A Qualitative Study of the Psychosocial, Physical and Spiritual Benefits and Challenges Experienced by Psychiatric Patients Engaging Community Mental Health Services

Abstract

Background Mental illness generates feelings of shame, low self-esteem, isolation, and hopelessness which affect wellbeing and quality of life. Mental health care practitioners, therefore, need to support their clients to improve their quality of life. Despite an increasing awareness of the importance of spirituality in mental health contexts, a religiosity gap exists in the difference in the value placed on spirituality and religion. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts and can result in people's spiritual needs being neglected or dismissed within clinical practice (K. Milner et al., 2020). Additionally, mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient and their family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons (Kakuma R et al., 2010). Objective: The aim of this study was to explore the contribution of community mental healthcare services to the wellbeing of persons with a history of mental illness using the Betty Ferrell’s Quality of Life (QoL) model. Methods A qualitative research approach was adopted, using exploratory descriptive design to describe the experiences of psychiatric patients engaging community mental health services. An in-depth interview was conducted using Betty Ferrell’s Model as a guiding framework. Each interview lasted about an hour. All interviews were audiotaped, transcribed, and the content analyzed thematically. A purposive sampling method was used to select 11 participants who participated in a face-to-face in-depth interview. Responses from the interviews were transcribed verbatim and analysed using the thematic content analysis approach. Results The findings from the study revealed the important and valuable contribution of community mental health nursing services to the quality of life and wellbeing of persons with mental illness in all spheres of their functioning. The main themes and sub-themes on how community mental healthcare services impact the wellbeing of persons with history of mental illness were Spiritual wellbeing (‘hope’, ‘transcendence’, ‘positive changes’), Social wellbeing (‘good social interaction’, ‘good relationship with family’, ‘good relationship with community members’, ‘good relationship with church members’), Psychological wellbeing (‘perception of overall quality of life’, ‘anxiety/depression’, cognition/attention’, assertiveness’), and Physical wellbeing (‘adherence to medication regimen’, overall physical health’, functional ability’, appetite’). Community mental health nurses have also been instrumental in promoting the social wellbeing of people with history of mental illness. Improvement in the spiritual lives and religious activities of the clients through the intervention of the nurses helped them to find some purpose and meaning in life. Counselling, reassurance, encouragement, and education of clients by the nurses provided some relief from their anxieties and depression and promoted client compliance with prescribed treatment regimen. Conclusion Both theoretical and empirical literature reviewed show that social and emotional support for persons living with mental illness, or with a history of mental illness, are important to their quality of life. The support given within the community is invaluable. Thus, community mental health care services span the well-being in the domains of physical, social, spiritual, and psychological functioning.