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Original Research
Unmet needs of young adults following first-episode psychosis in KwaZulu-Natal, South Africa: Baseline findings from a pilot randomised controlled trial of basic income support
Submitted: 06 December 2024 | Published: 16 February 2026
About the author(s)
Joyce P. Mlay, Discipline of Public Health Medicine, School of Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South AfricaVuyokazi Ntlantsana, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Neliswa Gcabashe, Discipline of Nursing, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Lise Jamieson, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
Thirusha Naidu, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Canada; and, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
Busisiwe S. Bhengu, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Lindokuhle T. Thela, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Saeeda Paruk, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Jonathan K. Burns, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
Bonginkosi Chiliza, Discipline of Psychiatry, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Richard Lessells, Centre for the AIDS Programme of Research in South Africa, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Andrew Tomita, KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Centre for Rural Health, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Abstract
Background: People with psychosis have multiple and complex needs. The first episode of psychosis (FEP), as a distinct health challenge that occurs frequently during adolescence or early adult years, is a serious threat because of high levels of poverty among the youth in South Africa.
Aim: This study quantifies the needs among unemployed FEP adults aged 18–29 in South Africa for potential early intervention targeting.
Setting: The study was conducted at government psychiatric facilities in Msunduzi Municipality, KwaZulu-Natal province, South Africa.
Methods: As part of a pilot randomised controlled trial of an unconditional cash transfer (UCT) intervention, also known as basic income support (BIS), 60 FEP participants were enrolled, and we assessed their needs using the Camberwell Assessment of Needs, the Household Food Insecurity Access Scale and the Water Insecurity Experience Scale. Descriptive cross-sectional analyses were summarised for various domains of needs.
Results: Most participants were black people (n = 58, 96.7%), male (n = 47, 78.3%), with a median age of 23 years (Interquartile Range [IQR] = 20.0–25.5), with half being diagnosed with schizophrenia (n = 30, 50%). The most significant severe unmet need was the inability to access government benefits to which one is entitled. Despite the limited availability of mental health services in South Africa, the majority reported that their need for managing psychotic symptoms was met or partially met.
Conclusion: The needs of youth must go beyond the temporary management of psychotic symptoms.
Contribution: This study highlights the unmet needs of young adults with FEP in resource-constrained environments and underscores the need for integrated interventions.
Keywords
Sustainable Development Goal
Metrics
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