A social support framework for mental health care users to promote continuity of care

Abstract

Mental healthcare users (MHCUs) often face mental health challenges such as relapse, consequently leading to readmissions due to inadequate continuity of care. The study aimed to develop a social support framework for MHCUs to promote continuity of care. The study was conducted in mental health institutions and primary health care (PHC) settings in Mopani, Vhembe and Capricorn districts in Limpopo province. A qualitative, grounded theory approach guided the study. Phase one sought to explore and describe the experiences of operational managers, mental healthcare providers (professional nurses and social workers), and MHCUs regarding social support and continuity of care. Purposive sampling was used, and data were collected from five operational managers, 14 professional nurses, three social workers and nine MHCUs using semi-structured face-to-face interviews. A comparison method was used to analyse the data. Four themes emerged. Theme one described issues related to support for MHCUs, namely the role of the multidisciplinary team (MDT) and other informal support structures, lack of support from family, the community and the Department of Health and significant social institutions in the daily support of MHCUs. Theme two concerned matters essential in relation to the provision of mental healthcare services, namely inter-professional collaborative mental healthcare services, mental healthcare providers’ (MHCPs) views on ideal mental healthcare services, knowledge deficits on issues surrounding mental healthcare, and leadership as the core of mental health. Theme three focused on contemporary issues in healthcare impacting mental health, namely COVID-19 restrictions’ hindrance to mental health. Theme four highlighted essential steps to move forward regarding the provision of support for MHCUs, namely mechanisms of support, communication media essential in promoting social support, and continuity of care. The findings of the qualitative, grounded theory approach reflected inadequate social support is being provided for MHCUs, prompting the researcher to develop a conceptual framework to address this phenomenon. Phase two of the study thus sought to develop a social support framework to promote continuity of care. Phase three focused on a group of experts and stakeholders validating the social support framework.