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South African Journal of Occupational Therapy

On-line version ISSN 0038-2337

Abstract

DUNCAN, Madeleine; SWARTZ, Leslie  and  KATHARD, Harsha. The burden of psychiatric disability on chronically poor households: Part 1 (costs). S. Afr. j. occup. ther. [online]. 2011, vol.41, n.3, pp. 55-63. ISSN 0038-2337.

Studies in occupational therapy on the costs associated with the intersections between chronic poverty and psychiatric disability are rare. This study, published in two parts, identified costs related directly to the illness behaviour of the mentally ill household member which eroded precarious assets including property, disposable income and savings. Psychiatric disability, a feature of social exclusion, added to the indirect cost burden that households with a mentally ill member had to absorb due, in part, to the stigma and cultural sanctions associated with illness behaviours. The multiple layers of action, reaction and interaction by everyone in the household in managing the daily struggle for survival in the presence of mental illness, suggests that disability is multiplied in the context of chronic poverty. Socially engaged occupational therapy, cognisant of the direct and indirect costs of psychiatric disability, could work towards enhancing individual and household resilience through occupation focussed interventions that are aligned with the basic tenets of community based rehabilitation and disability inclusive development.

Keywords : poverty; mental illness; psychiatric disability; cost burden; resilience.

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