Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review

dc.contributor.advisorBuchanan, Helen
dc.contributor.advisorRamafikeng, Matumo
dc.contributor.authorMabuza, Lozinyanga
dc.date.accessioned2025-09-03T12:11:34Z
dc.date.available2025-09-03T12:11:34Z
dc.date.issued2025
dc.date.updated2025-09-03T12:00:57Z
dc.description.abstractObjectives: To describe occupational therapy interventions for the community re-integration of mental health care users (MHCUs) and the factors that influence this process in low- and middle-income countries (LMICs) Introduction: Mental health issues affect a large portion of the global population, with severe mental illness (SMI) contributing significantly to the global disease burden particularly in LMICs where access to care is limited. Community re-integration for MHCUs is a serious challenge, often leading to the revolving door phenomenon. Community-based mental health care models aim to improve patient outcomes and support re-integration. Occupational therapy plays a significant role in this recovery process; however, the evidence is scattered, with no existing summary of literature for LMICs. Inclusion criteria: This scoping review included studies from 2002 to 2023 that reported occupational therapy interventions for community re-integration of previously institutionalised MHCUs with severe mental illness. The studies were selected from LMICs and included various research designs, theoretical articles, and grey literature. Methods: A search strategy was developed with a subject librarian and PubMed, Scopus, EBSCOHost (CINAHL, Africa-Wide Information, APA PsycArticles, and APA PsycInfo), OATD.org, and WorldCat were searched. The search was conducted from January to February 2023. Two reviewers independently screened eligible studies using the Rayyan web application. The data were extracted using a modified JBI data-charting tool and organised in a table using two organising categories. Data were coded by similar factors, summarised, and reported descriptively. Results: Of the 287 articles identified in the searches, 10 met the inclusion criteria. Sources were from South Africa (5 sources), India (2 sources), China (1 source) and Brazil (1 source), and were mostly qualitative and based in community practice sites. Nine distinct occupational therapy interventions were identified – actuality, community living skills and support, counselling, home visits, life skills, leisure, psychoeducation, self-care, and vocational rehabilitation. The six contributing factors included community-based rehabilitation principles, psychosocial strategies, assessment and outcome measures, the concept of recovery, occupational therapy-led programmes and elements of the interventions. Conclusion: Interventions that aligned with occupational therapy principles that were culturally adapted were particularly effective in facilitating MHCUs' re-integration in LMICs Adapting outcome measures and re-integration indicators to the local context is crucial.
dc.identifier.apacitationMabuza, L. (2025). <i>Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review</i>. (). University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy. Retrieved from http://hdl.handle.net/11427/41683en_ZA
dc.identifier.chicagocitationMabuza, Lozinyanga. <i>"Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review."</i> ., University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy, 2025. http://hdl.handle.net/11427/41683en_ZA
dc.identifier.citationMabuza, L. 2025. Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review. . University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy. http://hdl.handle.net/11427/41683en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Mabuza, Lozinyanga AB - Objectives: To describe occupational therapy interventions for the community re-integration of mental health care users (MHCUs) and the factors that influence this process in low- and middle-income countries (LMICs) Introduction: Mental health issues affect a large portion of the global population, with severe mental illness (SMI) contributing significantly to the global disease burden particularly in LMICs where access to care is limited. Community re-integration for MHCUs is a serious challenge, often leading to the revolving door phenomenon. Community-based mental health care models aim to improve patient outcomes and support re-integration. Occupational therapy plays a significant role in this recovery process; however, the evidence is scattered, with no existing summary of literature for LMICs. Inclusion criteria: This scoping review included studies from 2002 to 2023 that reported occupational therapy interventions for community re-integration of previously institutionalised MHCUs with severe mental illness. The studies were selected from LMICs and included various research designs, theoretical articles, and grey literature. Methods: A search strategy was developed with a subject librarian and PubMed, Scopus, EBSCOHost (CINAHL, Africa-Wide Information, APA PsycArticles, and APA PsycInfo), OATD.org, and WorldCat were searched. The search was conducted from January to February 2023. Two reviewers independently screened eligible studies using the Rayyan web application. The data were extracted using a modified JBI data-charting tool and organised in a table using two organising categories. Data were coded by similar factors, summarised, and reported descriptively. Results: Of the 287 articles identified in the searches, 10 met the inclusion criteria. Sources were from South Africa (5 sources), India (2 sources), China (1 source) and Brazil (1 source), and were mostly qualitative and based in community practice sites. Nine distinct occupational therapy interventions were identified – actuality, community living skills and support, counselling, home visits, life skills, leisure, psychoeducation, self-care, and vocational rehabilitation. The six contributing factors included community-based rehabilitation principles, psychosocial strategies, assessment and outcome measures, the concept of recovery, occupational therapy-led programmes and elements of the interventions. Conclusion: Interventions that aligned with occupational therapy principles that were culturally adapted were particularly effective in facilitating MHCUs' re-integration in LMICs Adapting outcome measures and re-integration indicators to the local context is crucial. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Community Re-integration KW - Interventions KW - Mental Health Care Users KW - Occupational Therapy KW - Scoping Review KW - Severe Mental Illness KW - Low-and-Middle Income Countries (LMICs) LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review TI - Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review UR - http://hdl.handle.net/11427/41683 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41683
dc.identifier.vancouvercitationMabuza L. Occupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review. []. University of Cape Town ,Faculty of Health Sciences ,Division of Occupational Therapy, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41683en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDivision of Occupational Therapy
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectCommunity Re-integration
dc.subjectInterventions
dc.subjectMental Health Care Users
dc.subjectOccupational Therapy
dc.subjectScoping Review
dc.subjectSevere Mental Illness
dc.subjectLow-and-Middle Income Countries (LMICs)
dc.titleOccupational therapy interventions for community re-integration of mental health care users with severe mental illness in low- and middle-income countries: a scoping review
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMasters
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