Some families in the Free State Province, specifically in Thabo-Mofutsanyana district, are families living with mentally ill family members. The families accompany the mentally ill family members to designated clinics which offer primary, secondary and tertiary mental health services, and all these levels of care provide care, treatment and rehabilitation of mentally ill persons (SA, 2002:2). Despite the care that these families give to their mentally ill family members, it seemed that they find it difficult to cope living with a mentally ill family member. This is supported by Zergaw, Hailemariam, Alem and Kebed (2008:191) who indicate the economic impact, disruption of daily life, work and family relationships experienced by families living with a mentally ill family member. This was also evident in a study by Du Plessis, Greeff and Koen (2004:4), that, because of a lack of a formal support system for families living with mentally ill family members, and lack of necessary skills to take on the responsibility of caring for mentally ill relatives, mentally ill family members relapse and are readmitted in the mental health care institutions. Adding to this, in most of the families living with mentally ill family members in the Thabo-Mofutsanyana district, it is not known how they cope and are supported. Once there is a clear understanding of how families experience living with mentally ill family members, health care practitioners can give better support to families living with mentally ill family members. The research objective of this study was to explore and describe the experiences of families living with a mentally ill family member in the Thabo-Mofutsanyana district, to explore and describe the strengths of families living with a mentally ill family member, and to formulate guidelines to support families living with mentally ill family members. A qualitative, phenomenological design was used which enabled the researcher to understand the way in which the families experience living with a mentally ill family member. The population studied in this research consisted of families living with mentally ill family members in the Thabo-Mofutsanyana district in South Africa. The purposive sampling was used to select participants with the assistance of a mediator. Permission to conduct research was negotiated with the district manager. Voluntary and informed consent in writing was obtained from all the participants. The sample size was determined by data saturation, which was reached after 14 interviews. Data analysis was carried out simultaneously with data collection. In consensus discussions, the researcher and the co-coder reached consensus on the main and sub themes. From the research findings, five main themes were identified. The first two themes are the positive and negative experiences of living with a mentally ill family member. The third theme is the concerns of family in staying with a mentally ill family member. The fourth theme is the strengths in coping with a mentally ill family member. The last theme is ways in which family members as families wanted to be supported. It could be concluded that the experience of families living with mentally ill family members in Thabo-Mofutsanyana district need to be supported. In order to address this support holistically and to enhance quality of life and to lessen the burden the families experience in living with a mentally ill family member, the support should firstly be addressed individually and then as a family. Following that, the collective support can be addressed by a support network system through involvement of the department of health, clinics, rehabilitation centres, community, mental health care workers, giving of medication and establishment support of groups of families living with mental health care users. From these findings the researcher proposed guidelines to support families living with mentally ill family members, and to increase knowledge in these families on how to handle a mentally ill family member. The researcher also compiled recommendations for nursing practice, nursing education and nursing research in families living with mental health care users. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Some families in the Free State Province, specifically in Thabo-Mofutsanyana district, are families living with mentally ill family members. The families accompany the mentally ill family members to designated clinics which offer primary, secondary and tertiary mental health services, and all these levels of care provide care, treatment and rehabilitation of mentally ill persons (SA, 2002:2). Despite the care that these families give to their mentally ill family members, it seemed that they find it difficult to cope living with a mentally ill family member. This is supported by Zergaw, Hailemariam, Alem and Kebed (2008:191) who indicate the economic impact, disruption of daily life, work and family relationships experienced by families living with a mentally ill family member. This was also evident in a study by Du Plessis, Greeff and Koen (2004:4), that, because of a lack of a formal support system for families living with mentally ill family members, and lack of necessary skills to take on the responsibility of caring for mentally ill relatives, mentally ill family members relapse and are readmitted in the mental health care institutions. Adding to this, in most of the families living with mentally ill family members in the Thabo-Mofutsanyana district, it is not known how they cope and are supported. Once there is a clear understanding of how families experience living with mentally ill family members, health care practitioners can give better support to families living with mentally ill family members. The research objective of this study was to explore and describe the experiences of families living with a mentally ill family member in the Thabo-Mofutsanyana district, to explore and describe the strengths of families living with a mentally ill family member, and to formulate guidelines to support families living with mentally ill family members. A qualitative, phenomenological design was used which enabled the researcher to understand the way in which the families experience living with a mentally ill family member. The population studied in this research consisted of families living with mentally ill family members in the Thabo-Mofutsanyana district in South Africa. The purposive sampling was used to select participants with the assistance of a mediator. Permission to conduct research was negotiated with the district manager. Voluntary and informed consent in writing was obtained from all the participants. The sample size was determined by data saturation, which was reached after 14 interviews. Data analysis was carried out simultaneously with data collection. In consensus discussions, the researcher and the co-coder reached consensus on the main and sub themes. From the research findings, five main themes were identified. The first two themes are the positive and negative experiences of living with a mentally ill family member. The third theme is the concerns of family in staying with a mentally ill family member. The fourth theme is the strengths in coping with a mentally ill family member. The last theme is ways in which family members as families wanted to be supported. It could be concluded that the experience of families living with mentally ill family members in Thabo-Mofutsanyana district need to be supported. In order to address this support holistically and to enhance quality of life and to lessen the burden the families experience in living with a mentally ill family member, the support should firstly be addressed individually and then as a family. Following that, the collective support can be addressed by a support network system through involvement of the department of health, clinics, rehabilitation centres, community, mental health care workers, giving of medication and establishment support of groups of families living with mental health care users. From these findings the researcher proposed guidelines to support families living with mentally ill family members, and to increase knowledge in these families on how to handle a mentally ill family member. The researcher also compiled recommendations for nursing practice, nursing education and nursing research in families living with mental health care users. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Studies have indicated that relapse is noted as a major problem facing mental health services both nationally and internationally whereby family members caring for mental health care users experience a serious burden. Factors commonly associated with relapse include poor adherence to treatment, substance abuse, co-morbid psychiatric illness, a co-morbid medical and or surgical condition, stressful life events and the treatment setting. Relapse prevention strategies have been identified and they include, empowering people with mental illness to recognize early warning signs of relapse in order to develop appropriate response plans as well as communication and understanding between the mentally ill person, their family, and specialist mental health system and community support services. The researcher was prompted by the problem of relapse faced by mental health services to explore and describe the strengths of families in assisting mental health care users to limit relapse and to formulate guidelines for psychiatric nurses to empower family members caring for mental health care users to limit relapse. A phenomenological design was used in this study and a purposive sampling technique was used to select participants who met the selection criteria. In-depth individual interviews were conducted with 15 family members. All interviews were recorded with an audio recorder after participants gave consent. Data saturation was achieved after 13 participants were interviewed and further two interviews confirmed data saturation. Field notes were written immediately after each interview. Data analysis was done according to Tesch as quoted by Creswell (2007:187) and the researcher and co-analyzer reached consensus on the themes in a meeting. The findings of research resulted in four main categories namely, accepting the condition of a mentally ill family member, having faith in God, involving a mentally ill family member in daily activities and being aware of what aggravates the mentally ill family member. The conclusion that can be made is that “acceptance through education” assisted family members in developing a positive attitude and acceptance of their feelings as well as the condition of their mentally ill family members. A strong spiritual base provides family members with strength and hope in times of adversity and teaches them how to have healthy relationships within the family unit and with others. It is also evident that sharing activities, as the things that all members of the family do together, reinforce and strengthen their togetherness and that if family members can be aware of what aggravates mentally ill family members by communicating well with them, that can bring harmony in families and ultimately limit relapse. Recommendations in this research are made for nursing education, nursing research and psychiatric nursing practice with guidelines for psychiatric nurses to empower families caring for mentally ill family members to use their strengths and contribute to limiting relapse. / MCur, North-West University, Potchefstroom Campus, 2014

Studies have indicated that relapse is noted as a major problem facing mental health services both nationally and internationally whereby family members caring for mental health care users experience a serious burden. Factors commonly associated with relapse include poor adherence to treatment, substance abuse, co-morbid psychiatric illness, a co-morbid medical and or surgical condition, stressful life events and the treatment setting. Relapse prevention strategies have been identified and they include, empowering people with mental illness to recognize early warning signs of relapse in order to develop appropriate response plans as well as communication and understanding between the mentally ill person, their family, and specialist mental health system and community support services. The researcher was prompted by the problem of relapse faced by mental health services to explore and describe the strengths of families in assisting mental health care users to limit relapse and to formulate guidelines for psychiatric nurses to empower family members caring for mental health care users to limit relapse. A phenomenological design was used in this study and a purposive sampling technique was used to select participants who met the selection criteria. In-depth individual interviews were conducted with 15 family members. All interviews were recorded with an audio recorder after participants gave consent. Data saturation was achieved after 13 participants were interviewed and further two interviews confirmed data saturation. Field notes were written immediately after each interview. Data analysis was done according to Tesch as quoted by Creswell (2007:187) and the researcher and co-analyzer reached consensus on the themes in a meeting. The findings of research resulted in four main categories namely, accepting the condition of a mentally ill family member, having faith in God, involving a mentally ill family member in daily activities and being aware of what aggravates the mentally ill family member. The conclusion that can be made is that “acceptance through education” assisted family members in developing a positive attitude and acceptance of their feelings as well as the condition of their mentally ill family members. A strong spiritual base provides family members with strength and hope in times of adversity and teaches them how to have healthy relationships within the family unit and with others. It is also evident that sharing activities, as the things that all members of the family do together, reinforce and strengthen their togetherness and that if family members can be aware of what aggravates mentally ill family members by communicating well with them, that can bring harmony in families and ultimately limit relapse. Recommendations in this research are made for nursing education, nursing research and psychiatric nursing practice with guidelines for psychiatric nurses to empower families caring for mentally ill family members to use their strengths and contribute to limiting relapse. / MCur, North-West University, Potchefstroom Campus, 2014