Family-systems and support for recovery: experiences of mental health service users and their family caregivers in Ghana

Ayim, Mary (2025). Family-systems and support for recovery: experiences of mental health service users and their family caregivers in Ghana. University of Birmingham. Ph.D.

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Abstract

Given the limited access to formal mental health services, which are still underdeveloped, coupled with the prevailing influence of traditional and spiritual perceptions of mental illness, Ghanaian families frequently function as the primary support system and assume the responsibility of care for their members experiencing mental illness. This thesis explores the role of family caregiving and support in the recovery journey of individuals experiencing mental illness in Ghana.
Central to this exploration are the lived experiences of Ghanaian mental health service users and their family caregivers, with a specific focus on how supportive or unsupportive family relationships can shape, facilitate, or hinder recovery. Drawing on relevant literature on systemic and socially based recovery frameworks such as Urie Bronfenbrenner’s (1979) Ecological Systems Theory/Model, Murray Bowen’s (1976) Family Systems Theory, Jerry Tew’s (2013) Recovery Capitals, Robert Weiss’s (1974) Social Provisions Theory and Leamy et al.’s (2011) Recovery Model to examine the social recovery framework in the Ghanaian context, alongside culturally grounded understandings of mental illness, this small-scale research identifies both the enabling and constraining dimensions of family caregiving and relationships towards mental illness recovery.
Employing Creswell’s (2014) explanatory mixed-methods participant selection model and Weiss’s (1974) social provisions scale, 140 service users were randomly sampled and medically screened to participate in the quantitative phase and subsequently 12 participants comprising six service users and their respective six family caregivers were quota sampled to complete the qualitative phase, examining the social interactions between service users and their family caregivers, underscoring how familial support influences service users’ recovery trajectories.
The findings reveal that while supportive family caregiving relationships can enhance social reintegration, attachment, and reassurance of worth (emotional stability), treatment adherence and guidance, and material provisions, they can also reproduce stigma, dependency, interrelation conflicts, negative sociocultural attributions, socioeconomic challenges, and physical burdens when not adequately supported.
Consequently, this thesis argues for enhancing family relationships in the caregiving process and shifting towards a rights-based approach to recovery that recognises the mutual interdependence of caregivers and service users within Ghanaian households. It recommends policy reforms to formally integrate family caregivers into mental health planning, including collaboration between biomedical, traditional, and faith-based systems of care, developing mental health social work practices to champion culturally sensitive psychoeducation programs, and providing psychosocial and economic support to families. By centring the experiences of both mental health service users and their family caregivers, this thesis ultimately contributes to a more holistic understanding of mental illness recovery as a shared and dynamic process within the realities of Ghanaian family and social life.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):