Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: South Africa has transformed its mental health service provision from in-hospital care to community-based rehabilitation. Although the idea is sound, the process places the caregiving families under an immense pressure. The aim of this study was to explore the impact that the de-institutionalisation process has had on the families as they care for their child with intellectual disability. The study was conducted by means of qualitative, unstructured interviews with families that have had a child de-institutionalised from Alexandra Hospital in the Western Cape. All of the patients were diagnosed with a dual diagnosis of intellectual disability and mental illness. Even though the patients were in group-homes or attended a day care centre, final responsibility for the patients lay with the parents. Three main themes emerged from the interviews that describe the impact of deinstitutionalisation, viz. the characteristics of the family member with intellectual disability (aggressive, abusive and self-destructive behaviour of the patient), the effect that these characteristics had on the family (marital stress and health risks to the care giver), and community and resource factors. The study placed the family central to its environment and discussed the impact deinstitutionalisation had on its environment as a whole. It was concluded that the burden that de-institutionalisation places on the families far exceeded their ability to cope with these circumstances. This status quo could be improved if adequate resources and skills are given to families prior to de-institutional / AFRIKAANSE OPSOMMING: In Suid-Afrika is geestesgesondheidsorg van hospitaliserende na gemeenskapsgebaseerde rehabilitasie, omskep. Terwyl hierdie stap wel as lewensvatbaar mag voorkom, plaas die proses ‘n hewige las op die sorggewende gesin. Die doel van hierdie studie was om die omvang van die impak hiervan op ‘n gesin met ’n lid met intellektuele gestremdheid en psiegiatriese siekte, te bepaal – nadat so ‘n pasient uit die inrigting ontslaan is. Die ondersoek is uitgevoer by wyse van kwalitatiewe, ongestruktureerde onderhoude met gesinne wie se lede met die diagnose uitgeplaas is deur die Alexandra Hospitaal in die Wes-Kaap. Elkeen van die pasïente is gediagnoseer met ernstige intellektuele gestremdheid, asook bykomende gedragsafwykings. Ten spyte van die feit dat die betrokke pasïente deur groepshuise of dagsorg eenhede versorg word, bly hulle hul ouers se verantwoordelikheid. Drie temas het ontstaan wat die impak van ontslag uit die inrigting omskryf, te wete die karaktertrekke van die gestremde gesinslid (aggressie, misbruikende en vernielsugtige gedrag van die pasïent), die effek van hierdie karaktertrekke op die gesin (stres op die huwelik en potensiële gesondheidsrisiko wat dit vir die versorger inhou), en die gemeenskap en ondersteunende faktore. Tydens die ondersoek is die gesin sentraal geplaas ten opsigte van die omgewing. Die impak van ontslag van die gediagnoseerde pasïent uit die inrigting op die omgewing as geheel, word bespreek. Daar is tot die slotsom gekom dat die vermoë van die gesin wat die las moet dra as gevolg van die ontslag, ver oorspan word. Hierdie toedrag van sake sou egter verlig kon word indien toereikende hulpbronne en vaardighede aan sulke gesinne beskikbaar gestel word alvorens so ‘n pasïent ontslaan is.

The system of care for persons suffering from mental retardation is in a state of upheaval. Considering the mentally handicapped as holistic beings, this study explored and assessed the needs of those residing in the community of District 22 (sub-district 222), KwaZulu-Natal, thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on Maslow's hierarchy of needs theory was carried out, using 167 respondents. The study revealed that despite being mentally retarded, they were still regarded as valuable members of the community, their needs did not differ from the needs of others in the rest of the world and that mental retardation is still rated low in the prioritization of health problems, hence the lack of resources and support needed for the rehabilitation of such persons. / Health Studies / M.A. (Health Studies)

The system of care for persons suffering from mental retardation is in a state of upheaval. Considering the mentally handicapped as holistic beings, this study explored and assessed the needs of those residing in the community of District 22 (sub-district 222), KwaZulu-Natal, thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on Maslow's hierarchy of needs theory was carried out, using 167 respondents. The study revealed that despite being mentally retarded, they were still regarded as valuable members of the community, their needs did not differ from the needs of others in the rest of the world and that mental retardation is still rated low in the prioritization of health problems, hence the lack of resources and support needed for the rehabilitation of such persons. / Health Studies / M.A. (Health Studies)

High prevalence of mental illness in South African and limited Mental Health Care (MHC) resources call for ways to supplement the overburdened system to meet the rehabilitative and supportive needs of service users as stipulated in the MHC Act no. 17 of 2002. Various psychological, social, and financial difficulties plaguing MHC users require holistic treatment intervention to help them cope with their conditions. This study explored the meaning of a Tshwane District community-based support group for MHC out-patients to help illuminate the value the group had for the members. A Social Constructionist epistemology informed the qualitative research approach. Data were collected by conducting semi-structured interviews and employing a collage-making method. The main themes illuminated by thematic analysis suggest that the group provided the members with a sense of belonging, mental and physical mobilisation and stimulation, a source of support, multiple learning experiences, and contributed to personal transformation and growth. / Psychology / M.A. (Social Science (Research Consultation))

High prevalence of mental illness in South African and limited Mental Health Care (MHC) resources call for ways to supplement the overburdened system to meet the rehabilitative and supportive needs of service users as stipulated in the MHC Act no. 17 of 2002. Various psychological, social, and financial difficulties plaguing MHC users require holistic treatment intervention to help them cope with their conditions. This study explored the meaning of a Tshwane District community-based support group for MHC out-patients to help illuminate the value the group had for the members. A Social Constructionist epistemology informed the qualitative research approach. Data were collected by conducting semi-structured interviews and employing a collage-making method. The main themes illuminated by thematic analysis suggest that the group provided the members with a sense of belonging, mental and physical mobilisation and stimulation, a source of support, multiple learning experiences, and contributed to personal transformation and growth. / Psychology / M.A. (S.S. (Research Consultation))

The purpose of this study was to investigate the possibility of implementing community based care for moderately mentally retarded persons in a specific centre in the Port Elizabeth area. The objectives of the study were to identify • the needs of the moderately mentally retarded children. • the physical, psychosocial and vocational rehabilitation means of meeting these needs. • how involved the communities, parents and government were in the care of moderately mentally retarded children. A quantitative, exploratmy and descriptive design was used. A sample of 50 moderately mentally retarded children was utilised. Data were collected by means of questionnaires and semi-structured interviews. The major research findings indicate that community care for MMRPs could only be feasible with sufficient resources, expertise and community involvement. All these aspects appeared to be lacking in the centre where this research was conducted raising questions as to benefits which the mentally retarded children and their parents and the community could derive from these services. However recommendations were made on identified shortcomings, problems and needs. / Health Science / M.A.(Nursing Science)

The purpose of this study was to investigate the possibility of implementing community based care for moderately mentally retarded persons in a specific centre in the Port Elizabeth area. The objectives of the study were to identify • the needs of the moderately mentally retarded children. • the physical, psychosocial and vocational rehabilitation means of meeting these needs. • how involved the communities, parents and government were in the care of moderately mentally retarded children. A quantitative, exploratmy and descriptive design was used. A sample of 50 moderately mentally retarded children was utilised. Data were collected by means of questionnaires and semi-structured interviews. The major research findings indicate that community care for MMRPs could only be feasible with sufficient resources, expertise and community involvement. All these aspects appeared to be lacking in the centre where this research was conducted raising questions as to benefits which the mentally retarded children and their parents and the community could derive from these services. However recommendations were made on identified shortcomings, problems and needs. / Health Science / M.A.(Nursing Science)