Change the world

School of Clinical Care Sciences

Focal areas: Barriers to care, health-seeking behaviour, right to health

Duration: 5 years (2010 – 2014)

Status: Ongoing

Key contact: Mr Kegan Topper

Principal Investigators: Prof Dalena van Rooyen and Dr Lena Andersson

Researchers: Dr Lena Andersson (Swe), Prof Dalena Van Rooyen (RSA), Prof Johanita Strümpher (RSA), Prof Esmeralda Ricks (RSA), Mr Kegan Topper (RSA), Dr Isabell Schierenbeck (Swe), Dr David Morton (RSA).

Funders: Swedish International Development Cooperation Agency (Sida)

Overview

Literature indicates that people with mental illness seldom receive the treatment they need and their human rights are often violated. It has been argued that mental health has received little attention in research and development in South Africa. There is thus a lack of knowledge on what hinders people with mental illness from accessing professional help from public health care institutions. The research study comprised three phases, each focusing on one of the three aspects of the health care system, namely: the service user (phase 1), the service provider (phase 2) and management in the mental health sector (phase 3).

Design

A mixed-methods design was used to investigate both quantitative and qualitative data.  

Methodology

In phase one, a cross-sectional study was conducted in the Eastern Cape Province of South Africa. More specifically, a total of 977 people (52% men and 48% female) between the ages of 18 and 40 were selected from urban and semi-urban areas of Nelson Mandela Bay (1 005 780 inhabitants) and semi-rural areas of Kirkwood (412 000 inhabitants) in order to make up urban and rural comparisons. In order to ensure a representative sample of the South African population, enumerator areas were randomly selected so that a sample of approximately 80% Black individuals, 10% White individuals and 10% Coloured individuals.

In phase two and three, in-depth qualitative interviews were conducted with both health care practitioners and managers and leaders in the mental health sector.

Keywords: barriers to care, help-seeking behaviour, mental health care, right to health

2015 Publications

  1. Moore, C.D., Schofield, C., Van Rooyen, D. & Andersson, L.M.C. 2015. Development and Preliminary Validation of a Scale to Measure Self-Efficacy in Seeking Mental Health Care (SE-SMHC). SpringerPlus, 4, 1, pages. doi: 10.1186/s40064-015-1109-1.

  2. Topper, K., Van Rooyen, K., Grobler, C., Van Rooyen, D. & Andersson, L.M.C. 2015. Posttraumatic Stress Disorder and Barriers to Care in Eastern Cape Province, South Africa. Journal of Traumatic Stress. 28, 4, 375-379. doi: 10.1002/jts.22032.

2014 Publications

  1. Strümpher, J., Van Rooyen, D., Topper, K., Andersson, L.M., & Schierenbeck, I. 2014. Barriers to accessing mental health care in the Eastern Cape Province of South Africa. African Journal of Nursing and Midwifery,16(1): 45-59.

  2. Van Rooyen, Topper, K., D., Morton, D., Strümpher, J., Andersson, L.M., & Schierenbeck, I. 2014. Health Care Practitioners’ Perceptions of Public Mental Health Care in the Eastern Cape, South Africa. Journal of Psychology in Africa. Manuscript accepted for publication. Manuscript accepted for publication.

2014 Prospective Publications

  1. Traumatic exposure among those living in Eastern Cape South Africa

  2. Traumatic exposure and the development of posttraumatic stress disorder in Eastern Cape, South Africa

  3. Socio-economic conditions and its association with self-rated emotional well-being among people living in the Eastern Cape, South Africa

  4. Predictor variables for health seeking among people with alcohol dependence and abuse disorder

  5. Barriers to care and the right to health among persons with substance dependence and abuse disorder in Eastern Cape, South Africa.

2013 Publications

  1. Schierenbeck, I., Johansson, P., Andersson, L. & Van Rooyen, D. 2013. Barriers to Accessing and Receiving Mental Health Care in Eastern Cape, South Africa. Health and Human Rights, 15, 2, 110-123.

  2. Andersson, L., Schierenbeck, I., Strumpher, J., Krantz, G., Topper, K., Backman, G., Ricks, E. & Van Rooyen, D. 2013.  Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa, Journal of Affective Disorders, 151, 2, 439-448.

2013 Conferences

21st South African Sociological Association Annual Congress

The Point of Critique. Knowledge, society, and the state in    

South Africa after 20 years of democracy

Location: Port Elizabeth, South Africa

Date: 6-8 July 2014

Presentation:

Morton, D., van Rooyen, D. Andersson, L. & Venter, D. 2014. Socio-demographic factors in relation to self-rated subjective well-being among people living in the Eastern Cape, South Africa. Social Indicators Research, in progress.

 

MEDIA: BAY TV

Location: BAY TV, Port Elizabeth, South Africa (Popular local television station reaching a large majority of poor populations)

Date: October

Presentation:

  • Lena Andersson and Kegan Topper were invited to contribute to a TV series on mental health. Project findings concerning barriers to care and help seeking behavior among people with mental health concerns in the Eastern Cape were discussed, the same issues raised in the Mental Health Colloquium. The aim of the series was to create awareness of mental health issues. This was very much in line with our findings as results indicate that a significant barrier to seeking mental health care is a lack of knowledge concerning the nature and treatment of mental health problems.

                                                                                                

Mental Health Colloquium

Revitalizing Mental Health in Eastern Cape

The Mental Health Colloquium was hosted by the School of Clinical Care Sciences and held at the North Campus Conference Centre on 15 November. A total of 90 delegates attended the event, of which there were leaders, academics and health care practitioners from a variety of disciplines in mental health. Seven presentations were presented throughout the day. Topics included depression, post-traumatic stress disorder, alcohol and substance abuse, barriers to care, help-seeking behaviour and the right to health among people with mental illness.

The day ended with a dynamic and informative panel discussion by experts in mental health which focused on strategies to improve access to and availability of mental health services in the Eastern Cape. The media, including BAY TV and journalists representing various newspapers and magazines, captured the event in an effort to create public awareness of mental health issues. In addition, principal researcher Lena Andersson and project coordinator Kegan Topper, were interviewed by BAY TV and consequently televised to a large majority of the Eastern Cape population.

 

Mental Health Symposium

Substance Use and Mental Health

Location: Nelson Mandela Metropolitan University, South Africa

Date: 28 October

Presentation:

  • Preliminary findings were presented by J. Strümpher on alcohol dependence, alcohol abuse,  substance dependence and substance abuse in the Eastern Cape, South Africa.

 

Global Mental Health Forum

Sustainable Development through Global Action

Location: Institute of Psychiatry, King’s College, London

Date: 27-28 September

Presentation:

  • Andersson, L., Schierenbeck, I., Strumpher, J., Krantz, G., Topper, K., Backman, G., Ricks, E. & van Rooyen, D. 2013.  Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa, Journal of Affective Disorders, 151, 2, 439-448.

 

Annual Nursing Education Conference (ANEC)

Making the Journey Together

Location: Boksburg, Gauteng, South Africa

Date: 2–4 September

Presentation:

  • Strumpher, J., van Rooyen, D., Topper, K., Andersson, L.M., & Schierenbeck, I. 2014. Barriers to accessing mental health care in the Eastern Cape Province of South Africa. African Journal of Nursing and Midwifery, 16(1): 45-59.
  • van Rooyen, Topper, K., D., Morton, D., Strumpher, J., Andersson, L.M., & Schierenbeck, I. 2014. Health Care Practitioners’ Perceptions of Public Mental Health Care in the Eastern Cape, South Africa. Journal of Psychology in Africa. Manuscript accepted for publication.

 

South African Community Epidemiology Network on Drug Use (SACENDU)

36th Regional Report Back Meeting

Location: Port Elizabeth, Eastern Cape, South Africa

Date: 10 October 2014

Presentation:

  • Jordan, P., van Rooyen, D., Ricks, E. & Andersson, L.M. Barriers to mental health care among people with substance dependence and substance abuse disorder in Eastern Cape, South Africa. Paper in Process.
  • Twum-Antwi, A., Staland-Nyman, C., van Rooyen, D. & Andersson, L.M. Prevalence and risk factors for alcohol dependence and alcohol abuse among young men and women in a general population sample in Eastern Cape Province, South Africa. Paper in Process.