Experiences of reintegration and homelessness among mental health care users who have been treated and discharged from the Accra Psychiatric Hospital – A qualitative study

Date
2020-12
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Reducing homelessness and challenges associated with social reintegration among MHCUs is of core interest to health care providers. However, it appears attempts at reducing homelessness while socially integrating MHCUs have been fraught with more complications than anticipated. Aims and objectives therefore were to (1) explore perceptions and experiences of MHCUs‘ homelessness after they have been treated and discharged from the Accra Psychiatric Hospital in Ghana; (2) gain an understanding of the challenges of reintegration of MHCUs back into their families and societies after discharge from mental hospitals; and (3) explore issues, which may support or be a barrier to reintegration including family factors (support, resources), mental health history and beliefs around illness, and access to mental health services. Using a descriptive qualitative method, 15 MHCUs were purposively sampled and interviewed from the Accra Psychiatric hospital. This included 7 males and 8 females within the ages of 21 and 69 (mean age of 46.6 years). From framework analysis four (4) major themes and twelve (12) sub-themes were identified as the experiences of homelessness among MHCUs who have been treated and discharged from the Greater Accra Psychiatric hospital. With the first major theme – Individual factors – issues affecting homelessness and reintegration such as the issue sense of worth/belongingness, and concerns for health/wellbeing after discharge were found. The second major theme – family factors – also revealed factors such as the lack of will or readiness of family, marginalization from family, issue of stigma and financial constraints as affecting homelessness and reintegration. The third theme was community factors where subthemes - general misconceptions about mental illness and stigma with marginalization were found. Finally, the fourth major theme - institutional factors – with subthemes - poor admission and discharge procedures, lack of proximal mental health facility/service and material benefits from the psychiatric hospital was found. These findings support most literature reviewed for the study and is well explained by the Afrocentric Worldview. Implications are thoroughly discussed. Key words: homelessness, social reintegration, barriers and facilitators
AFRIKAANSE OPSOMMING: Die vermindering van haweloosheid en die uitdagings wat verband hou met sosiale herintegrasie onder geestesgesondheidsorggebruikers is van kardinale belang vir gesondheidsorgverskaffers. Dit blyk egter asof pogings om haweloosheid te verminder, gepaard met die sosiale integrasie van geestesgesondheidsorggebruikers, belemmer word deur verskeie komplikasies. Doelwitte en doelstellings was dus om (1) die persepsies en ervarings van geestesgesondheidsorggebruikers se haweloosheid te verken nadat hulle behandel en ontslaan is van die Akkra-psigiatriese hospitaal in Ghana; (2) die uitdagings van die herintegrasie van GGSGs in hul gesinne en samelewing te verstaan na ontslaning van geesteshospitale; en (3) kwessies te ondersoek wat herintegrasie ondersteun of versper, insluitende gesinsfaktore (ondersteuning, hulpbronne), geestesgesondheidsgeskiedenis en oortuigings rondom siekte en toegang tot geestesgesondheidsdienste. Deur gebruik te maak van 'n beskrywende kwalitatiewe metode, is 15 GGSGs van die Akkra-psigiatriese hospitaal doelbewus gesteekproef en onderhoude mee gevoer. Dit sluit in 'n algehele gebruik van 7 mans en 8 vroue tussen die ouderdom van 21 en 69 (gemiddelde ouderdom van 46,6 jaar). Vanuit raamwerkanalise is vier/ (4) hoof temas en twaalf (12) subtemas geïdentifiseer as die ervarings van haweloosheid onder GGSGs wat behandel en ontslaan is van die Akkra-psigiatriese hospitaal. Met die eerste hoof tema – individuele faktore – is kwessies wat haweloosheid en herintegrasie beïnvloed gevoel van waardigheid/behorenheid, en bekommernisse vir gesondheid/welsyn na ontslaning, gevind. Die tweede hoof tema - familiefaktore - het ook faktore soos die gebrek aan wil of bereidwilligheid van die gesin, marginalisering van die gesin, kwessie van stigma en finansiële beperkinge wat dakloosheid en herintegrasie beïnvloed, onthul. Die derde tema was gemeenskapsfaktore met subtemas – algemene wanoortuigings oor geestesongesteldheid en soos stigma met marginalisering. Ten slotte is die vierde hoof tema – institusionele faktore – met subtemas – swak toelatings- en ontslaningsprosedures, 'n gebrek aan proksimale geestelike gesondheidsfasiliteit/diens en wesenlike voordele van die psigiatriese hospitaal, bevind. Hierdie bevindinge ondersteun die meerderheid van die literatuur wat vir hierdie studie hersien was en word goed verklaar deur die Afrosentriese Wêreldsiening en Gesondheidsoortuigingsmodel. Implikasies word deeglik bespreek. Sleutelwoorde: haweloosheid, sosiale herintegraie, verperrings and fasiliteerders
Description
Thesis (MA)--Stellenbosch University, 2020.
Keywords
Homelessness -- Mental health services, Mental health services -- Ghana, Mentally ill homeless persons, Mentally ill -- Family relationships, Mentally ill -- Social reintegration -- Ghana, UCTD
Citation