Patients’ and healthcare professionals’ perspectives on a community-based intervention for schizophrenia in Pakistan: a focus group study

Khattak, M. I., Dikomitis, L., Khan, M. F., Haq, M. U., Saeed, U., Awan, N. R., Haq, Z. U., Shepherd, T., Mallen, C. D. and Farooq, S. (2022) Patients’ and healthcare professionals’ perspectives on a community-based intervention for schizophrenia in Pakistan: a focus group study. PLoS ONE, 17(8), e0273286. (doi: 10.1371/journal.pone.0273286) (PMID:36037187) (PMCID:PMC9423632)

Abstract

Objective: To explore the perceptions and experiences of schizophrenia from patients, their care givers, health care providers, spiritual and traditional healers to develop a community-based intervention for improving treatment adherence for people with schizophrenia in Pakistan. Methods: This qualitative study involved four focus group discussions (FGD) with a total of 26 participants: patients and carers (n = 5), primary care staff (n = 7), medical technicians (n = 8) and traditional and spiritual healers (n = 6). The participants were selected using purposive sampling method. FGDs were audio-recorded and transcribed. A thematic analysis was applied to the data set. Results: The themes identified were (i) Schizophrenia is not merely a biomedical problem: participants believed that poverty and an inferiority complex resulting from social disparity caused schizophrenia and contributed to non-adherence to medications; (ii) Spiritual healing goes hand in hand with the medical treatment: participants regarded spiritual and traditional treatment methods as an inherent part of schizophrenia patients’ well-being and rehabilitation; (iii) Services for mental illness: mental health is not covered under primary health in a basic health unit: participants believed that the lack of services, training and necessary medication in primary care are major issues for treating schizophrenia in community; (iv) Barriers to community-based interventions: primary care staff believed that multiple pressures on staff, lack of incentives, non-availability of medication and lack of formal referral pathways resulted in disintegration of dealing with schizophrenia patients in primary care facilities. Conclusion: The study has identified a number of barriers and facilitators to developing and delivering a psychosocial intervention to support people living with schizophrenia in Pakistan. In particular, the importance of involving spiritual and traditional healers was highlighted by our diverse group of stakeholders.

• Item Type: Articles
• Additional Information: STOPS+ was funded by a grant from the UK’s Medical Research Council (REF number MR/S00243X/1). Christian Mallen is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration West Midlands and the National Institute for Health Research (NIHR) School for Primary Care Research.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ul Haq, Dr Zia

Creator Roles

Haq, Z. U.: Project administration, Supervision

• Authors: Khattak, M. I., Dikomitis, L., Khan, M. F., Haq, M. U., Saeed, U., Awan, N. R., Haq, Z. U., Shepherd, T., Mallen, C. D., and Farooq, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: PLoS ONE
• Publisher: Public Library of Science
• ISSN: 1932-6203
• ISSN (Online): 1932-6203
• Copyright Holders: Copyright © 2022 Khattak et al.
• First Published: First published in PLoS ONE 17(8): e0273286
• Publisher Policy: Reproduced under a Creative Commons License