Households in mental health care: an experimental study on the role of the household in the care for people with a severe mental illness in South Africa.

South Africa has a high burden of severe mental illness – such as schizophrenia, bipolar disorder and major depressive disorder. In step with global movements and budgetary limitations, the country promotes deinstitutionalisation – from hospitals to local communities – to care for these people living with severe mental illness (PSMI). This push towards deinstitutionalisation, however, has not been fit with an according health care model in these communities. PSMI are discharged into a household context without any support – often resulting in treatment non-adherence and a cyclical pattern of short readmissions to the hospitals that they have been discharged from, following relapses in treatment gains. In the context of limited resources for deinstitutionalized mental health care, research into the potential of the household in the care for discharged PSMI is a clear priority. We hypothesize that improving the mental health knowledge and communication skills of households will enable ownership of the problem and increase social support to the PSMI. This will eventually positively impact treatment adherence and lower re-admission rates of PSMI. Aim of this project is to develop and test an intervention stimulating this mental-health competence of households – in a cluster randomized-controlled trial using a longitudinal process evaluation. As such, this project responds to the urgent need in many low- and middle income settings to optimize the deinstitutionalisation of PSMI.

Keywords:PERSONALIZED HEALTH CARE, SOCIOLOGY OF HEALTH, MENTAL HEALTH, COMMUNITY HEALTH

Disciplines:Family care, Mental healthcare services, Sociology of health, Sociology of life course, family and health not elsewhere classified

Project type:Collaboration project