant effect is that many South Africans are traumatised and require assistance to manage and deal with the impact of traumatic exposure. Counselling and psychological services within the South African context are limited, potentially expensive and often inaccessible to the poor. One way to address the needs of victims of crime and violence, is through the establishment of one-stop multidisciplinary crisis centres that specialise in short term crisis intervention service delivery. One such a crisis centre is the Sinoville Crisis Centre (SCC). The purpose of the study is to present an exploratory qualitative and participatory action research account of the SCC's endeavours and ongoing challenges in providing crisis intervention services as well as to serve as a guideline for future development. Research interviews with seven (7) SCC counsellors were complimented with a focus group interview. Subsequent conclusions were grounded in relation to relevant subject theory. Three (3) broad categories of recommendations are provided. Specific recommendations are levelled in relation to: * The SCC's crisis intervention models * The SCC's need to manage organisational change and loss; and * The SCC's role within the Victim Empowerment Programme. / Psychology / M.A. (Psychology)

South Africa is a country steeped in decades of conflict and animosity. Apartheid and its consequences do not simply die: it has created a society struggling for survival. Against the backdrop of a country and its people still experiencing an extended social crisis, these struggles are socially constructed through various forms of aggressive, traumatic and violent behaviours such as crime victimisation. The resultant effect is that many South Africans are traumatised and require assistance to manage and deal with the impact of traumatic exposure. Counselling and psychological services within the South African context are limited, potentially expensive and often inaccessible to the poor. One way to address the needs of victims of crime and violence, is through the establishment of one-stop multidisciplinary crisis centres that specialise in short term crisis intervention service delivery. One such a crisis centre is the Sinoville Crisis Centre (SCC). The purpose of the study is to present an exploratory qualitative and participatory action research account of the SCC's endeavours and ongoing challenges in providing crisis intervention services as well as to serve as a guideline for future development. Research interviews with seven (7) SCC counsellors were complimented with a focus group interview. Subsequent conclusions were grounded in relation to relevant subject theory. Three (3) broad categories of recommendations are provided. Specific recommendations are levelled in relation to: * The SCC's crisis intervention models * The SCC's need to manage organisational change and loss; and * The SCC's role within the Victim Empowerment Programme. / Psychology / M.A. (Psychology)

A descriptive survey to identify factors influencing relapse of psychiatric outpatients in the rural communities of the Eastern Cape was undertaken. A questionnaire was used to collect data from family caregivers who were relatives of psychiatric patients receiving their monthly medications from two rural clinics. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 17. A total number of 92 family caregivers participated. Respondents reported side effects of psychotropic drugs, poor family role, poor referral system, lack of home visits, non-compliance and stigmatization as major factors contributing to relapse of psychiatric outpatients. Active involvement of caregivers in follow up care of their relatives is effective in fostering collaboration between the psychiatric hospitals and patients with the common goal of relapse avoidance. It is recommended that adequate provision of resources in conjunction with health education is effective in enhancing collaboration towards prevention of relapse in psychiatric patients. This would promote team work among patients, caregivers and health care providers. / Public Health / M.A. (Public Health)