Browsing by Author "Voges, Tawni Kim"
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- ItemExploratory study of stigma as a potential barrier to accessing care for children with Attention-Deficit/Hyperactivity Disorder(Stellenbosch : Stellenbosch University, 2021-12) Voges, Tawni Kim; Schoeman, Renata; Van Wyk, Sherine Bronvin; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.ENGLISH ABSTRACT: Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex psychiatric disorder which affects approximately 5% of children worldwide. When left untreated, ADHD is linked to negative intrapersonal, interpersonal, and academic outcomes. In South Africa, while mental health services do exist in the community, many children with ADHD do not receive any treatment. Misperceptions regarding ADHD may cause children and their families to experience stigma due to their diagnosis, which may discourage families from seeking treatment. This study sought to address the knowledge gap which exists around stigma and ADHD in South Africa and explore the ways in which this affects help-seeking behaviour. A mixed-method study was conducted consisting of three self-administered questionnaires and a semi-structured interview. Twenty-six parents of children screened by Goldilocks and The Bear Foundation (#gb4adhd) and 19 educators from schools where #gb4adhd has rendered services completed i) a demographic questionnaire, ii) The Knowledge of Attention Deficit Disorders Scale (KADDS) and iii) The Barriers of Access to Care Evaluation (BACE-3). Of these, 12 parents and six teachers participated in a semi-structured follow up interview. Parents and educators showed poor knowledge of ADHD, scoring 37% of items regarding overall knowledge of ADHD correctly. Educators scored significantly higher than parents on all domains including knowledge of symptoms and diagnosis (64.30% vs 45.30%), treatment (48.70% vs 35.20%), associated features (43.20% vs 23.80%) and overall knowledge of ADHD (48.60% vs 28.40%). The most frequently reported barriers to accessing treatment were the financial cost involved, wanting to solve their/their children’s difficulties themselves, concerns about the available treatment and worries about seeming weak for accessing treatment. Instrumental barriers were found to be more significant than stigma-related barriers. Participants described stigma as the recognition of difference and being labelled which leads to bullying, exclusion and being overlooked. Children with ADHD experienced lowered self-esteem and isolation. Families of children with ADHD expressed changing their day-to-to routine in order to avoid stigmatizing reactions from the community and increased emotional hardship. Financial barriers, lack of help, difficulties knowing where to access help, and lack of education about ADHD were highlighted as significant barriers to accessing treatment. Parents expressed a need for increased awareness and empathy in the community, and for ADHD to be normalised. Suggested methods for addressing the stigma included increasing awareness and education through using mass-media, role models and public health initiatives, and was thought to be the collective responsibility of government, educators, and parents. Findings from this study indicate that stigma does play a role in the under-utilisation of treatment but does not account for all reasons that children do not receive help. Other additional factors such as financial constraints, poor awareness and lack of parental support pose significant barriers. Stigma could be viewed less as a barrier to treatment, and more as a barrier to overall wellbeing due to its extensive impact on the child and family’s lives. Recommendations for multi-stakeholder collaboration to identify effective culturally and contextually relevant initiatives to decrease stigma, increase awareness and enhance service provision are proposed to decrease barriers to accessing treatment.