Exploring the Lived experiences and quality of life of mental health care users in chronic psychiatric facilities in KwaZulu- Natal.

Abstract

Introduction: The quality of life for mental health care users in public sector psychiatric facilities remains a significantly under-researched area in South Africa. These facilities, while providing essential care, often present challenges such as prolonged institutionalization, limited psychosocial engagement, and restricted contact with family. Understanding the lived experiences of mental health care users is essential to inform holistic, client-centered interventions that support mental health recovery and community reintegration.

Methods: An exploratory qualitative design was employed, using semi-structured interviews to collect data from twelve purposively selected participants. Participants aged 30 to 60 years, with lengths of stays ranging from eight months to 12 years were selected. Thematic analysis was used to analyze data.  

Findings: The main themes to emerge included “Home is where the heart is” “Appraising treatment and care” the “Challenges of being a MHCU” and the “Positive experiences of the MHCUs”. The subthemes related to longing for home and family connection, coping through spiritual practices and solitude, and the therapeutic value of occupational therapy. While some participants appreciated the structure and support provided by the facility, others reported emotional distress related to rigid routines, poor environmental conditions and limited autonomy.

Conclusion: Occupational therapy can play a critical role in promoting emotional well-being, facilitating skills development, and advocating for environmental improvements in psychiatric settings. Utilizing psychosocial interventions and family reintegration strategies may enhance the quality of life for MHCUs in public psychiatric care.

Implications for Practice

• Occupational therapists can enhance the emotional well-being of mental healthcare users through engagement in meaningful activities, life skills training, and structured daily routines.
• Improving the infrastructure of state psychiatric facilities in terms of infrastructure, privacy, nutrition, and clothing provided is critical for safeguarding dignity and supporting recovery.
• Strengthening family contact and community reintegration efforts can reduce isolation and promote continuity of care.
• Expanding vocational programmes can prepare service users for independence and future work opportunities.
• Addressing violence and ensuring safer therapeutic environments requires staff training in de-escalation techniques and consistent monitoring of aggressive, psychotic and vulnerable individuals.
• Occupational therapists, as part of the multidisciplinary team, should advocate for systemic improvements that promote client-centred care and improved quality of life for mental healthcare users in chronic state psychiatric facilities.