A Qualitative Enquiry on the Experiences of Family Caregivers of Mental Health Care Users in Rural UMkhanyakude Health District, KwaZulu-Natal, South Africa

Background: Globally, family caregivers develop experiences specific to their home caring activities of their mental health care user relatives. This results in them adopting coping strategies and coping mechanisms, which may be positive or negative. The strategies and mechanisms shape the resultant adaptation context from which theoretical frameworks develop over time. Coping is often influenced by the cultural and belief systems, as well as available and received support from personal relationships, which suggests a need to enquire about burden of care among people in different settings. Study Objectives: To identify and describe the coping mechanisms and strategies used by family caregivers of their mental health care user relatives during the home caring process in a rural setting in KwaZulu-Natal. Methods used: In-depth interviews were used to collect data from a sample of 36 family caregivers for chronic and serious mental disorders. Nvivo version 14 was used to analyse the data. Findings: The sample was made up of 36 participants who experienced different levels of burden of care. Nine themes emerged from the data and were classified under the three domains of coping mechanisms/styles; the active behavioural coping mechanisms, the active cognitive coping mechanisms and avoidance coping mechanisms. Themes which were classified under the active behavioural coping mechanisms were, help seeking behaviour, negotiating with MHCU and being firm with the MHCU. Being patient and positive, commitment to care and give everything up to God were the themes which fell under the active cognitive coping mechanisms. Themes grouped under avoidance coping mechanisms were given up hope, walk away from trouble and seeking revenge. Themes under the active cognitive coping mechanisms as well as avoidance coping mechanisms, were the most interchangeably applied by participants in all levels of burden of care; with themes classified under the active behavioural coping mechanisms being the least used. Conclusion: It is recommended that caregivers need to be empowered with coping skills, which will enhance their coping mechanisms.