M.A. / The line between the postmodernism and modernism is largely unbridgeable. The line between left and right sides is also division. Sometimes there is a narrow and rapid point of crossing, and then it is gone. Modernism and post modernism are only alike in their sharing of a common semantic. The line is a division in thinking. Both sides are isolated by the lack of a significant bridge. The line also signifies that there can either be one or the other way of thinking, the two cannot exist on the same page - but they do. And they do it in life, too. Psychology has, by it's very attempts to prove itself a science, isolated the individuals uniqueness and connection with other humanity, by inadvertently developing a therapeutic stance of separateness and isolation. What makes this doubly sad is that psychology has rationalised that this is not the case. The right side of the text speaks clearly of human input, and pro-active contact on a physical and caring level, and the residents grow. The left hints at what might be the case, because it is, after all, only a theory. The research conducted looks good, but may not be correct... No theory will put itself on the line. The right side is on the line every second of every day. Lives are being built here. By sitting and reflecting at a person, in a 'therapeutic environment', the person is immediately isolated from any human social interaction or input. By studying the individual and his behaviour with a view to dissect cause, effect and totality have become victims. The person of needs be must become 'abnormal'. He becomes different, an anomaly. Then both himself and the community scream for an end to stigmatization. This text is a metaphor for the conflict experienced between being humans and psychology. There are many other ways to view this text.

published_or_final_version / Medicine / Master / Doctor of Medicine

The individualization and medicalization of the emotional distress of those given psychiatric diagnoses deny the social, political, and economic context in which the presenting behaviours arose and leads away from making changes to society. Some people who are psychiatrically labelled join in groups for solidarity in the face of being stigmatized. In these groups the members can resist the disempowerment and helplessness learned in the psychiatric system. With co-researchers from a self-help group this study gives expression to the usually silenced voices of psychiatrized people. Feminist and standpoint theories, co-cultural and living systems theories form a framework for this narrative study. A structural narrative method is used to analyze the stories, found in the transcripts of six individual interviews, told by the co-researchers about their experiences in psychiatric services and in the recovery process. The stories reveal how the ideology and practices of psychiatry use stigma, oppression and the creation of the identity of psychiatric patient for control and management. The stories also reveal the reality of hope for recovery through the support of peers and from the role models of those who have significantly recovered their mental health. Two focus group interviews were conducted with members of the self-help group where suggestions for programs were developed to address issues raised within the groups and in the individual interviews. The findings of the research will be reported to the self-help group who will use the study to back proposals for the funding of recovery-oriented programs. When social workers and other mental health professsionals recognize the importance of supporting the process of recovery, consumer/survivor-run programs will be acknowledged as effective and integral parts of any mental health system

M.Cur. (Psychiatric Nursing) / The purpose of this study was to explore the experiential world of the chronic psychiatric patient In a rehabilitation centro and to sot guidelines for the psychiatric nurso to utilize the principles of restoration of merital health. Various stumbling blocks In the recovery process of chronic psychiatric patients were noticed in a rehabilitation centre. The centre Is highly structured and democratic decision making does not always transpire. The external environment Is In a residential area characterised by violence. The question arising, was to what degree the chronic psychiatric patient's experience of his/herworld In the rehabilitation centre, can contribute towards the mobilization of resources In order to facilitate the restoration of mental health of the chronic psychiatric patient and reintegration Into society. The approach followed, was that of the Nursing Whole Person Theory. With this theory as basis, the chronic psychiatric patient Is viewed as a whole In Interaction with his/her Internaland external environment In his/her questfor mental health as Integral part of wholeness. An exploratory and descriptive qualitative study, contextual of nature, was used as research design. The method for research was phenomenological, semi· structured interviews with chronic psychiatric patients In a rehabilitation centre. The participants In this study were selected In a purposive and non-selective manner. Botes' Model for Nursing Research was used to structure the research of this study. Measures used for reliability and validity, were that of Woods and Catanzaro. The central question "How do you experience living In this rehabilitation centre?" was asked. Similar studies were Investigated In order to ascertain similarities and unique aspects of this study. Categories of experience within the unit of assessment and diagnosis from the Nursing for the Whole Person Theory, Indicated both stumbling blocks and facilitating elements. Stumbling blocks In chronic psychiatric patients' (In a rehabilitation centre) quest for wholeness were experiences of avoidance, frustration, anxiety, lack of motivation, Inability to maintain longstanding relationships and dispute.

The individualization and medicalization of the emotional distress of those given psychiatric diagnoses deny the social, political, and economic context in which the presenting behaviours arose and leads away from making changes to society. Some people who are psychiatrically labelled join in groups for solidarity in the face of being stigmatized. In these groups the members can resist the disempowerment and helplessness learned in the psychiatric system. With co-researchers from a self-help group this study gives expression to the usually silenced voices of psychiatrized people. Feminist and standpoint theories, co-cultural and living systems theories form a framework for this narrative study. A structural narrative method is used to analyze the stories, found in the transcripts of six individual interviews, told by the co-researchers about their experiences in psychiatric services and in the recovery process. The stories reveal how the ideology and practices of psychiatry use stigma, oppression and the creation of the identity of psychiatric patient for control and management. The stories also reveal the reality of hope for recovery through the support of peers and from the role models of those who have significantly recovered their mental health. Two focus group interviews were conducted with members of the self-help group where suggestions for programs were developed to address issues raised within the groups and in the individual interviews. The findings of the research will be reported to the self-help group who will use the study to back proposals for the funding of recovery-oriented programs. When social workers and other mental health professsionals recognize the importance of supporting the process of recovery, consumer/survivor-run programs will be acknowledged as effective and integral parts of any mental health system / Arts, Faculty of / Social Work, School of / Graduate

D.Litt. et Phil. / The mentally ill population is one of the most neglected subpopulations of the Western World and this is most certainly the case in Southern Africa. With the restructuring of the mental health system, the process of discharging properly rehabilitated individuals from long term hospital stays into a strong community mental health support structure has become a priority. In order to embark on a process driven by an ethos of primary health care, the present inpatients in custodial settings need to be discharged into the open community. This process is termed deinstitutionalisation, and involves the discharge of all able patients from chronic or long-term custodial care institutions, into the open community as functional members, with all of the rights and freedom which this may imply. Deinstitutionalisation as a concept embraces the essence of human rights, as the person takes control of his/ her life circumstances with all of the accompanying responsibilities. Present deinstitutionalisation practice in traditional South African long-term care facilities has no rehabilitation/ recovery focus with which to drive the discharge process of patients. Barriers to the success of the process are the lack of rehabilitation services, poor discharge planning and process, and lack of follow-up and integration of community services. These would seem to be the biggest stumbling blocks to the success of a deinstitutionalisation initiative. The initial process of design and implementation of a viable programme, and one that addresses uniquely South African issues was challenging. This was because of the lack of information, and reliable reporting systems with which to identify availability and need of service, client subpopulations, and service provision agencies. A preexisting NGO system was described and assessed for service provision and success rates, and the same system was used to measure the availability and applicability of psychosocial rehabilitation service in South Africa. The process comprised describing a the necessary components required by a recovery-driven, psychosocial rehabilitation system, using international literature as well as the early findings and results of the changed system. Suggestions have been made in terms of necessary facilities and services required, as well as staff competencies and methods of addressing historic issues of anti trust which have developed because of apartheid mental health practice.

published_or_final_version / Social Work / Master / Master of Social Sciences

The purpose of this study was to develop a medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe. The study used the grounded theory approach utilising a mixed sequential dominant status design. Purposive sampling of key stakeholders was the primary method and theoretical sampling became necessary as the study evolved in the qualitative phase. A confirmatory retrospective document review of 119 files of patients was done in the quantitative phase. Pierre Bourdieu’s conceptual canon of field, habitus and capital was utilised as the theoretical point of departure for the study. Findings and results showed dislocation and dissonance between and within the habitus of social fields the judiciary, health (medical) and the prison systems with an ensuing hysteretic effect that negatively affected the outcome of forensic psychiatric rehabilitation in special institutions in Zimbabwe. Forensic psychiatric patients were caught up in a double bind situation of aligning to both of the contradictory functions of the medical and the prison systems. The result of this hysteretic scenario seemed to breed some kind of rehabilitative schizophrenia. The developed medico-judicial framework is projected to transform the libido dominandi of the present into a widened scope of therapeutic jurisprudence. The medico-judicial framework is forwarding the forensic psychiatric practitioner to a new address since it has changed its residence from the special institution to the forensic psychiatric hospital. It is inviting the person involved with forensic psychiatric rehabilitation to begin again, inciting him or her to be open to the possibilities of mapping a path through the tangled growth of current realities into an increased width and depth of comprehensive forensic psychiatric practice that follows an empowering legislative prescript / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of this study was to develop a medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe. The study used the grounded theory approach utilising a mixed sequential dominant status design. Purposive sampling of key stakeholders was the primary method and theoretical sampling became necessary as the study evolved in the qualitative phase. A confirmatory retrospective document review of 119 files of patients was done in the quantitative phase. Pierre Bourdieu’s conceptual canon of field, habitus and capital was utilised as the theoretical point of departure for the study. Findings and results showed dislocation and dissonance between and within the habitus of social fields the judiciary, health (medical) and the prison systems with an ensuing hysteretic effect that negatively affected the outcome of forensic psychiatric rehabilitation in special institutions in Zimbabwe. Forensic psychiatric patients were caught up in a double bind situation of aligning to both of the contradictory functions of the medical and the prison systems. The result of this hysteretic scenario seemed to breed some kind of rehabilitative schizophrenia. The developed medico-judicial framework is projected to transform the libido dominandi of the present into a widened scope of therapeutic jurisprudence. The medico-judicial framework is forwarding the forensic psychiatric practitioner to a new address since it has changed its residence from the special institution to the forensic psychiatric hospital. It is inviting the person involved with forensic psychiatric rehabilitation to begin again, inciting him or her to be open to the possibilities of mapping a path through the tangled growth of current realities into an increased width and depth of comprehensive forensic psychiatric practice that follows an empowering legislative prescript / Health Studies / D. Litt. et Phil. (Health Studies)