Rehabilitation of individuals with schizophrenia in southwest Nigeria: experiences and practices of clients, families and healthcare practitioners

Abstract

Background: schizophrenia is the most chronic form of mental illness. It is a noncommunicable disease of the mind that affects the thoughts, feelings, moods, and behaviour of an individual. A person with schizophrenia presents with features such as hallucinations and delusions that reduce social desirability, career or employment sustainability. Moreover, schizophrenia-like other mental illnesses cause stigma due to the person's behaviour, which is supposedly unpredictable, invariably reducing the productivity and self-care of the individual; these put a burden on the family who must care for the clients who are unable to care for themselves. To increase the social relevance and productivity of individuals with mental illness (schizophrenia), the World Health Organization recommended psychosocial rehabilitation(PSR) as the best method of post-recovery care, which also helps to assume productive functioning.

Problem statement: PSR, although recommended, has an unclear mode of execution in some countries like Nigeria. The WHO emphasises that PSR should be a contextually relevant practice in each country. Over the decades, high-income countries have managed to implement context-specific PSR; however, almost all African countries, Nigeria included, have no practice guide for PSR, except for South Africa and Botswana. It is therefore a concern how Nigeria practices PSR.

Purpose: The purpose of the study is to improve the care of people living with schizophrenia in Southwest Nigeria with the development of a context-specific practice guide for PSR of individuals with schizophrenia.

Methods and design: This study followed a multi-method; qualitative descriptive design, scoping review of literature on PSR in Sub-Sahara Africa, and used semi-structured interviews with the clients, families, and health care practitioners(HCPs).

Result: The study revealed that clients experience dictatorship from families and professionals except those who have been abandoned by families and are just within hospital facilities for accomodation. Preferences of clients are self autonomy. Families desire recruitment of more rehabilitation experts into skills acquisition while professionals desire improved human and material resources.

Conclusion: This study concludes that individuals with schizophrenia can have more effective rehabilitation if the HCPs are equipped in terms of training on rehabilitation alongside the developed practice guide.