Experiences of the COVID-19 pandemic amongst individuals with severe mental health conditions and caregivers in South Africa: a qualitative study

Abstract

Abstract Background People with severe mental health conditions such as schizophrenia are an underserved and under-researched group in low and middle income countries, requiring evidence to promote development of services for their needs. This study investigated the experiences and coping strategies of people with lived experience of this condition, and their family caregivers, in South Africa during the initial stages of the COVID-19 pandemic. Methods Telephonic qualitative interviews were conducted with people with schizophrenia (n = 14) and caregivers (n = 15) from the Nelson Mandela Bay District in the Eastern Cape, South Africa between April and June 2020, the most restrictive period of the COVID-19 lockdown in South Africa. Audio recordings were transcribed and translated to English from isiXhosa. Thematic analysis was conducted with NVivo12. Results Participants described several negative impacts including increased material hardship, intensified social isolation and heightened anxiety, particularly among caregivers who had multiple caregiving responsibilities. Coping strategies included finding ways to get and give social support from others, engaging in productive activities and taking care of physical health. Main limitations of the study are inclusion only of people with access to a telephone, and the use of telephonic interviews, which may have limited richness of data. Conclusions These findings highlight that support needs for people with mental health conditions and their families should include opportunities for social interaction and sharing coping strategies. Current support is likely to be inadequate with the ripple effects of the COVID-19 pandemic. Based on these findings, implementation of additional community-based recovery-focused services for families must be prioritized.