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South African Journal of Occupational Therapy
versión On-line ISSN 2310-3833
versión impresa ISSN 0038-2337
S. Afr. j. occup. ther. vol.41 no.3 Pretoria 2011
ARTICLES
The burden of psychiatric disability on chronically poor households: Part 2 (coping)
Madeleine DuncanI; Leslie SwartzII; Harsha KathardIII
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
ABSTRACT
Studies in occupational therapy on the strategies which people with psychiatric disability and their households use to navigate the daily struggle for survival in the context of chronic poverty are rare. This qualitative study, published in two parts, identified multiple layers of action, reaction and interaction used by everyone in the household to cope with the demands of daily subsistence including the costs of poor mental health. Major organising ideas centred on the discursive social forces that shaped people's daily activities, tasks and roles. While poverty aggravates the precarious situation of mentally ill individuals and their households, they mobilise coping strategies by drawing on locally relevant ways of knowing and 'being-in-the-world'. Socially engaged occupational therapy, cognisant of the cost burden of psychiatric disability, could work towards enhancing individual and household resilience through occupation focussed interventions that strengthen self-action and inter-action within indigenous explanatory frameworks.
Key words: poverty, psychiatric disability, coping strategies, relational economy
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Correspondence:
E. M. Duncan
E-mail: eve.duncan@uct.ac.za