Doctoral Degrees (Psychology)

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Browsing Doctoral Degrees (Psychology) by Author "Braathen, Stine Hellum"

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    'No one bothers about the confused people': Care for people with psychosocial disabilities in rural South Africa
    (Stellenbosch : Stellenbosch University, 2016-12) Braathen, Stine Hellum; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: This dissertation explores care for people with psychosocial disabilities in a rural area in the Eastern Cape province of South Africa. In Low and middle-income countries, including South Africa, the gap between the need for mental health services and available services is critical. Reasons for this have been said to be lack of priority at policy level, lack of equipment, personnel, and medication, and low mental health literacy. As a result, the majority of people with psychosocial disabilities are not diagnosed or treated. In order to close the gap between need and provision, there is a call for more community based mental health services, for task-shifting and a move towards recognising medical pluralism. There is lack of evidence on family and community care, traditional systems of healing and medical pluralism. Care is often reduced to health care, but arguably also includes assistance with daily tasks, companionship, conversation and intimacy. Explanatory models for psychosocial disability are crucial in care seeking, diagnosis, treatment and cure. As such, the theoretical points of departure for this dissertation are the concepts of psychosocial disability and care. The aim of this study was to explore practices, views, knowledge and experiences related to care for people with psychosocial disabilities living in a rural, South African context. To do this, a qualitative methodology was deemed suitable. The study is divided into two linked, but methodologically different parts, namely a contextual part and a case study part. The overarching methodological principles are the same; they are both anchored within a qualitative, explorative research design. The dissertation has found that in the context of psychosocial disability in Madwaleni, care is much broader than health care, and about much more than curing illness or looking after someone who is ill or dependent. In an attempt to improve mental health, and prevent, treat and cure mental disorder, it is essential to apply a broad definition of care. We need to rethink how we deliver mental health services, moving away from care as pacifying, to care as activating. Care must be integrated into real-world settings. The global mental health literature emphasises shifting the focus of mental health care from cure to promotion and prevention. It also stresses the value of using an interdisciplinary team of lay and trained health workers from the professional, folk and popular sectors. This strategy needs to be complemented by other strategies, for example, integrating mental health into other projects focussing on sustainable livelihoods and development of infrastructure. The challenges are complex, as this small study shows, but it is only by looking closely at local conditions that it is possible to develop culturally and contextually appropriate interventions and make optimal use of local resources.