ARTICLES

 

The burden of psychiatric disability on chronically poor households: Part 1 (costs)

 

 

Madeleine Duncan^I; Leslie Swartz^II; Harsha Kathard^III

^IMSc OT (UCT), D.Phil (Psych) (Stell). Associate Professor, Division of Occupational Therapy, University of Cape Town
^IIPhD. Professor, Department of Psychology, University of Stellenbosch
^IIID.Ed. Associate Professor and Director, Department of Health and Rehabilitation Sciences, University of Cape Town

Correspondence

 

 

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ABSTRACT

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.

Key words: poverty, mental illness, psychiatric disability, cost burden, resilience

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Correspondence:
E. M. Duncan
E-mail: eve.duncan@uct.ac.za