Women surviving chronic poverty and psychiatric disability

Abstract

Background: Chronic poverty affects many South Africans and compounded with psychiatric disability, has a significant effect on human occupation. This dynamic interaction was investigated amongst a group of isiXhosa women with enduring mental illness living in adverse socioeconomic conditions in a peri-urban informal human settlement.
Methods: A descriptive qualitative approach using focus group discussions, conducted in Xhosa by an external facilitator, yielded narrative data which was deductively analysed to describe interactions between poverty, disability and occupation. 
Findings: Two themes within a central plot emerged: one highlighting the daily grind of meeting basic survival needs and one pointing to the personal and social costs of managing a mental illness in the context of socioeconomic hardship. The plot suggests that while survival is promoted through a range of practical and relational strategies, quality of existence is compromised by the monotony and strain of performing occupations in an under-resourced environment.
Conclusion: Implications of these findings are discussed in relation to what the women were able to accomplish everyday in spite of being affected by a serious mental illness. Providing information for practitioners addressing mental health and community development in the context of poverty, it argues for greater attention amongst occupational therapists to the impact of context on people’s occupational performance.
Key words: Chronic poverty, Psychiatric disability, Livelihood strategies