The experiences of caregivers of mental health care users with bipolar disorder in Harare, Zimbabwe

Abstract

Zimbabwe has an estimated population of 14 million people and the capital city is Harare, which has a population of 1.6 million. Just like many other developing countries Zimbabwe is faced with multiple social, economic and political challenges. As such mental health is a low priority, as issues of food shortages and HIV and AIDS have taken the priority. With the move towards deinstitutionalisation of mental health services, family members are expected to provide care to their relatives with mental health conditions. Nevertheless, there is limited research on the experiences of caregivers in Zimbabwe. Therefore, the rationale for this study was to address this gap in research and provide recommendations to improve intervention and support to caregivers of persons diagnosed with bipolar disorder in Zimbabwe. The goal of the study was to explore and describe the experiences of family caregivers of mental healthcare users diagnosed with bipolar disorder in Harare, Zimbabwe. This qualitative study used an instrumental case study research design to explore the lived experiences of caregivers of mental health care users with bipolar disorder. The ten caregiver research participants were purposively sampled, using the following selection criteria: participants had to be caregivers of patients diagnosed with bipolar disorder at the unit; the bipolar patients had to be consistently receiving treatment from this institution for the past 12 months; bipolar patients had to be staying with their families (nuclear or extended), who are their caregivers in Harare; participants had to be adult males or females above eighteen years; and had to be primary caregivers, for at least one year, appreciating that they had adequate experience in caregiving for bipolar patients. The ten caregivers were interviewed at Parirenyatwa Annex Psychiatry Unit in Harare, using a sem-structured interview guide. The research findings reflect that caregivers experienced physical, psychological, emotional, social stigma and financial challenges. Subsequently, caregivers adopted varied coping mechanisms that included acceptance, faith and religion and family. The study also revealed that caregivers of mental health users need financial and emotional support. It was also identified that there are inadequate community mental health care services. Recommendations include capacity building for caregivers of mental healthcare users through providing them with ongoing emotional and psychoeducation support; developing community awareness programmes that educate families and communities on bipolar disorder and other mental illness to address the high stigma and discrimination associated with mental illness.