Abstract
Severe mental illnesses (SMI) contribute significantly to the global burden of disease. In low-and-middle-income countries (LMICs), the treatment gap impacts the clinical and personal recovery of people living with an SMI. The drive to reduce this treatment gap in LMICs makes it pertinent to understand service providers’ views on recovery from SMI. Semi-structured interviews and focus groups with service providers from health services and non-profit organisations in the Western Cape Province, South Africa, were conducted in this qualitative study. Seventeen participants were purposively selected, and data were thematically analysed. Three major themes emerged: delineating recovery, available services supporting recovery from SMI, and facilitators and barriers to recovery at the service level. Health services favoured clinical over personal recovery. Participants thought that many service users’ personal recovery from SMI was hindered by intersecting social, economic, cultural, and political inequalities that extended beyond the influence of the health sector.
Highlights
Severe mental illnesses (SMI) are some of the main causes of years lived with disability (YLDs) (Vos et al, 2017)
17 service providers agreed to participate in interviews and focus group discussions (FGDs)
Service providers are aware of personal recovery, they focus on clinical recovery
Summary
Severe mental illnesses (SMI) (schizophrenia spectrum disorders, non-organic psychotic disorders, and bipolar affective disorder) are some of the main causes of years lived with disability (YLDs) (Vos et al, 2017). Despite schizophrenia being a low prevalence disorder, the Global Burden of Disease study (2016) ranked it as the 12th most disabling disorder out of 310 injuries and diseases (Vos et al, 2017), contributing 1.7% of total YLDs globally, equivalent to 13.4 million YLDs (Charlson et al, 2018). The burden associated with these disorders is four times greater in low-and-middleincome countries (LMICs) than high-income (HICs) due to the substantial treatment gap (Charlson et al, 2018). As many LMICs allocate insufficient resources to SMI services in primary levels of care treatment for SMI remains inadequate in these settings (Iseselo & Ambikile, 2017), and there is little integration between hospitals and community-based services (Eaton et al, 2011).
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