Exploring the life narratives of individuals with schizophrenia utilising out-patient services at a district level hospital in the Eastern Cape, South

Abstract

Background: The study aimed to explore the lived experiences of 13 individuals with schizophrenia utilizing out-patient services at a district level hospital in the Eastern Cape, South Africa. Influences of context and culture on life experiences, and living with an ‘invisible’ disability, including the associated emotional, social, and cultural implications, were explored. Methods: This study employed a qualitative design supported by the principles of face-to-face semi-structured interviews and participant observation, using purposive sampling. An interpretive paradigm was followed, aiming to explore the subjective reasons and meanings of the participant’s experiences. Data collection took place in English, Afrikaans, and isiXhosa. All data were audio-recorded, transcribed, and translated into English, and analyzed utilizing an inductive approach according to the principles of thematic analysis. Member checking took place, to ensure rigour. Results: Themes identified included the perception of the participants on the cause of their condition (such as jealousy and bewitchment, family history, and substance abuse) and how they experience the symptoms of schizophrenia, the experiences of managing the condition on a day-to-day basis (including treatment), and how they are affected by the environment (such as poverty). Participants’ coping strategies mostly included turning to religion. Implications: The integration of mental health into primary healthcare may help narrow the treatment gap. The role of the speech-language therapist (SLT) in mental health is one that requires development in South Africa. The implementation of community-based programs, and changes within policies, such as the National Mental Health Framework Policy, are needed to improve mental healthcare services, including overcoming barriers of accessibility and promoting awareness within the community. Conclusion: Schizophrenia is a complex spectrum disorder, and the attached stigma leaves individuals feeling isolated and silenced. Hearing the life experiences may help provide perspectives on how to manage and understand this condition, which may contribute to improving accessible healthcare