Browsing by Author "O'Brien, Constance"

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    An investigation into mental health care deficits in South Africa: exploring an alternative intervention strategy
    (2018) Daniels, Ingrid; O'Brien, Constance; John-Langba, Johannes
    This study investigates mental health care deficits in South Africa and explores an alternative intervention strategy that promotes an integrated community-based intervention model to reach the vulnerable majority living with the debilitating consequences of mental illness. The research is grounded in human rights, empowerment and human scale development theories. A mixed-methods research design consisting of a dominant quantitative methodology complemented by a qualitative methodology was adopted. The research design was carried out in three sequential phases. The first phase of the study involved an online survey with 19 mental health professionals employed at State psychiatric facilities and 90 social workers at 17 mental health non-government organisations. The second phase involved 5 focus group discussions with a total of 40 mental health service users from the Western Cape, Eastern Cape, KwaZulu-Natal, Northern Cape and Limpopo Provinces. The third and final phase of the study involved telephonic interviews with two key informants, using a semi-structured interview guide. Purposive sampling procedures were used to recruit respondents from all nine provinces in South Africa. Findings indicate that less than half of the mental health professionals (49%, n=53) reported that the National Mental Health Policy Framework and Strategic Plan 2013‒2020 is a very good policy, whereas 42.6% (n=46) agreed that the policy is highly appropriate for a developing country. The Chi-square test showed a significant relationship between respondents’ perceptions of a good policy and its appropriateness for mental health care in South Africa [χ² (9, n=109) = 120.5, p <.000]. The focus group findings indicated that only a few service users were aware of the policy as a 'strategic plan’ whilst the majority of focus group participants were unfamiliar with the policy and thought that it should be summarised in clear language and disseminated. The issue of stigma experienced and confirmed by service users was regarded as a major barrier to mental health care – the majority (89.9%, n=98) of respondents indicated that mental illness remains one of the most highly stigmatised conditions in South Africa. There is a significant relationship between how well mental illness is understood and the stigma associated with mental illness [χ² (16, n=109) = 40.7, p<.001]. The Chi-square test indicated a significant association between mental health professionals’ perception about vulnerability and the discrimination against mental health service users [χ² (9, n=109) = 25.0, p<.003]. These findings were confirmed by the focus group participants who said: “As long as there is stigma – we as mental health patients get judged by our community, by our families and people around you – then nothing will change”. The majority (94.5%, n=103) of respondents agreed that people with mental illness are more vulnerable to abuse by society than those without mental illness. The majority (80.7%, n=88) of mental health professionals reported that the medical model is the dominant approach to diagnosis and treatment of mental illness in South Africa. The focus group participants were keenly aware that “just taking your medication isn’t always balancing out”. The majority of mental health professionals (83.5%, n=91) agreed that poor socio-economic conditions increased mental illness, whereas 73.4% (n=80) agreed that there was a direct link between poverty and the increase in demand for mental health services. The Chi-square test indicated that there is a significant association between poor socio-economic conditions and the increased demand for mental health services in South Africa [χ² (16, n=109) = 199.2, p<.001]. Focus group discussions confirmed this link between poverty and mental illness with participants highlighting the constraints of meagre grants and their inability to find jobs. Findings from the key informants concur with the aforementioned main findings. Conclusions drawn from the triangulated findings show the major deficits in treatment; the lack of resources and funding; the lack of community-based mental health interventions and the exclusion of mental health service users as significant role-players. Finally this study both recommended and designed a comprehensive patient-centred, integrated community-based mental health service model that is aligned with South Africa’s National Mental Health Policy. The proposed model took into account the perspectives of mental health professionals, mental health service users, and findings from the survey respondents, as well as ideas from 'best practice models’ found in Zimbabwe, Uganda, Brazil and India – and was corroborated by key informants.
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    Challenges faced by NPOs providing services to refugees and asylum seekers in the Cape Town Metropolitan area
    (2016) Reiss, Chloé; O'Brien, Constance
    Non-Profit Organisations (NPOs) providing services to refugees and asylum seekers are hard-pressed to effectively address the many challenges that these individuals face. Many struggling Black South Africans perceive these migrants as competing for scarce resources or as being able to achieve better livelihoods than they have in their own country. This study examines the challenges faced by NPOs providing services to refugees and asylum seekers in the Cape Town metropolitan area. A qualitative research design was adopted and a total of twenty-one respondents from twelve NPOs were purposively targeted. Thus a non-probability sampling strategy was used. Data was collected through face-to-face in-depth interviews using a semi-structured schedule. The findings reveal that the legacy of the past and perpetuating socio-economic inequalities hinder the integration of refugees and asylum seekers in South Africa. Xenophobia remains a major concern and the approach of government toward migration appears contradictory. Documentation, administration and corruption at the Department of Home Affairs (DHA), the closure of the Cape Town Refugee Reception Office (CTRRO), abuse and discrimination, are major challenges for refugees and asylum seekers. NPOs assisting them remain constrained by lack of funding and government cooperation. Further awareness initiatives, community mobilisation and social cohesion programmes are required. These findings inspired some recommendations for further research as well as for NPOs, which include lobbying for the establishment of a Central Migrant Help Desk; enhancing access to psychological services; developing more social cohesion programmes and further facilitating access to basic social services. Other recommendations encourage NPOs to develop a policy document to present to parliament tackling the issues of backlogs, renewal of documents, regulations in the workforce, documentation awareness, improvement of professional training of stakeholders; and advocating for progressive and coherent policy-decision making.
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    Exploring the need for a community liaison person in facilitating family and community involvement in schools in the Western Cape: a case study of schools in the Joe Slovo Park informal settlement
    (2014) Du Pont, Jonelle; O'Brien, Constance
    This study assessed the viability of a Community Liaison Person (CLP) in facilitating family and community involvement in schools in the Western Cape. A sample of sixteen participants consisting of five educators, four learners and four parents was drawn from two schools in the Joe Slovo Informal Settlement area. Furthermore, representatives of three NGOs were selected based on the focus of their work in education in various informal settlement areas around Cape Town. This study adopted an exploratory qualitative design using semistructured interview schedules to guide face-to-face interviewing. Purposive non-random sampling procedures were adopted in selecting the participants. The data was analysed using Tesch?s (1990) approach. The main findings were: * Fourteen participants indicated that the non-involvement of parents in their children?s learning was largely due to time constraints and being uninformed about the role of their children?s learning outcomes. * Parents indicated that there was a lack of communication between themselves and the school, and did not know what happens at school. The principal believed there to be a breakdown of communication between parents and the school. * All sixteen participants indicated that having a Community Liaison Person (CLP) would be beneficial to the learner and saw the main role of the CLP as being the link person between the school, the family, the community and other stakeholders. Furthermore, the majority of participants believed that the CLP could create a support networks amongst various stakeholders. The main recommendations were: * Training should be provided to school volunteers either by the Western Cape Education Department or a Non-Governmental Organisation so that school/family/ community linkages can be formed. * That further research (mixed methodology) be taken to determine the need and feasibility of implementing such a role as a CLP. * Specially trained community persons or someone who has a social work/community development background could fill the role of CLP.
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    Exploring the perceptions of NPOs about EU development Aid in facilitating services aimed at women empowerment and children's development in Mauritius
    (2017) Yone Shin, Yen Mee Cheng; O'Brien, Constance
    The study explores how the EDF has enhanced the work of NPOs in the field of women empowerment and children's development in Mauritius. In addition to that, the study explores the outcomes and challenges that NPOs experienced regarding the funding. Using a qualitative and exploratory research approach, this study explores the nature and extent of NPO services that were specifically funded by the European Development Fund. There are five research objectives: to explore the nature and extent of services provided by the NPOs that have been specifically funded by the EDF; to examine how the EU has facilitated the service delivery of the NPOs; to find out how women and children have been empowered; to ascertain how the service delivery has improved the lives of the beneficiaries and to determine the nature of the challenges facing these organisations in the post EU funding period. The findings showed interesting features of the EU funding and the present context of post EU funding. In spite of the small sample of 19 NPOs that participated in this exploratory study, NPO participants have provided valuable insights on how the EU funding have facilitated service delivery towards women empowerment and children's development. The findings showed interesting features of the EU funding and the present context of post EU funding. Obviously more research is needed. The main findings of this research motivated some recommendations that are presented in three different sections. First, recommendations for further research has been presented, followed by some recommendations for NPOs in the sector with regards to accessing funding and finally, some recommendations for the Mauritian government. The key assumptions that EU funding accelerated growth in the NPO sector; increased service delivery and enhanced women and children's development has been confirmed. In conclusion, despite of the limited sample of participants that participated in this exploratory study, they have provided valuable insights into how the European Development Aid has facilitated various development programmes that have made a difference in the lives of women and children.