Schizophrenia: a neglected problem in Pakistan

Hasan, Shahzain; Adil, Munsif

doi:10.1016/s0140-6736(19)30290-9

Cited by 5 publications

(7 citation statements)

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“…31 Scholars have also reported that this feeling of worthlessness arises when individuals with schizophrenia experience abandonment by their family for any reason. 1,32,33 Notably, some participants' perceptions were influenced by defective insights into their diagnoses.…”

Section: Discussionmentioning

confidence: 99%

Living beyond the limitation: Rehabilitation, life and productivity of individuals with schizophrenia in South‐West Nigeria

Oyelade

Nkosi-Mafutha

2021

Health Expectations

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Introduction Schizophrenia, the most chronic and stigmatized form of mental illness, can be described as a brain disorder that affects an individual's cognition. Individuals with schizophrenia exhibit socially unacceptable symptoms that affect their psychosocial lives. They suffer from reduced productivity due to the debilitating effect of the illness, and the negative symptoms impede their employability; such symptoms and effects aggravate the stigma around mental illness. However, when rehabilitation is successfully achieved, so is productivity, and this decreases the associated stigma. Thus, this study describes the rehabilitation experiences and productivity of individuals with schizophrenia in South‐West Nigeria. Methods and analysis A descriptive qualitative approach with semi‐structured interviews was used to gather information from mental health service users. The discharged users in this study received in‐hospital or outpatient rehabilitation care at four outpatient units within two specialist mental health‐care facilities in South‐West Nigeria. These facilities offer vocational training and rehabilitation services for individuals with schizophrenia. Twenty‐nine mental health service users were interviewed. The data from the interviews were independently analysed by two researchers through a content analysis approach using NVIVO version 11. The researchers compared the results of the analysis and reached an agreement on the conclusion. Findings and recommendations The rehabilitation services availed by patients in the research setting are of three types. Some attend occupational rehabilitation to learn a trade; they depend on professionals for the choice of skill but at a cost that is not affordable to many. Some stay in rehabilitation units linked to the hospital, rendering their services at a cost, and their living expenses and skill acquisition processes are based on the remuneration they get from the services rendered to the institution. Others depend on their family members' efforts to afford rehabilitation services but set up on job by family or employed in family business. The mental health service users in this study who offered their services to the institutions were able to make informed decisions and showed better performance with their chosen occupation than those who depended on their family or health professionals for the choice of rehabilitation service or vocational career. Therefore, this study concludes that prioritizing mental health facility users' preferences in terms of productive activities (sales, services, vocation) or rehabilitation goals should be encouraged.

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Section: Discussionmentioning

confidence: 99%

Living beyond the limitation: Rehabilitation, life and productivity of individuals with schizophrenia in South‐West Nigeria

Oyelade

Nkosi-Mafutha

2021

Health Expectations

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“…Again, self-perception in this study was the feeling of uselessness through rejection or abandonment in the hospital. According to Loh (2018), Hasan and Adil (2019), and Moorkath et al (2019), the feeling of uselessness, is the reactions individuals with schizophrenia experience from family. Moorkath et al (2019) discovered that families abandon relatives with schizophrenia for many reasons ranging from avoidance of labelling of the family name, to burden of care and feeling of hopelessness.…”

Section: Discussionmentioning

confidence: 99%

“…Moorkath et al (2019) discovered that families abandon relatives with schizophrenia for many reasons ranging from avoidance of labelling of the family name, to burden of care and feeling of hopelessness. Hasan and Adil (2019) stated families abandon people with schizophrenia to protect their social outlook and financial status. In Loh's (2018) view, in their study conducted in developing countries, schizophrenia constituted a cause of attention and family distress, and families abandon individuals living with schizophrenia to reduce their own stress and burden.…”

Section: Discussionmentioning

confidence: 99%

Let us say what we need ourselves: report of the interview of mental health service users with schizophrenia in South-West Nigeria.

Oyelade

Nkosi

2019

Preprint

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Schizophrenia is one of the, most chronic mental illnesses that subjects’ individuals who are suffering from dictatorship and control by close associates/friends, family and health professionals. The productivity of individuals who have schizophrenia is also reduced, due to the debilitating effect of the illness. In some countries, the right of such individuals is protected by laws guiding their treatment, however in the majority of the low-middle income countries (64%), Nigeria included, there are no Mental Health Acts that protect the rights of individuals in such categories. Without law or guidance, individual health professionals engage in trial and error, subjective ideas, or dictatorship. However, in a situation where recovery has been achieved, which is a function of remission of symptoms, there is a need for mental health service users to take part in their care. When a mental health service users’ voice is heard and appreciated, there is a high tendency for quick improvement, and this makes rehabilitation goals achievable. This study, therefore, describes the rehabilitation activities for individuals with schizophrenia in South-West Nigeria. A descriptive qualitative approach and semi-structured interviews were used to gather information from mental health service users at the eight clinics of the two tertiary psychiatric institutions in South-West Nigeria. Twenty-nine mental health service users were interviewed. The results of the interview were analysed independently by both researchers through a content analysis approach, using NVIVO version 11. The results of the analysis were compared, and an agreement reached on the conclusion. This study revealed that there was no uniform approach to rehabilitation of individuals with schizophrenia in South-West Nigeria, and instances of dictatorship and dependence by professional on the choice of activities were eminent. For the few who were able to make an informed decision, the mental health service users did better on what they chose to do themselves than what the family and health professionals suggested. However, when the mental health service users, did what they felt was best for them; this indicated a certain level of rehabilitation. This study, therefore, encourages the development of practice guidelines for the rehabilitation of individuals with schizophrenia in Nigeria.

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“…Within Pakistan, 1–2% of the population is estimated to be affected by schizophrenia, although the exact number is unknown ( 4 ). The estimated duration of untreated psychosis is between about 5 months to over 34 months ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Exploring biomedical and traditional care pathways for people with psychosis in Karachi, Pakistan

Khan,

Qureshi,

Pasha

et al. 2023

Front. Psychiatry

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BackgroundPsychosis is known to have an adverse impact on an individual’s quality of life, social and occupational functioning. A lack of treatment options for psychotic disorders such as schizophrenia contributes to adverse outcomes for individuals. A significant proportion of people with psychosis consult both formal and traditional routes of care. This warrants a need to explore perceptions around treatment options provided by diverse care providers, as the identification of avenues for support can improve psychiatric, alternative treatment and social outcomes.MethodsFocus groups discussions (FGDs) and in-depth interviews (IDIs) were used. Interactive Research and Development (IRD) research staff conducted 20 IDIs and 2 FGDs to obtain information about the perspectives, treatment pathways and experiences of individuals with psychosis, their caregivers, and service providers. Questions for clinician care providers and faith healers revolved around perceptions of psychosis, service users’ background, subject knowledge and treatment, feedback and referral mechanisms, and promotion of services. A thematic analysis was used to analyze the interviews and coding was conducted on NVivo.ResultsThe results were categorized into five themes: perception of psychosis, experience of seeking/receiving care, assessment and diagnosis methods, promotion of services, and living with psychosis. Across service providers and patients, there was a wide variety of causes attributed to psychosis, and an overall lack of awareness regarding severe mental health conditions from both formal and informal care-providers. Biomedical treatment received mixed reviews, while some reported it as beneficial, the limited number of institutes and clinicians to cater for patients, stigma within society and care providers, the burden of caregiving, and misinformation from faith healers were all significant barriers to treatment.ConclusionThe results highlight the use of traditional healing practices for psychosis in Pakistan, which, coupled with inadequate referral mechanisms, present an opportunity to bridge the treatment gap between clinical and traditional healing practices through integration of treatment within community structures and systems. Better awareness of psychosis and its treatment methods, alongside interventions that reduce stigma could help facilitate help-seeking behavior and reduce the burden of caregiving.

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Schizophrenia: a neglected problem in Pakistan

Cited by 5 publications

References 1 publication

Living beyond the limitation: Rehabilitation, life and productivity of individuals with schizophrenia in South‐West Nigeria

Living beyond the limitation: Rehabilitation, life and productivity of individuals with schizophrenia in South‐West Nigeria

Let us say what we need ourselves: report of the interview of mental health service users with schizophrenia in South-West Nigeria.

Exploring biomedical and traditional care pathways for people with psychosis in Karachi, Pakistan

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