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Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights

BACKGROUND: Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, n...

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Autores principales: Labys, Charlotte A., Susser, Ezra, Burns, Jonathan K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029022/
https://www.ncbi.nlm.nih.gov/pubmed/27660651
http://dx.doi.org/10.1186/s13033-016-0089-z
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author Labys, Charlotte A.
Susser, Ezra
Burns, Jonathan K.
author_facet Labys, Charlotte A.
Susser, Ezra
Burns, Jonathan K.
author_sort Labys, Charlotte A.
collection PubMed
description BACKGROUND: Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, non-hospital settings. Using the perspective of formal and informal community service providers, we aimed to uncover descriptions of people with psychosis in a rural South African community and illuminate the potential complexities of their help-seeking journeys. METHODS: We conducted a qualitative study of 40 key informant interviews and seven focus groups with stakeholders (traditional leaders, traditional healers, religious leaders, health care nurses, heads of non-governmental organizations, schoolteachers, community caregivers) in a rural Zulu community (Vulindlela). Thematic analysis of the data was performed using the inductive analysis approach. RESULTS: Interviewees discussed 32 individuals with probable psychosis in their community and provided rich descriptions of their symptoms. A complex picture of help-seeking behavior, primarily involving informal mental health service providers, emerged. Over half of the reported cases had no contact with formal health services in the course of their help-seeking journey; while more than two-thirds never attended a hospital and only 1 in 8 accessed a psychiatric hospital. CONCLUSIONS: Our results highlight the important role of informal care providers in LMICs as well as the need for more research on mental illness and local providers in non-hospital contexts. Community stakeholders can contribute to a fuller understanding of these issues, thereby assisting in the creation of appropriate and effective mental health interventions for rural South African communities like Vulindlela.
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spelling pubmed-50290222016-09-22 Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights Labys, Charlotte A. Susser, Ezra Burns, Jonathan K. Int J Ment Health Syst Research BACKGROUND: Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, non-hospital settings. Using the perspective of formal and informal community service providers, we aimed to uncover descriptions of people with psychosis in a rural South African community and illuminate the potential complexities of their help-seeking journeys. METHODS: We conducted a qualitative study of 40 key informant interviews and seven focus groups with stakeholders (traditional leaders, traditional healers, religious leaders, health care nurses, heads of non-governmental organizations, schoolteachers, community caregivers) in a rural Zulu community (Vulindlela). Thematic analysis of the data was performed using the inductive analysis approach. RESULTS: Interviewees discussed 32 individuals with probable psychosis in their community and provided rich descriptions of their symptoms. A complex picture of help-seeking behavior, primarily involving informal mental health service providers, emerged. Over half of the reported cases had no contact with formal health services in the course of their help-seeking journey; while more than two-thirds never attended a hospital and only 1 in 8 accessed a psychiatric hospital. CONCLUSIONS: Our results highlight the important role of informal care providers in LMICs as well as the need for more research on mental illness and local providers in non-hospital contexts. Community stakeholders can contribute to a fuller understanding of these issues, thereby assisting in the creation of appropriate and effective mental health interventions for rural South African communities like Vulindlela. BioMed Central 2016-09-20 /pmc/articles/PMC5029022/ /pubmed/27660651 http://dx.doi.org/10.1186/s13033-016-0089-z Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Labys, Charlotte A.
Susser, Ezra
Burns, Jonathan K.
Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights
title Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights
title_full Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights
title_fullStr Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights
title_full_unstemmed Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights
title_short Psychosis and help-seeking behavior in rural KwaZulu Natal: unearthing local insights
title_sort psychosis and help-seeking behavior in rural kwazulu natal: unearthing local insights
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029022/
https://www.ncbi.nlm.nih.gov/pubmed/27660651
http://dx.doi.org/10.1186/s13033-016-0089-z
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