Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa

Tomita, Andrew; Burns, Jonathan K.; King, Howard; Baumgartner, Joy Noel; Davis, Glen P.; Mtshemla, Sisanda; Nene, Siphumelele; Süsser, Ezra

doi:10.1080/00981389.2015.1088926

Cited by 7 publications

(10 citation statements)

References 37 publications

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“…In a prospective longitudinal study of first-episode psychosis in South Africa, Chiliza et al (2014) found a significant improvement in QoL as well as psychotic symptoms in outpatients treated with a depot antipsychotic. In another South African study, Tomita et al (2016) found that unmet needs were associated with poorer quality of family relations in hospitalized patients with severe mental illness. There is therefore a clear need for additional evidence on QoL and mental illness within the African context.…”

Section: Introductionmentioning

confidence: 96%

Predictors of quality of life among community psychiatric patients in a peri-urban district of Gauteng Province, South Africa

Mapatwana

Tomita

Burns

et al. 2019

Int J Soc Psychiatry

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Background: Few studies on quality of life (QoL) among people with mental illness have been conducted in South Africa, and none in community dwelling individuals. However, a greater understanding of subjective QoL may inform community-based medical, psychotherapeutic, or social interventions. This study examined the QoL, clinical and sociodemographic characteristics of psychiatric patients attending community mental health clinics in the Gauteng Province of South Africa. Methods: A cross sectional interview-based study was conducted with 121 adult patients attending community psychiatric clinics. To reduce the impact of acute psychiatric symptoms on subjective QoL, only clinically stable patients were included. Sociodemographic details and clinical characteristics were recorded. Subjective QoL was assessed using the World Health Organization QOL-Bref scale (WHOQOL-Bref), and severity of psychiatric illness measured with the Brief Psychiatric Rating Scale, expanded version 4.0 (BPRS-E). Results: Just over half of the sample rated their overall QoL as good or very good. Residual psychiatric symptomatology was the strongest predictor of a poor QoL in all four domains of the WHOQOL-Bref. The most severe BPRS scores were for the symptoms of depression, anxiety and somatic concern. Perceived social support significantly predicted a better QoL in the psychological, social relationships and environmental domains. Conclusion: This study highlights the negative impact of residual psychiatric symptoms on subjective QoL and the importance of social support in enhancing QoL.

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Section: Introductionmentioning

confidence: 96%

Predictors of quality of life among community psychiatric patients in a peri-urban district of Gauteng Province, South Africa

Mapatwana

Tomita

Burns

et al. 2019

Int J Soc Psychiatry

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“…8 , 9 Patients in hospital settings perceive a higher number of needs, including intimate relations, sexual needs and information about the treatment. 10–13 The presence of unmet needs in psychiatric inpatients has been associated with an increased severity of symptoms, 13 social impairment, functional disability and greater negative perception of the illness. 14 , 15 On the other hand, meeting needs have been associated with an improved motivation for treatment, 16 subjective welfare 17 and better subjective quality of life after hospitalization.…”

Section: Introductionmentioning

confidence: 99%

“… 29 Length of hospital stay has been reduced and admissions occur when the community care has not been effective. 30–32 Some studies have analysed outpatients needs in Spain, 8 , 10 but psychiatric inpatients needs remain to be investigated. The aim of this study was to determine the main areas of self-reported needs among inpatients with severe mental disorder and to assess risk factors of the group of patients with the greatest number of unmet needs.…”

Section: Introductionmentioning

confidence: 99%

Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain

Sánchez-Lafuente¹,

Guzmán-Parra²,

Lopez-Zambrano³

et al. 2021

NDT

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Purpose Patients with severe mental disorder have health and social needs that require care. The aim of the study was to determine the main areas of perceived needs among inpatients with severe mental disorders and to identify risk factors of the group of patients with the greatest unmet needs. Patients and Methods A total of 150 patients with severe mental illness were assessed during admission prior to discharge from the hospital. Camberwell Assessment of Needs was used as evaluation measure, in addition to clinical status (The Brief Psychiatric Rating Scale), social functioning (Personal and Social Performance) and sociodemographic variables. A descriptive and a multivariate logistic regression analysis were used to analyse variables related to the group of patients with the highest number of unmet needs (≥3). Results Mean number of needs was 7.93, being 4.61 the mean number of needs met and 3.32 the needs unmet. The highest proportion of unmet needs were intimate relationships (44.0%), company (40.7%) and daytime activities (38.7%). A relationship was also found between the presence of three or more unmet needs and the following variables: Brief Psychiatric Rating Scale score (p=0.004), Personal and Social Performance score (p = 0.013), marital status (p=0.018), employment status (p=0.009) and voluntary admission (p=0.032). The multivariate model explained 29.5% of the variance (Nagelkerke’s R 2 : 0.295). Conclusion Treatments aimed at improving social relationships and daytime activities could be a good option for inpatients with many unmet needs.

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“…Severe mental illnesses (SMIs) such as schizophrenia, schizoaffective disorder and bipolar mood disorders are associated with difficulties in self‐care, social participation and job performance, which in turn contribute to disability, further social isolation and family burden (Tomita et al., 2016). Although community‐based services do exist for these patients, such services are commonly insufficient and/or too difficult to access.…”

Section: Introductionmentioning

confidence: 99%

“…Researchers indicate that failing to account for unmet needs within the community leads to a significant reduction in life quality (Muralidharan, Mills, Evans, Fujii, & Molinari, 2019; Ochoa et al., 2003). In particular, companionship, intimate relationships, physical health and daily activity scheduling have been identified as critical domains that impact quality of life and treatment success among schizophrenic patients (Becker & Kilian, 2006; Lasalvia et al., 2005; Tomita et al., 2016).…”

Section: Introductionmentioning

confidence: 99%

Post‐discharge needs of Iranian women diagnosed with severe mental illness: A qualitative study

Rezaie

Phillips

2020

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? A search of common databases indicates the absence of any research focused on the needs of Iranian women diagnosed with severe mental illness post‐discharge from an inpatient setting. Moreover, there is a lacuna of information about the unique experiences and needs of persons diagnosed with severe mental illness living in non‐Western communities (esp. Middle Eastern communities). What this paper adds to existing knowledge This study examined interviews of women diagnosed with severe mental illness receiving treatment at an Iranian inpatient hospital. Three categories of post‐discharge needs emerged: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self‐management skills. Lastly, information distinguished between illness‐related information and women's health information. What are the implications for practice? Findings highlight the need for systemic changes to current care models. Broadly, families should be incorporated into care to improve outcomes and decrease stigma. Regarding mental health nursing, results highlighted the need for additional nursing and occupational therapy interventions to empower families and patients. Nursing practitioners can aid in preparing these patients for employment and public health initiatives to decrease stigma and improve access to care. Abstract IntroductionUnderstanding the post‐discharge needs of patients diagnosed with severe mental illness is critical for improving treatment outcomes. AimThe aim of the present study was to determine the unique post‐discharge needs of Iranian women diagnosed with severe mental illness. MethodConventional content analysis was utilized to analyse data gathered via focus group interviews conducted within the psychiatric inpatient unit at Farabi hospital located in Kermanshah, Iran. Participants (N = 42; M age = 40; SD = 6.3 years) had been diagnosed with a severe mental illness, had a history of at least two psychiatric hospitalizations and were awaiting discharge following significant symptom improvement. ResultsContent analysis extracted three categories of post‐discharge needs: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self‐management skills. Lastly, information distinguished between illness‐related information and women's health information. Discussion/Implications for practiceAnalysis of interview data highlighted the general need for adopting a family‐system approach to reduce stigma, increase knowledge and foster skill acquisition. Regarding mental health nursing, results highlighted the unique role of nurses and their capacity to pre‐emptively address needs such as aiding in employment. Lastly, findings are contrasted against Western care models.

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Beyond symptom management: Family relations, unmet needs of persons living with severe mental illnesses, and potential implications for social work in South Africa

Cited by 7 publications

References 37 publications

Predictors of quality of life among community psychiatric patients in a peri-urban district of Gauteng Province, South Africa

Predictors of quality of life among community psychiatric patients in a peri-urban district of Gauteng Province, South Africa

Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain

Post‐discharge needs of Iranian women diagnosed with severe mental illness: A qualitative study

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