Strengthening Equitable Mental Health Care in Rural South Africa: Leveraging Health and Community Resources to Support Informal Caregivers
1
Health and Rehabilitation Sciences, University Of Cape Town, Cape Town, South Africa
2
Health and Rehabilitation Sciences, Stellenbosch, Stellenbosch, South Africa
3
Occupational Therapy, Sefako Makgatho University, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2635
ABSTRACT
INTRODUCTION:
Informal caregivers are important in supporting persons with severe mental disorders, yet their needs are often overlooked. Many experience emotional strain, limited mental health knowledge, and challenges navigating fragmented services. 1,2 In rural South Africa, resource constraints and structural barriers add to these difficulties. 3,4 Although a multilevel framework exists to address caregiver burden, limited guidance is available on how to translate these strategies into practical actions.3,4 This study explores ways to integrate caregiver support into existing health and community resources in rural South Africa to strengthen equitable and inclusive mental health care.
METHODS:
A two day World Café approach was conducted with 33 stakeholders in Bushbuckridge, including district hospital management, primary healthcare(PHC) managers, the mental health coordinator, mental health workers, community based workers, and informal caregivers. Participants were grouped by designation to reduce power imbalances. Discussions focused on steps for integrating caregiver support at individual, interpersonal, organizational, and community levels. A deductive framework analysis was conducted.
RESULTS:
Participants identified actions to strengthen caregiver support. At the individual level, they suggested caregiver psychoeducation and help with understanding care pathways. At the interpersonal level, they emphasised shared caregiving responsibilities and family education. At the organizational level, participants proposed clearer referral processes and improved collaboration between district hospitals and PHC facilities to support follow up of service users and caregivers. At the community level, they recommended awareness activities through local radio and community meetings, and collaboration with traditional leaders and community policing forums. The need for stronger communication and collaboration among health and community stakeholders was emphasised.
CONCLUSIONS:
Integrating caregiver support into existing structures may contribute to equitable rural mental health services. These multilevel strategies align with WHO guidance on community based mental health services involving families and may enhance continuity of care, caregiver well-being, and equitable access in rural settings.5,6
Informal caregivers are important in supporting persons with severe mental disorders, yet their needs are often overlooked. Many experience emotional strain, limited mental health knowledge, and challenges navigating fragmented services. 1,2 In rural South Africa, resource constraints and structural barriers add to these difficulties. 3,4 Although a multilevel framework exists to address caregiver burden, limited guidance is available on how to translate these strategies into practical actions.3,4 This study explores ways to integrate caregiver support into existing health and community resources in rural South Africa to strengthen equitable and inclusive mental health care.
METHODS:
A two day World Café approach was conducted with 33 stakeholders in Bushbuckridge, including district hospital management, primary healthcare(PHC) managers, the mental health coordinator, mental health workers, community based workers, and informal caregivers. Participants were grouped by designation to reduce power imbalances. Discussions focused on steps for integrating caregiver support at individual, interpersonal, organizational, and community levels. A deductive framework analysis was conducted.
RESULTS:
Participants identified actions to strengthen caregiver support. At the individual level, they suggested caregiver psychoeducation and help with understanding care pathways. At the interpersonal level, they emphasised shared caregiving responsibilities and family education. At the organizational level, participants proposed clearer referral processes and improved collaboration between district hospitals and PHC facilities to support follow up of service users and caregivers. At the community level, they recommended awareness activities through local radio and community meetings, and collaboration with traditional leaders and community policing forums. The need for stronger communication and collaboration among health and community stakeholders was emphasised.
CONCLUSIONS:
Integrating caregiver support into existing structures may contribute to equitable rural mental health services. These multilevel strategies align with WHO guidance on community based mental health services involving families and may enhance continuity of care, caregiver well-being, and equitable access in rural settings.5,6
| eISSN: | 2654-1459 |
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