title: The psychosocial problems of families caring for relatives with mental illnesses and their coping strategies: a qualitative urban based study in Dar es Salaam, Tanzania.
abstract: BACKGROUND
  Mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient's family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family as a whole. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons. The aim of the study was to determine the psychosocial problems of mental illness on the family including the coping strategies utilized by family members caring for a person with mental illness.
  
  
  METHODS
  A qualitative study was conducted, involving four focus group discussions and 2 in-depth interviews of family members who were caring for patient with mental illness at Temeke Municipality, Dar es Salaam. Purposive sampling procedure was used to select participants for the study. Audio-recorded interviews in Swahili were conducted with all study participants. The recorded interview was transcribed and qualitative content thematic analysis was used to analyse the data.
  
  
  RESULTS
  Financial constraints, lack of social support, disruption of family functioning, stigma, discrimination, and patients' disruptive behaviour emerged as the main themes in this study. Acceptance and religious practice emerged as the major coping strategies used by family members.
  
  
  CONCLUSIONS
  Familial care for a person with mental illness has its advantages, yet it has multiple social and psychological challenges. Coping strategies and skills are important for the well-being of the caregiver and the patient. Addressing these psychosocial challenges requires a collaborative approach between the health care providers and government so that the needs of the family caregivers and those of the patients can be addressed accordingly.
authors.affiliation: Department of Clinical Nursing, Muhimbili University of Health & Allied Sciences (MUHAS), P.O.Box 65004, Dar es Salaam, Tanzania. masungaiseselo@yahoo.com.
authors.forename: Masunga K
authors.initials: MK
authors.lastname: Iseselo
authors.affiliation: Department of Psychiatry and Mental Health, Muhimbili University of Health & Allied Sciences (MUHAS), P.O.Box 65001, Dar es Salaam, Tanzania.
authors.forename: Lusajo
authors.initials: L
authors.lastname: Kajula
authors.affiliation: Tanzania Commission for Science & Technology (COSTECH), Ali Hassan Mwinyi Road, Kijitonyama (Sayansi) COSTECH Building, P.O. Box 4302, Dar es Salaam, Tanzania.
authors.forename: Khadija I
authors.initials: KI
authors.lastname: Yahya-Malima
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000534:rehabilitation; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D057545:Social Stigma; D012944:Social Support; D013636:Tanzania; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Caregiver; Mental illness; Psychosocial problems; Relatives