Stakeholders facilitating hope and empowerment amidst social suffering: A qualitative documentary analysis exploring lives of homeless women with mental illness

2021 ◽  
pp. 002076402110111
Author(s):  
Prama Bhattacharya ◽  
Kumar Ravi Priya
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Service Providers ◽  
Medical Model ◽  
Mental Health Research ◽  
Constructivist Grounded Theory ◽  
Social Suffering ◽  
Documentary Analysis ◽  
Homeless Mentally Ill

Background: Globally homeless mentally ill (HMI) individuals are considered one of the most vulnerable populations. An individual-centric, psychopathology-oriented focus of the existing mental health-care system limits the understanding of the HMI individuals through the disability lens overlooking their strengths and resilience that enable them to survive extremely hostile environments. Contemporary mental health research has embraced a paradigm shift that allows researchers to look beyond the predominant medical model to give precedence to a socio-culturally contexted and experientially firm understanding of human behaviour. Aim: Through the theoretical lens of social suffering, this article attempts to understand the lived experiences of the HMI women, the perspective of their caregivers and the standpoint of service providers in the context of homelessness and mental illness. Methodology: A documentary analysis as a qualitative research methodology has been used to reflect upon the concerns mentioned above. Following Figueroa’s approach to the analysis of audio-visual texts, the documentary Lapata Zindagi, directed by Radhika Lata Murthy, has woven the stories of four HMI women and their caregivers have been analysed. The two-phased analysis involved constructivist grounded theory procedures. Results: The methodological steps, rigour and the resulting categories (experience of social suffering associated with homelessness among HMI women, denial of care and rights within patriarchy, helplessness associated with the burden of caregiving and roles of NGO and community in building hope and empowerment) have been discussed through the lens of social suffering and how stakeholders might facilitate hope and empowerment amidst it. Conclusion: The article highlights the dire and urgent need to integrate mental health into primary health care and community-based intervention and move beyond clinical recovery to nurture ‘hope’ to enable recovery and empowerment for such marginalised populations.

“Hear me out”: Experiences of mothers suffering from severe mental illness with health care providers – A qualitative perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s899-s899 ◽  
Author(s):  
D. Banerjee ◽  
G. Desai ◽  
P.S. Chandra
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Seeking Help ◽  
Competing Interest

BackgroundContrary to popular myth, majority of mentally ill women are mothers with increasing number of them seeking help. Little is known about their own experiences in this regard and the extent to which their needs are met.ObjectivesTo assess the barriers and facilitators in seeking help from mental health care providers in matters of pregnancy and parenting.MethodsThe study used qualitative design with social constructivist paradigm. A purposive sample of 30 mothers with severe mental illness was obtained. Data was collected through one-to-one in-depth semi-structured interviews. After verbatim transcription, inductive thematic analysis was used to explore transcripts.ResultsMost women considered motherhood “central” to their lives and almost all of them experienced the burden of the “dual role”. Main barriers in seeking help were stigma, treatment side effects, wrong information and time constraints. Whereas self-advocacy, early engagement, education of women and involvement of the family with service providers were the facilitating factors. The prime expectations of the mothers as identified were early and direct communication, patient audience and basic guidance in regards to child health and parenting issues.ConclusionWomen who are mothers and also users of mental health services face special challenges in managing the contradictory aspects of their dual identity. Hearing their voices are essential for service provision and ensuring adequate mental health needs. Early and direct intervention along with understanding and addressing critical areas are necessary for proper care of both the mother and child.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attitudes toward Psychology, Psychiatry and Mental Illness in the Central Eastern Cape of South Africa

1996 ◽  
Vol 26 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Christopher R. Stones
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Service Providers ◽  
Psychiatric Treatment ◽  
First Year ◽  
Eastern Cape ◽  
Medical Practitioners ◽  
General Medical Practitioners

A survey of attitudes held by a large sample of university students as well as by smaller samples of psychologists, general medical practitioners, members of the public, psychiatric hospital staff and patients in the central eastern Cape toward mental illness and mental health-care service providers was conducted during the early part of 1994. It was found that marked differences existed between the different samples and that the extent of a person's knowledge about mental illness, as well as the degree of contact with mental-health professionals and their services, were important influences on the attitudes of respondents. In particular, third-year psychology students tended to be more negatively disposed to psychiatric treatment than those students in their first year of study. Conversely, the attitudes of final-year students toward the discipline of psychology were more positive than those held by students in their first year of studying psychology. Within both the student and the patient samples, only a small minority indicated that they would first seek help from general medical practitioners if they were ever to contemplate taking their own lives or if they were seriously mentally ill. Psychiatric patients and service providers indicated their confidence in psychiatric treatment and the psychiatrist was considered to be the most appropriate professional to deal with mental illness. Members of the general public were found to be more optimistic than psychologists about the efficacy of psychological and psychiatric treatment, but less so than general medical practitioners. Although mental health-care professionals were viewed in a favourable light, most respondents indicated that they would nevertheless prefer to approach a friend in times of psychological distress.

Deinstitutionalization and The Homeless Mentally Ill

2020 ◽  
Vol 3 (01) ◽  
pp. 1-3
Author(s):  
Sarada Menon ◽  
Jayakumar Menon ◽  
P. Poornachandrika
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Special Needs ◽  
Serious Mental Illness ◽  
Mentally Ill ◽  
Critical Evaluation ◽  
Homeless Mentally Ill ◽  
Public Body ◽  
Oxford Dictionary

According to the Oxford dictionary “Institution” is an important public body, a home providing care for people with special needs and ‘institutionalise’ is placing such persons in a residential institution. In the context of the topic being discussed, institution is a home for persons with special needs and similarly institutionalisation is placing the persons with serious mental illness, whether acute, subacute or chronic. Deinstitutionalisation is increasingly being projected as the most needed reform in the mental health care by many experts in our country, but the implications of this merit’s critical evaluation.

scholarly journals Deinstitutionalization and The Homeless Mentally Ill

2020 ◽  
Vol 3 (01) ◽  
pp. 1-3
Author(s):  
Sarada Menon1 ◽  
Jayakumar Menon ◽  
P. Poornachandrika
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Special Needs ◽  
Serious Mental Illness ◽  
Mentally Ill ◽  
Critical Evaluation ◽  
Homeless Mentally Ill ◽  
Public Body ◽  
Oxford Dictionary

According to the Oxford dictionary “Institution” is an important public body, a home providing care for people with special needs and ‘institutionalise’ is placing such persons in a residential institution. In the context of the topic being discussed, institution is a home for persons with special needs and similarly institutionalisation is placing the persons with serious mental illness, whether acute, subacute or chronic. Deinstitutionalisation is increasingly being projected as the most needed reform in the mental health care by many experts in our country, but the implications of this merit’s critical evaluation.

scholarly journals Ethical Implications of Mental Health Stigma: Primary Health Care Providers’ Perspectives

2019 ◽  
Vol 11 (12) ◽  
pp. 165 ◽  
Author(s):  
Sawsan Abuhammad ◽  
Heyam Dalky
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Research ◽  
Mental Health Stigma ◽  
Care Providers ◽  
Ethical Implications ◽  
Primary Health

Stigma towards mental illness is a widespread phenomenon not just in the developing world, but also in developed countries. Unfortunately, this stigma is not only restricted to the general population, but is also prevalent among professional health care providers. Research from developing countries is scarce. Thus, the aim of this paper was to explore health care providers’ attitudes toward mental illness stigma in the primary health care settings. The review sheds light on the ethical implications of mental health stigma as perceived by primary health care providers, and the proposed recommendations for responsible conduct of research and policy initiative in the context of mental health research. Utilizing CINAHL, Medline and Scopus electronic data bases, results are reported for the 41 studies that are grouped according to being from USA, Europe, Australia, Africa, and Asia and Arab World. The results from this review confirmed that stigma associated with mental illness have many ethical implications in the context of research including use of consent form, fair treatment, and good respect for individual rights concerning treatment choices. To counter stigma and prevent the ethical implications of such stigma, interventions in the form of awareness and training programs would be the best way to minimize and stop it. Further, govermnetal and political are needed to initiate a national code of ethics for mental health research in their respective coutries.

scholarly journals Pathways to mental health care in KwaZulu - Natal

Curationis ◽  
2004 ◽  
Vol 27 (3) ◽  
Author(s):  
L.P. Mkize ◽  
L.R. Uys
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Service Providers ◽  
Mental Illnesses ◽  
Structured Interviews ◽  
Violent Behaviour ◽  
Health Institution ◽  
Mental Health Institution

The understanding of popular beliefs about mental health care and the pathways clients take prior to admission to a mental health institution is vital in planning to reduce delays in seeking treatment. The objectives of this exploratory survey were to determine pathways of care the clients with mental illness take, which ultimately lead to the mental health institution, the effects of socio-cultural and economic factor on the pathways to mental health care and the satisfaction with different service providers consulted. Data was gathered through semi-structured interviews. The results indicate that African clients interpret mental illness as bewitchment. Delays in seeking appropriate mental health care are experienced because traditional and faith healers are the first port of call. The short pathways are used when the first signs of psychotic features are severe, including like aggressive or violent behaviour. Financial constraints seem to be the problem for most of the clients in accessing mental health care. Furthermore, defaulting treatment was also observed due to the fact that mental illnesses are stigmatised in African communities.

Mental Illness and Mental Health Care as Experienced by Persons who Die by Suicide; a Qualitative Analysis of Suicide Notes

2017 ◽  
Vol 41 (S1) ◽  
pp. S293-S293
Author(s):  
Z. Furqan ◽  
J. Zaheer ◽  
M. Sinyor ◽  
A. Schaffer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Constructivist Grounded Theory ◽  
Subjective Experiences ◽  
Suicide Notes ◽  
Open Coding ◽  
Competing Interest ◽  
Axial Coding

While mental illness is a risk factor for suicidal behaviour and many suicide victims receive mental health care prior to death, there is a comparative lack of research that explores their narratives of care. Suicide notes offer unique insight into these subjective experiences. Our study explores the following questions: “How is mental health care experienced by those who die by suicide?” and “What role does this experience play in an individual's journey to suicide?” Our sample is a set of 21 purposefully selected notes that explicitly make mention of mental illness and/or mental health care, from a larger sample of 255 notes obtained through the Toronto Coroner's Office. We utilized a constructivist grounded theory framework to engage in line-by-line open coding, axial coding, memo-ing and theorizing of the data. Preliminary themes include (1) perception of recurrent utilization of mental health care as personal failure, (2) recurrent utilization of mental health care as a manifestation of accumulating hopelessness, (3) the construction of suicide as being beyond the scope of mental health care, (4) tensions between the conceptualization of mental illness as an inherent part of the self and mental illness as a disease to be fought or overcome, and (5) suicide as an exertion of self-autonomy, distinct from the influence of mental illness. An exploration of the complexity of an individual's relationship with mental illness and mental health care can foster better identification, understanding and support for those at risk for suicide.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Establishing views of traditional healers and biomedical practitioners on collaboration in mental health care in Zanzibar: a qualitative pilot study

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Lindsay Solera-Deuchar ◽  
Mahmoud I. Mussa ◽  
Suleiman A. Ali ◽  
Haji J. Haji ◽  
Peter McGovern
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Pilot Study ◽  
Service Providers ◽  
Traditional Healers ◽  
The Other ◽  
People With Mental Illness ◽  
Biomedical Practitioners ◽  
Two Sectors

Abstract Background This qualitative pilot study aimed to establish views of traditional and biomedical practitioners towards collaboration between the two sectors on the treatment of people with mental illness in Zanzibar, Tanzania. Methods Six traditional healers (known as “waganga” in Swahili) and six nurses working in government secondary mental health services were invited to participate in a series of focus group discussions (FGDs). Two sets of FGDs took place approximately seven weeks apart. In each set, FGDs were conducted with traditional healers only, nurses only, and finally nurses and traditional healers together. FGDs were conducted in Swahili, audio-recorded and then translated to English by an independent translator and coded thematically using NVivo software. Results All participants expressed that they were in favour of collaboration between traditional and biomedical practitioners on mental healthcare. Opinions varied regarding what form this collaboration should take. For many nurses and healers, there was acknowledgement of the role of the other group in providing treatment for people with mental illness, with support for the idea of bi-directional referrals between the two sectors. For some nurses, the value of collaboration would be purely in the education of traditional healers in the recognition of mental illness, with subsequent referral to biomedical services. For some traditional healers, the idea of collaboration seemed to appeal in part because of a perceived opportunity to learn additional skills from biomedical practitioners. Both categories of participant expressed a belief that patients possessed by a jinn (a spirit) or those that had been bewitched needed treatment by traditional healers. On the other hand, those with what participants considered to be “mental illness” needed treatment at the hospital clinic. However, some nurses felt that that traditional healers might be able to provide helpful treatment for mental illness, as well as those suspected to be affected by jinn or witchcraft. There was agreement on the need to establish clear referral pathways between the two service providers. The creation of an office for traditional healers at the hospital was an area where there was disagreement among participants. Conclusions We conclude that there is a positive view of collaboration among traditional healers and nurses who participated, and a willingness to work towards actual collaboration. The results suggest that views vary as to what form this collaboration should take, with opinions differing between nurses, as well as between traditional healers. Additional work is needed in order to further explore the nature of potential collaboration and extend the research to the wider population of traditional and biomedical practitioners in Zanzibar, to include primary health care workers.

A Tribute to the Late William J. Curran

1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
United Nations ◽  
Mental Health Care ◽  
Harvard University ◽  
Legal Medicine ◽  
General Assembly ◽  
International Institute ◽  
University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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