Browsing by Author "Gamieldien, Fadia"

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    An exploration of recovery among persons with severe mental health conditions in South Africa
    (2025) Gamieldien, Fadia; Sorsdahl, Katherine; Galvaan, Roshan; Myers, Bronwyn
    Background Severe mental health conditions have long-term impacts on multiple stakeholders, especially in low- and middle-income countries. Historically, public mental health services have focused on symptom reduction, emphasising clinical recovery. However, personal recovery, which considers mental health service users' lived experience, has received little attention. Since contextual factors influence outcomes, understanding and measuring recovery in low-resource settings is crucial. This study sought to explore personal recovery from severe mental health conditions in South Africa, where challenges, including poverty, stigma, and limited mental health resources intersect to shape the recovery process. Aim and objectives The overarching research question underpinning the thesis was: What constitutes and facilitates recovery for persons living with severe mental health conditions in South Africa? I aimed to answer this question and contribute to closing the research gap by pursuing four research objectives: (i) To conduct a scoping review on how personal recovery is conceptualised for persons living with severe mental health conditions in low- and middle-income countries; (ii) To explore and describe service provider perspectives on what recovery is for persons with severe mental health conditions in South Africa; (iii) To explore and describe what recovery is for men with severe mental health conditions and their caregivers in South Africa; and (iv) To evaluate the psychometric properties of the Recovery Assessment Scale among persons with severe mental health conditions in South Africa. Methods This mixed-methods study included both qualitative and quantitative components. Initially, a scoping review was undertaken to explore how recovery from severe mental health conditions is conceptualised and facilitated in low- and middle-income countries. Ten articles were included and thematically analysed. Next, semi-structured interviews and focus groups were conducted with 17 service providers in the Western Cape. This qualitative phase also included interviews with four male mental health service users and three of their caregivers. Visual participatory methods such as photovoice and life graphs were used to collect data. Finally, a quantitative evaluation was conducted to assess the psychometric properties of the Recovery Assessment Scale among 250 South African mental health service users. Results The scoping review revealed that recovery from severe mental health conditions is perceived as a continuous, non-linear process. While high-income countries focus on autonomy and independence, low- and middle-income countries emphasise social ii connectedness and spirituality as key recovery elements. Service providers suggested that clinical recovery models dominate mental health care, but personal recovery requires an approach that addresses social, economic, and cultural inequalities. For mental health service users, long-term relational support was vital to recovery. Even though spirituality was crucial to recovery, stigma from faith-based communities sometimes hindered access to spiritual support. Finally, the psychometric evaluation of the Recovery Assessment Scale showed a five-factor structure, with “Empowerment and Inner Strength” emerging as a new factor. The adapted Recovery Assessment Scale demonstrated strong internal consistency and reliability, proving a suitable tool for measuring recovery in South Africa. Discussion and conclusion The findings were synthesised into the Recovery Mandala, which identifies seven interconnected elements central to recovery from severe mental health conditions in South Africa: Collaborative Co-creation, Person-Centeredness, Hope and Empowerment, Social Network Utilisation, Caregiver Involvement, Spirituality and Religion, and Employment. These elements reflect the relational and holistic nature of recovery
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    Disability Students Postgraduate Open Educational Resources Posters
    (2014-09-18) Gamieldien, Fadia; Mahmoud, Meqdad; Malonza, Patrice; Essop, Fatima
    A series of posters on unique models of Disability in an African context, developed by the Postgraduate students of the Disability Studies Program.
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    Interventions to reduce perceived stress among university students in LMICs: a scoping review
    (2023) Mangozho, Tinashe Nigel; Sorsdahl, Katherine; Gamieldien, Fadia
    Stress has been defined as the perception that one's resources to meet a demand for change are not adequate. It is also an emotional response to stressors. Stressors and cumulative adversities have been associated with mental health problems. Research suggests that university students are a vulnerable part of the population with exposure to diverse stressors and a high prevalence of mental health problems, including psychological distress, depression, and anxiety. This may be due to experiencing several stressors and decreased access to protective factors, such as family support. Although studies have explored the effectiveness of interventions to prevent stress related problems among university students, most studies originate from high income settings and primarily focus on studies from these settings. As a result, a synthesis of the current body of evidence regarding interventions to reduce stress in university students focused on low- and middle-income settings, is warranted. Method; This review used the Arksey & O'Malley (2005) scoping review framework that includes six stages: (1) identification of the research question, (2) identification of relevant studies, (3) selection of studies, (4) charting the data, (5) collating, summarising and (6) collaboration. The following databases were used for the identification of relevant studies: Google Scholar, Academic Search Premier, Africa-Wide Information, CINAHL, ERIC, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycInfo, PubMed, and Scopus. Abstracts of relevant studies were screened before the final articles were selected for inclusion in the review. Eligible studies were reviewed using the CASP checklist. Reporting of methods follows the Preferred Reporting Items for Systematic Reviews and Meta Analyses – Extension for Scoping Reviews (PRISMA-ScR). Data was collected using post-hoc tool designed for this review by the first author. The data extracted included bibliographic information, country of origin, type of study, study population, methodology, interventions, outcome measurement and key findings relating to the review question. Results This study identified eight studies. Six were randomised control trials and two were quasi experimental studies using a pre-test post-test design. Seven studies were from lower-middle income countries and one from an upper middle-income country investigating the 13 effectiveness of a range of interventions including: Mindfulness Based Interventions (n = 2),Rational Emotive Therapies (n = 3), Cognitive Behavioural Therapies (n = 1), Breathing Therapy and Emotional Freedom Therapies (n = 1), and Critical Thinking Interventions (n = 1). Primary outcome measures focussed on a stressed related variable were all self-report including the Depression, Anxiety and Stress Scale (DASS) (n = 2); the Perceived Stress Scale (PSS) (n = 4); the Exam Stress Scale (ExamSS) (n = 1); and the ASQ (n = 1). Only one study used a validated tool provided in the study participants' first language. Appraisal for this study was done using the CASP Appraisal tool (see Appendix 6). Four papers were rated as high quality (scoring highly in all three domains on the CASP) and 4 were rated as medium (scoring highly in at least 2 of the three domains of the CASP). The results of the analysis showed significant reductions in stress-related problems which were maintained at follow-up. Although all studies provided significant results for the chosen intervention, they were plagued by several limitations. Conclusion; This scoping review set out to identify interventions to reduce stress in university students in LMIC. The results of this scoping review suggested that there is not enough evidence to make definitive statements on the effectiveness of interventions to reduce perceived stress. The findings highlight the significant limitations of available studies and the need for further research in this area.
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    Perspectives of male mental health service users on their community integration following participation in a residential-based rehabilitation programme
    (2015) Gamieldien, Fadia; Duncan, Madeleine; Galvaan, Roshan
    Current re-engineering of primary mental health care in South Africa is directed towards providing a continuum of care for people with serious mental disorders in order to relieve the cost and resource burden of longterm hospitalisation. In the Western Cape, Healthcare 2030 has been adopted as the guiding vision for health system reform. Residential-based rehabilitation programmes have been introduced to assist mental health service users to improve their functioning in occupations of daily life so that they are better equipped to cope with community living. Problem: There is limited South African occupational therapy research into male mental health service users' perspectives on the contribution that residential-based rehabilitation programmes makes to their community integration, despite the high numbers of males using the service. Purpose: To inform public mental health services on the contribution of a residential-based rehabilitation programme to the community integration of men with serious mental disorders. Research question: How does participation in a residential-based rehabilitation programme contribute to the community integration of men with serious mental disorders? Objectives of the study: To identify what men with serious mental disorders consider community integration to be, and to describe the key elements within the residential-based rehabilitation programme that influenced their community integration. Research design and methodology: An instrumental case study design was used to guide the research methodology and five male participants were identified through purposive sampling. Observations, semi-structured interviews, community maps and document analysis w ere used as data collection tools. Data was audio-recorded and transcribed f or inductive and thematic cross-case analysis. Ethical principles of beneficence, autonomy and non-maleficence were upheld throughout the research process. Findings: One theme and three categories emerged in the findings. The theme, 'It's a catch-22 situation', comprises three categories, namely: 'It's not just what you call it'; 'There's no one size for all'; and 'It's tricky choosing between places to go and things to do'. Conclusion: Male mental health service users who participate in a residential-based rehabilitation programme will be better prepared for community integration if they are involved in co-constructing their recovery plan so that it is more personalised.