Introduction

Psychotic disorders, including schizophrenia, schizoaffective disorder, and delusional disorder, are a group of severe mental illnesses that can significantly impact an individual’s perception of reality, thinking, behavior, and emotions. These disorders affect approximately 3.5% of the general population globally Saha et al., and can have a significant impact on an individual’s quality of life and ability to function. Treating individuals with psychotic disorders can be challenging, requiring a multidisciplinary approach that includes medication, psychotherapy, and psychosocial interventions. Mental health professionals, including psychiatrists, psychologists, social workers, and nurses, play a crucial role in the care of these patients. However, their experience working with psychotic patients can be emotionally and physically demanding and may lead to burnout and high turnover rates [1].

Psychotic disorders are a significant mental health concern in Pakistan, with a prevalence rate estimated to be around 1.2% of the population [2]. The most common psychotic disorders reported in Pakistan are schizophrenia and delusional disorder. Psychotic disorders have a significant impact on the individual’s functioning, quality of life, and social interactions. However, despite the high prevalence of these disorders, mental health services in Pakistan are limited, and there is a significant treatment gap. A study conducted in Pakistan reported that only 15% of individuals with psychotic disorders received appropriate treatment [3].

Prevalence of mental health professionals in Pakistan

The availability of mental health professionals is a critical factor in addressing the treatment gap for individuals with psychotic disorders in Pakistan. However, the number of mental health professionals in Pakistan is low, and there is a significant shortage of trained mental health professionals in both urban and rural areas. According to the World Health Organization (WHO), there are only 0.5 psychiatrists per 100,000 people in Pakistan [4]. The situation is even worse for other mental health professionals such as clinical psychologists, psychiatric nurses, and social workers. The shortage of mental health professionals in Pakistan is a significant barrier to providing adequate care to individuals with psychotic disorders.

The limited number of mental health professionals in Pakistan is further compounded by the lack of training and support for those working in the field. Mental health professionals in Pakistan face significant challenges, including high workloads, lack of resources, inadequate training, and low salaries [5]. These challenges contribute to burnout and high turnover rates among mental health professionals, making it difficult to retain qualified mental health professionals and provide consistent care to individuals with psychotic disorders.

In conclusion, the prevalence of psychotic disorders in Pakistan is high, and the treatment gap is significant. The shortage of mental health professionals and the lack of training and support for those working in the field are significant barriers to providing adequate care to individuals with psychotic disorders. Addressing these challenges will require a significant investment in mental health services, including training and support for mental health professionals, and improving access to mental health services for individuals with psychotic disorders in Pakistan.

Qualitative research is an important tool for exploring the experiences of mental health professionals who work with individuals with psychotic disorders. Qualitative research provides a deeper understanding of the subjective experiences of individuals, allowing for a more nuanced exploration of the challenges and rewards of working with this population. Additionally, qualitative research can provide insights into ways to improve the training and support provided to mental health professionals who work with individuals with psychotic disorders.

The aim of this study is to explore the experiences of mental health professionals who work with individuals with psychotic disorders. The study will use a qualitative methodology to gain a detailed understanding of the challenges and rewards of working with this population. The findings of this study can inform the development of training programs and support initiatives for mental health professionals who work with individuals with psychotic disorders.

Materials and Methods

Participants for this study were mental health professionals (N=12) psychiatrists and psychologists working in different settings, including public and private psychiatric hospitals, community mental health centers, and private practices. Participants were recruited through purposive sampling, where individuals who meet the inclusion criteria will be invited to participate in the study. Inclusion criteria will include mental health professionals who have at least two years of experience working with psychotic patients in Pakistan.

Data will be collected through semi-structured interviews with participants. The interviews will be conducted face-to-face, and each interview will last between 45 min-60 min. The interviews will be audio-recorded with the consent of the participants and transcribed verbatim. The interview questions will be designed to explore the experiences of mental health professionals working with psychotic patients, including their challenges, coping strategies, and support systems. The questions will be open-ended and will allow participants to share their experiences in their own words.

Data analysis will follow a phenomenological approach, which seeks to identify themes and patterns in the data. The analysis will begin with an initial reading of the transcripts to gain a sense of the overall themes and patterns. The data will then be coded and categorized into themes and sub-themes. The themes and sub-themes will be refined through an iterative process of data analysis until no new themes emerge. The analysis will be conducted by two independent researchers to ensure the reliability and validity of the findings.

Ethical considerations

This study will follow ethical guidelines for research involving human subjects. Participants will be informed about the study’s purpose, and their consent will be obtained before the interviews are conducted. The participants will be informed that their participation is voluntary and that they can withdraw at any time without penalty. Confidentiality will be maintained throughout the study, and the data will be stored securely. The study will be approved by the institutional review board before data collection begins.

Results

Theme 1: Challenges faced by mental health professionals

The participants reported several challenges they faced when working with psychotic patients. These challenges included managing violent behaviors, addressing cultural and religious beliefs, dealing with the stigma associated with mental illness, and managing complex medication regimes. One participant stated:

“It’s difficult to manage patients who become aggressive and violent during their episodes. We have to find ways to manage their behaviors while also protecting ourselves and other patients.”

Theme 2: Coping strategies employed by mental health professionals

Participants reported employing various coping strategies to deal with the challenges of working with psychotic patients. These strategies included seeking support from colleagues and supervisors, engaging in self-care activities, and finding meaning and purpose in their work. One participant stated:

“I find that talking to my colleagues about the challenges I face helps me cope. I also try to take care of myself by exercising and spending time with my family.”

Theme 3: Support systems for mental health professionals

Participants reported that having support systems in place was essential to their ability to work with psychotic patients effectively. Support systems included access to supervision and training, having colleagues who could provide support, and having access to resources such as medication and equipment (Table 1).

“Having a supportive supervisor whom I can go to with questions or concerns has been invaluable. It’s also helpful to have colleagues whom I can talk to about difficult cases.”

Overall, the findings suggest that working with psychotic patients in Pakistan is challenging but that mental health professionals employ various coping strategies and rely on support systems to manage these challenges effectively. These findings can inform the development of interventions to support mental health professionals and improve the quality of care for individuals with psychotic disorders in Pakistan.

Discussion

The findings of this qualitative study provide valuable insights into the experiences of mental health professionals working with psychotic patients in Pakistan. The study identified several challenges faced by mental health professionals, including managing violent behaviors, addressing cultural and religious beliefs, dealing with the stigma associated with mental illness, and managing complex medication regimes. These challenges are consistent with the challenges reported in other studies of mental health professionals working with psychotic patients [6].

The study also found that mental health professionals employ various coping strategies to manage these challenges effectively. These strategies included seeking support from colleagues and supervisors, engaging in self- care activities, and finding meaning and purpose in their work. Having access to support systems, including supervision and training, colleagues, and resources such as medication and equipment, was also essential to mental health professionals’ ability to manage these challenges effectively.

The findings of this study have several implications for mental health services in Pakistan. First, there is a need for increased support for mental health professionals working with psychotic patients. This support could include additional training and supervision, access to resources such as medication and equipment, and interventions to address stigma and cultural and religious beliefs. Second, mental health services could benefit from greater collaboration between mental health professionals and other stakeholders, such as family members, community leaders, and religious leaders, to address the cultural and religious beliefs that can impact the care of individuals with psychotic disorders. Third, interventions to promote mental health professionals’ self-care and well-being could help to reduce burnout and improve the quality of care provided to individuals with psychotic disorders.

It is important to acknowledge the limitations of this study. The sample size was relatively small, and the participants were recruited through purposive sampling, which could limit the generalizability of the findings. The study was also conducted in a specific cultural context, and the findings may not be applicable to other settings. Future research could address these limitations by using larger samples and recruiting participants from a variety of settings and cultural contexts [7,8].

Conclusion

This qualitative study provides valuable insights into the experiences of mental health professionals working with psychotic patients in Pakistan. The findings highlight the challenges faced by mental health professionals and the coping strategies and support systems they employ to manage these challenges effectively. These findings can inform the development of interventions to support mental health professionals and improve the quality of care for individuals with psychotic disorders in Pakistan.

Limitations and Future Recommendations

• Small sample size: The study was conducted with a relatively small sample size, which may limit the generalizability of the findings.

• Recruitment strategy: Participants were recruited through purposive sampling, which may introduce bias into the sample selection process. It is possible that the participants who agreed to participate in the study may have had unique experiences that differ from those who did not participate.

• Limited geographic scope: The study was conducted in a specific geographic location in Pakistan, which may limit the generalizability of the findings to other regions.

• Potential for social desirability bias: Participants may have provided socially desirable responses, which could limit the accuracy of the findings.

• Lack of quantitative data: The study was qualitative in nature, which may limit the ability to draw generalizable conclusions about the prevalence or frequency of certain experiences or themes.

• Potential for researcher bias: The researcher’s own biases and perspectives may have influenced the interpretation of the data and the identification of themes.

It is important to acknowledge these limitations when interpreting the findings of the study. Future research could address these limitations by using larger sample sizes, recruiting participants from a variety of settings and cultural contexts, and using both qualitative and quantitative methods to provide a more comprehensive understanding of the experiences of mental health professionals working with psychotic patients in Pakistan.

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Citation: Experience of Mental Health Professional Working with Patients of Psychotic Disorder: A Qualitative Study. ASEAN Journal of Psychiatry, Vol. 24(S4) March, 2024; 1-5.