A recovery-oriented social work programme in mental health care in a rural area of South Africa

Abstract

In order to advance mental health care services, there has been a shift from the biomedical model to recovery-oriented care. Recovery has been steadily gaining ground as a guiding principle for mental health services, and has progressed from the lived experiences of people who use such services (Care Services Improvement Partnership [CSIP], 2007:iv). This is based on the premise that everyone should be involved in mental health services, and given the opportunity to work together and integrate various skills and experiences (CSIP, 2007:iv). Nationally and internationally, there is an increasing interest in the concept of “recovery,” particularly in the field of mental health and psychiatry. Consequently, professional bodies, health care agencies, and governments have become increasingly interested in focusing on recovery as the guiding principle for mental health policy, practice, and service (Osborn, 2012:8). This empirical study was conducted in Limpopo Province. The research sites were the Departments of Health and Social Development - Capricorn, Vhembe and Mopani Districts for the first phase. The second phase was conducted in the Vhembe and Mopani districts. The study followed a mixed-methods approach (qualitative and quantitative). The first phase was based on a qualitative approach, and the second phase on a quantitative approach. For the first phase, the participants included thirteen mental health care users (MHCUs) from Evuxakeni, Shiluvana and Hayani Hospitals. Five caregivers from Mapapila Village in Malamulele. Fourteen social workers from Capricorn, Vhembe and Mopani Districts and sixteen social workers from Malamulele, Hayani, Nkhensani, Evuxakeni, Shiluvana, Polokwane, and Seshego Hospitals. Lastly, eight social work managers from Malamulele, Giyani, Polokwane, Thohoyandou and the DSD provincial office. For the second phase, thirty-seven social workers were trained using a pre-test of a preliminary intervention programme, and subsequently the post-test was administered. A mixed-methods approach was employed using the exploratory sequential mixedmethods design. An intervention research was implemented. A collective case study design was selected for the first phase (qualitative) and a one-group pre-test post-test design (pre-experimental design) was implemented as a pilot study (quantitative). The qualitative findings and the literature review contributed to the development of a Collaborative Recovery-oriented Mental Health Care Programme (CROCMEHC). It was evident from the findings that MHCUs and caregivers have unmet needs and that social workers lacked knowledge in mental health care. Therefore, the findings from the first phase determined the content of the preliminary intervention programme. From the quantitative findings, it was concluded that the CROCMEHC programme will need to be refined; however, the results were promising for future development of this intervention programme. It is therefore recommended that the CROCMEHC programme be refined and its effectiveness improved. The CROCMEHC programme has the potential to capacitate social workers in mental health care, especially in the rural areas of South Africa.