Poverty alleviation for people with severe mental health conditions in South Africa: A qualitative study
6 affiliations
- 1Nottingham Centre of Public Health and Epidemiology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- 2Institute of Mental Health, University of Nottingham, United Kingdom
- 3Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, South Africa
- 4Discipline of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- 5Division of Psychiatry, Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, Scotland, United Kingdom
- 6Department of Psychiatry and WHO Collaborating Centre in Mental Health Research and Capacity Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Abstract
People with severe mental health conditions (SMHC) and caregivers in South Africa often experience poverty. The PRIZE trial found that recovery groups were acceptable, feasible and potentially effective in reducing relapse. Addressing economic needs was identified as a means to increase impact. This study aimed to understand the acceptability of poverty alleviation interventions as an adjunct to psychosocial interventions.We conducted two focus group discussions and 12 in-depth interviews with 14 people with SMHC and 13 caregivers in Eastern Cape Province, South Africa. An inductive thematic analysis was conducted. We identified four themes. 1: Financial insecurity as a defining influence on life. Participants perceived financial security as crucial to recovery. However, financial insecurity was entrenched due to violence in neighbourhoods and fractured communities.2: Government disability grants are not a panacea. There were difficulties accessing disability grants. Whilst welcomed, they sometimes caused problems such as family disagreements about how the money was spent.3: Group savings offer tentative hope if carefully managed. Several caregivers had experiences of community-based credit unions. However, some were fearful of members absconding with funds. Participants emphasised that trust, safety and fairness are essential for successful group savings. 4: Income-generating activities are desired but need capital and come with safety concerns. Many had ideas and motivation for small businesses but needed financial capital. There were concerns that gaining wealth could make one a target of crime. Poverty alleviation interventions could positively impact the wellbeing of people with SMHC in South Africa as an adjunct to psychosocial interventions and psychiatric care. Approaches could include supporting access to social protection or existing savings groups, and nesting new savings groups or income generation initiatives into psychosocial interventions. Any model would need to incorporate mechanisms to ensure participants’ safety and would be enhanced by public health interventions to build social capital and reduce violence.
Related
- ‘People need to be a bit more understanding that my body is wrecked’: A qualitative exploration of inpatient hospital care for people living with multiple long-term conditions
- Negotiating belonging and identity across the life course: A qualitative study using Social Identity Mapping with people with psychosis
- Supporting physical activity through co-production in people with severe mental illness (SPACES): study protocol for a pragmatic, parallel-group randomised controlled trial.
- Moving towards integrated people-centred primary healthcare for non-communicable diseases in Bangladesh: a qualitative study
- Antiretroviral therapy, perceived health, and fertility decision-making among people living with HIV: a qualitative study at a district antiretroviral therapy clinic in the Ashanti Region, Ghana
BibTeX
@article{asher2026poverty,
title = {{Poverty alleviation for people with severe mental health conditions in South Africa: A qualitative study}},
author = {Laura Asher and Bongwekazi Rapiya and Bonginkosi Chiliza and Charlotte Hanlon and Inge Petersen and Carrie Brooke-Sumner},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0006551},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006551},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Poverty alleviation for people with severe mental health conditions in South Africa: A qualitative study
AU - Laura Asher
AU - Bongwekazi Rapiya
AU - Bonginkosi Chiliza
AU - Charlotte Hanlon
AU - Inge Petersen
AU - Carrie Brooke-Sumner
PY - 2026
DA - 2026/09/09
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0006551
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006551
AB - People with severe mental health conditions (SMHC) and caregivers in South Africa often experience poverty. The PRIZE trial found that recovery groups were acceptable, feasible and potentially effective in reducing relapse. Addressing economic needs was identified as a means to increase impact. This study aimed to understand the acceptability of poverty alleviation interventions as an adjunct to psychosocial interventions.We conducted two focus group discussions and 12 in-depth interviews with 14 people with SMHC and 13 caregivers in Eastern Cape Province, South Africa. An inductive thematic analysis was conducted. We identified four themes. 1: Financial insecurity as a defining influence on life. Participants perceived financial security as crucial to recovery. However, financial insecurity was entrenched due to violence in neighbourhoods and fractured communities.2: Government disability grants are not a panacea. There were difficulties accessing disability grants. Whilst welcomed, they sometimes caused problems such as family disagreements about how the money was spent.3: Group savings offer tentative hope if carefully managed. Several caregivers had experiences of community-based credit unions. However, some were fearful of members absconding with funds. Participants emphasised that trust, safety and fairness are essential for successful group savings. 4: Income-generating activities are desired but need capital and come with safety concerns. Many had ideas and motivation for small businesses but needed financial capital. There were concerns that gaining wealth could make one a target of crime. Poverty alleviation interventions could positively impact the wellbeing of people with SMHC in South Africa as an adjunct to psychosocial interventions and psychiatric care. Approaches could include supporting access to social protection or existing savings groups, and nesting new savings groups or income generation initiatives into psychosocial interventions. Any model would need to incorporate mechanisms to ensure participants’ safety and would be enhanced by public health interventions to build social capital and reduce violence.
SN - 2767-3375
ER -