Experiences and Support Needs of Caregivers of Clients Diagnosed with a Mental Illness Regarding Compliance to Psychotropic Drugs in Malawi
DOI:
https://doi.org/10.25159/2520-5293/20917Keywords:
caregivers, mentally ill diagnosed clients, medication non-adherence, psychotropic drugs, qualitative researchAbstract
Mental illness is one of the chronic illnesses which require support from caregivers throughout the life trajectory of clients. Caregivers meet a lot of psychosocial challenges in the process of caring for clients. Despite experiencing psychosocial challenges, caregivers are not supported in their role. This study explored the experiences and support needs of caregivers of clients diagnosed with mental illness regarding compliance to psychotropic drugs at Mangochi District Hospital in Malawi. The study found that caregiver experiences related to cultural beliefs, false perceptions of the mental well-being, stigma, relapse of the patients’ condition and frequent hospitalisation. In addition, it showed that caregivers lacked knowledge on the importance of drug compliance, resources and accessibility to the services.
References
Alyafei, A.H., Alqunaibet, T., Mansour, H., Ali, A. and Billings, J. 2021. “The Experiences of Family Caregivers of People with Severe Mental Illness in the Middle East: A Systematic Review and Meta-synthesis of Qualitative Data.” Plos one 16(7). https://doi.org/10.1371/journal.pone.0254351 DOI: https://doi.org/10.1371/journal.pone.0254351
Bosworth, C., Watsford, C., Buckmaster, D. and Rickwood, D. 2024. “Caregiver Involvement in Psychotherapy for Young People with Borderline Personality Disorder and Borderline Personality Disorder Features: A Systematic Review.” Clinical Psychology and Psychotherapy 31(6). https://onlinelibrary.wiley.com/doi/abs/10.1002/cpp.70027 https://doi.org/10.1002/cpp.70027 DOI: https://doi.org/10.1002/cpp.70027
Butas, A. (2020). “Things a Family Caregiver Needs Most.” homecareassistancemesa.com.
Casteel, A. and Bradier, N.L. 2021. “Describing Populations and Samples in Doctoral Student Research.” International Journal of Doctoral Studies 16(1): 339–362. https://doi.org/10.28945/4766 DOI: https://doi.org/10.28945/4766
Cham, C.Q., Ibrahim, N., Siau, C.S., Kalaman, C.R., Ho, M.C., Yahya, A.N. and Lee, K. W. 2022. “Caregiver Burden Among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-analysis.” Healthcare 10(12): 4–16 MDPI. https://doi.org/10.3390/healthcare10122423 DOI: https://doi.org/10.3390/healthcare10122423
Chittenden, K. 2022. “Patient Non-compliance: A Barrier to Successful Outcomes in Medicine and Healthcare Service. Journal of Clinical Case Studies Reviews & Reports 4(12): 1–4. https://www.academia.edu/download/96483991/patient_noncompliance_a_barrier_to_successful_outcomes_in_medicine_and_healthcare_service_1_.pdf https://doi.org/10.47363/JCCSR/2022(4)236 DOI: https://doi.org/10.47363/JCCSR/2022(4)236
Cruz, E., Pare, M.A., Stan, C., Voth, J., Ward, L. and Taboun, M. 2024. “Caring for the Caregiver: An Exploration of Experiences of Caregivers of Adults with Mental Illness.” Qualitative Research in Health 5: 1–9 https://doi.org/10.1016/j.ssmqr.2-24.100406 DOI: https://doi.org/10.1016/j.ssmqr.2024.100406
Creswell, J.W. and Creswell, J.D. 2017. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Sage Publications, Dublin City.
Cutler, R.L., Fernandez-Llimos, F., Frommer, M., Benrimoj, C. and Garcia-Cardenas, V. 2018. “Economic Impact of Medication Non-adherence by Disease Groups: A Systematic Review.” British Medical Journal Open I 8(1), e016982. https://doi.org/10.1136/bmjopen-2017-016982 DOI: https://doi.org/10.1136/bmjopen-2017-016982
Daliri, D.B., Afaya, A., Laari, T.T., Abagye, N. and Aninanya, G.A. 2024. “Exploring the Burden on Family Caregivers in Providing Care for Their Mentally ill Relatives in the Upper East Region of Ghana.” PLOS Global Public Health4(4), e0003075. https://doi.org/10.1371/journal.pgph.0003075 DOI: https://doi.org/10.1371/journal.pgph.0003075
Di Lorenzo, R., Dardi, A., Serafini, V., Amorado, M.J., Ferri, P. and Filippini T. 2024. “Psychoeducational Intervention for Caregivers of Adolescents and Young Adults with Psychiatric Disorders: A 7-year Systematic Review.” Journal of Clinical Medicine 13:1–26. https://doi.org/10.3390/jcm13237010 DOI: https://doi.org/10.3390/jcm13237010
Docrat, S., Besada, D., Cleary, S., Daviaud, E. and Lund, C. 2019. “Mental Health System Costs, Resources and Constraints in South Africa: A National Survey.” Health Policy Plan 34(9): 706–719. https://doi.org/10.1093/heapol/czz085 DOI: https://doi.org/10.1093/heapol/czz085
Dohm, M.A.K., Hammonds, L.S. and Gehyigon, P. 2025. “Costly Consequences: Increasing Medication Adherence to Support Mental Health Stability.” Creative Nursing 31:2. https://doi.org/10.1177/10784535251327563. DOI: https://doi.org/10.1177/10784535251327563
Downey, P.M, Collins, J.C., El-Den, S. and O’Reilly, C.L. 2025. “Caregivers’ Perspectives Regarding the use of Psychotropic Medication in Children and Young Adults: A Systematic Review.” International Journal of Social Psychiatry 1–17. https://doi.org/10.1177/00207640251384126 DOI: https://doi.org/10.1177/00207640251384126
Ghosh, P., Balasundaram, S., Sankaran, A., Chandraseka, V., Sarkar, S. and Choudhury, S. 2022. “Factors Associated with Medication Non-adherence Among Patients with Severe Mental Disorder: A Cross-sectional Study in a Tertiary Care Centre.” Exploratory Research In Clinical and Social Pharmacy 7: 1–6 https://dx.doi.org/10.1016/j.resop.2022.100178 DOI: https://doi.org/10.1016/j.rcsop.2022.100178
Gonani, C.G. 2019. “Family Caregiving in Mental Health: Experience of Family Caregivers of People Living with Severe Mental Illness in Rural Malawi.” Master’s thesis, Havard Medical School. https://dash.harvard.edu/server/api/core/bitstreams/8fe033d5-b47b-4083-9757-0686159fbaa5/content
Health Management Information System (HMIS). 2021. Mangochi Health Management Information System (HMIS) Hospital Data.
Issac, A., Nayak, S.G., George, R., Priyadarshini, T. and Jacob, J. 2025. “Barriers and Facilitators to Medication Adherence Among Individuals with Mental Disorders: A Qualitative Systematic Review and Evidence Synthesis.” Nursing and Health Sciences, 27(2), e70153. https://doi.org/10.1111/nhs.70153 DOI: https://doi.org/10.1111/nhs.70153
Kleinheksel, A.J., Rockich-Winston, N., Tawfik, H. and Wyatt, T.R. 2020. “Qualitative Research in Pharmacy Education: Demystifying Content Analysis.” American Journal of Pharmaceutical Education 84(1), 127–137. https://doi.org/10.5688/ajpe7113 DOI: https://doi.org/10.5688/ajpe7113
Lincoln, Y.S. and Guba, E.G. 1986. “But is it Rigorous? Trustworthiness and Authenticity in Naturalistic Evaluation. New Directions for Program Evaluation.” 1986 (30), 73–84. https://doi.org/10.1002/ev.1427 DOI: https://doi.org/10.1002/ev.1427
Malhotra, R. and Lim-Soh, J. 2024. “Family Caregiving: Time-varying Contexts of Social Support, Finances, Burden and Benefits.” Innovational Aging 8:198. DOI:10.1093/geroni/igae098.0639 DOI: https://doi.org/10.1093/geroni/igae098.0639
Matambela, K.C. 2024. “Factors Influencing Family Decision-making on Mental Health Care Systems in the Vhembe District, South Africa: Exploring Witchcraft Beliefs and Conflicting Care Practices.” African Journal of Development Studies14(2), 29–52 https://doi.org/10.31920/2634-3649/2024/v14n2a2 DOI: https://doi.org/10.31920/2634-3649/2024/v14n2a2
Mekani, P., Mugomeri, E., Mbuba, C.K. and Mbakaya, B.C., 2023. “Clinic Appointments and Medication Adherence Among Patients Accessing Mental Health Services in Central Malawi: A Cross-sectional Analytical Study. Research Square. https://doi.org/10.21203/rs.3.rs-2934648/v1 DOI: https://doi.org/10.21203/rs.3.rs-2934648/v1
Mokwena, K.E. and Ndlovu, J. 2021. “Why do Patients with Mental Disorders Default Treatment? A Qualitative Enquiry in Rural Kwazulu-Natal, South Africa.” Healthcare 9: 461. https://doi.org/10.3390/healthcare9040461. DOI: https://doi.org/10.3390/healthcare9040461
Malawi Ministry of Health (Accessed December 2025). Malawi Health Sector Strategic Plan III, 2023–2030. Reforming for Universal Health Coverage. Malawi Health Sector Strategic Plan 2023_2030.pdf
Monnapula-Mazabane, P. and Petersen, I. 2023. “Mental Health Stigma Experiences Among Caregivers and Service Users in South Africa: A Qualitative Investigation. Curr Psychol 42: 9439–9427. https://doi.org/10.1007/s12144-021-02236-y DOI: https://doi.org/10.1007/s12144-021-02236-y
National Statistical Office (NSO). 2020. The Fifth Integrated Household Survey (IHS5) 2020 report. Malawi Government Printers. Accessed from www.nsomalawi.mw
Ntsayagae, E.J., Poggenpoel, M. and Myburgh, C. 2019. “Experiences of Family Caregivers of Persons Living with Mental Illness: A Meta-synthesis.” Curations 42(1): 1–9. https://doi.org/10.4102/curationis.v42i1.1900 DOI: https://doi.org/10.4102/curationis.v42i1.1900
Sakwape, K, Kovane, G.P., Chukwuere, P.C., Moagi, M.M. and Machailo, R. 2025. “Exploring the Needs of Family Caregivers of People Living with Mental Illness: A Qualitative Study in Lobatse, Botswana.” BMC Nursing 24: 1–11. https://doi.org/10.1186/s12012-025-02813-7 DOI: https://doi.org/10.1186/s12912-025-02813-7
Seena M.C., George R., Krishnakumar P., Ravindran, R.K. 2021. “Non-compliance to Treatment Among Persons with Mental Illness.” Indian Journal of Psychiatric Nursing (18):43–48. DOI:10.4103/iopn.iopn_54_20 DOI: https://doi.org/10.4103/iopn.iopn_54_20
Sharif, L., Basri, S., Alsahafi, F., Altaylouni, M., Albugumi, S., Banakhar, M., Mahsoon, A., Alasmee, N. and Wright, R.J. 2020. “An Exploration of Family Caregiver Experience of Burden and Coping While Caring for People with Mental Disorder in Saudi Arabia: A Qualitative Study.” International Journal of Environmental Research and Public Health, 17 (17): 1–15. https://doi.org/10.3390/ijerph17176405 DOI: https://doi.org/10.3390/ijerph17176405
Shimange, M.E., Poggenpoel, M., Myburgh, C.P. and Ntshingila, N. 2022. “Lived Experiences of Family Members Caring for a Relative with Mental Illness.” International Journal of Africa Nursing Sciences 16: 1–7. https://doi.org/10.1016/j.ijans.2022.100408 DOI: https://doi.org/10.1016/j.ijans.2022.100408
Silaule, O., Nkosi, N.G. and Adams, F. 2024. “Experiences of Burden of Care and Support Needs of Informal Caregivers of Persons with Severe Mental Disorders in Rural South Africa: A Qualitative Study.” Mental Illness 2024, 1–14. https://doi.org/10.1155/mij/7186759 DOI: https://doi.org/10.1155/mij/7186759
Tadesse, G., Geremew, G.W., Alemayehu, T.T., Getachew, D., Demelash, D. and Fentahun, S. 2025. “Psychotropic Medication Non-adherence and its Determinants Among People Living with Mental Illnesses in Ethiopia: Systematic Review and Meta-analysis Study.” BMC Public Health 25:13–33. https://doi.org/10.1186/s12889-025-22408-w DOI: https://doi.org/10.1186/s12889-025-22408-w
Velásquez, M.J.A. and Carrión, I.P.S., 2024. “Adherence to Psychopharmacological Treatment in Patients with Severe and Persistent Mental Disorders: A Systematic Review.” Revista Colombiana de Psiquiatría (English ed.) 53(2): 192–205. https://doi.org/10.1016/j.rcpeng.2022.01.004 DOI: https://doi.org/10.1016/j.rcpeng.2022.01.004
Verity, F., Turiho, A., Mutamba, B.B. and Cappo, D. 2021. “Family care for Persons with Severe Mental Illness: Experiences and Perspectives of Caregivers in Uganda.” International Journal of Mental Health Systems 15(1): 48. https://doi.org/10.1186/s13033-021-00470-2 DOI: https://doi.org/10.1186/s13033-021-00470-2
Wiley. 2019. “Psychotropic Drug Use among Caregivers of Patients with Dementia –Clipp-1990.” Journal of the American Geriatrics Society –Wiley Online Library https: // agsjournals.onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.1990.tb03496.x
Xiong, L. 2023. “Psychoeducation: Enhancing Mental Health Awareness and Empowering Individuals.” Clinical Neuropsychology 6 (3): 1–4. https://doi.org/ 10.4174/cnoa.1000178
Zwide, G.E., Dewet, Z.T. and Sokudela, F.B., 2025. “Medication Non-adherence in Re-admitted Patients at a Psychiatric Hospital: A Qualitative Study.” South African Journal of Psychiatry 31(0): 23–45. https://doi.org/10.4102/sajpsychiatry.v31i0.2345 DOI: https://doi.org/10.4102/sajpsychiatry.v31i0.2345
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Unisa PressAccepted 2026-01-23
Published 2026-06-23