Development of a recovery oriented mental health care programme for nurses in Botswana

Abstract

Mental health issues and mental illness are a global burden, and many people continue to be affected by the responsibility of mental illness directly and indirectly. Therefore, researchers and mental health experts continuously make efforts to deal with mental health issues and support people living with mental illnesses. One such move is the adoption of the recovery-oriented mental health care services, which is more evident in most Western countries. However, Africa is left behind in adopting more evidence-based mental health programmes. In addition, most countries are still operating with none or old mental health policies. Therefore, this study was conducted to develop and validate a recovery-oriented mental health care programme for nurses working in mental health facilities in Botswana. The study received ethical clearance from the North-West University Research Ethics committee and the Ministry of Health and Ethics committee.The study adopted a convergent mixed-method approach, and it was conducted in three phases; the empirical, development and validation. Phase one included the situational analysis, which involved the quantitative and qualitative phases of the scoping review. The scoping review was conducted to find out the origins of the recovery-oriented mental health care problems and where they have been mostly implemented in the hope of finding gaps for further research. The quantitative phase used the Recovery Knowledge Inventory (RKI) scale to assess the knowledge of nurses working in mental health facilities of recovery. Finally, the qualitative phase explored and described the nurses' views of recovery, focusing on how they view the meaning of recovery and how a recovery-oriented mental health care programme for Botswana can be developed and implemented.The findings of phase one of the study were classified according to the Practice Oriented Theory of Dickoff, James and Wildenbach and concept classification was used to develop the conceptual framework for the programme in phase two. Phase three used the developed conceptual framework to develop the programme. The programme showed the involvement of all stakeholders, such as government, mental health facility managers, health care workers, people living with mental illness, community leaders, traditional healers, herbalists, and spiritualists, as necessary to a functional recovery-oriented mental health care programme. In addition, the stakeholders viewed having funds, qualified mental healthcare experts, and policies and standards in place as elements that can facilitate the recovery programme. The developed programme was validated by a health specialist who saw it as relevant for the setting, believed it could boost the recovery of people with mental illness, and recommended it for use. The programme adds to the literature on recovery-oriented practice in Africa.