Substance abuse by adolescents may be a problem that contributes to their mental illness. Substance abuse does affect not only the individual who is abusing it but also friends, family and the whole community. The adolescent abusing substances may be mentally unstable and have unpredictable behaviour. There is no research on the experiences of parents with adolescents abusing substances in Giyani, South Africa.
The purpose of the study was to explore and describe the experiences of parents with adolescents abusing substances admitted to a mental health institution in Giyani.
A qualitative, exploratory, descriptive and contextual research design was used. Data were collected by means of conducting individual, in-depth, phenomenological interviews, observations and field notes. The following central question was asked to the participants: ‘How is it for you to have an adolescent who is abusing substances’. Data were analysed by using a thematic method of coding. An independent coder analysed data together with the researcher, and consensus was reached.
Four themes emerged from the data: parents experienced uncontrolled thoughts regarding their adolescent abusing substances, not being able to control their adolescent abusing substances through discipline, negative feelings regarding their adolescent abusing substances and negative consequences regarding their adolescents abusing substances.
From the study result, it is clear that parents with adolescent abusing substances need professional assistance and support as evidenced by the challenges faced in terms of promoting, maintaining and restoring their mental health. Psychiatric nurses should take responsibility to educate the community about substance abuse, for example offering school health programmes. Further research studies can also be conducted in other villages to gain a greater understanding of those parents’ experiences with an adolescent abusing substances.
Substance abuse is a significant problem contributing to individuals’ mental illness. It does affect not only the individuals who are abusing substances but also their family, friends, community and the healthcare system. Substance abuse occurs in all age groups, but adolescents are the most vulnerable population (Taylor
According to the World Health Organization (WHO
In South Africa, 12% of youth experiment with alcohol before the age of 13 years (Reddy et al.
There are many types of substances being abused. These are classified as depressants, stimulants, opioids, hallucinogens and cannabinoids (Nitescu
Dauber et al. (
Parents experience stress and stigma attached to their adolescent who abuses substances. There also seems to be a link between substance abuse and mental illness, as many adolescents suffer from mental illness because of substance abuse (Kalam & Mthembu
Substance abuse poses a far greater threat to adolescents than many parents care to admit (Taylor
The author who initially conducted the research (Hlungwani
Based on the above studies, it is evident that studies have been conducted concerning substance abuse amongst adolescents across the world, including South Africa. Giyani in the Limpopo Province is a deprived rural part of the country, where such studies have not been conducted before. The reason why the researchers decided to conduct this study in Giyani was the unique cultures, values and traditions. There is a gap in the description of the experiences of parents who have adolescents abusing substances in Giyani. This article thus explored and described the experiences of parents with adolescents abusing substances as they provide care for them. The research question that arose from this problem statement is as follows:
What are parents’ experiences of an adolescent abusing substances admitted to a mental health institution in Giyani?
The purpose of this article was to explore and describe the experiences of parents with an adolescent abusing substances admitted to a mental health institution in Giyani.
Experience is the practical involvement in an activity or event, which affects a person directly (Hole & Hawker
Parents are two or more people who regard themselves as family and who perform some typical family functions. These people may or may not be related by blood or marriage, and may or may not live together (Turnbull & Turnbull
Adolescence is the period of life when a child develops into an adult; it is the period from puberty to maturity terminating legally at the age of majority (the age at which full civil rights are accorded) (Merriam-Webster Dictionary
‘Substance’ means chemical, psychoactive substances that are prone to be abused, including tobacco, alcohol, over-the-counter drugs, prescription drugs and substances defined in the
Substance abuse is when the person shows maladaptive substance use resulting in a clinically significant failure to fulfil major role obligations at work, school or home (eds. Uys & Middleton
The research design is qualitative, exploratory, descriptive and contextual. This design was applied to ascertain the fundamental nature of the experiences of parents with an adolescent abusing substances (Creswell
The research was conducted in Giyani, which is one of the municipalities falling within Mopani District Municipality in the Limpopo Province (Greater Giyani Municipality
The population included the parents of adolescents abusing substances admitted to a mental health institution in Giyani. A purposive sampling method was used to select the participants. The author who initially conducted the research selected the participants to be included in the study, namely the parents of an adolescent abusing substances. The sampling size was determined by the in-depth information required for the author to gain insight into the phenomenon (Gray, Grove & Sunderland
Parents who have adolescents between the ages of 15 and 17 years who are abusing substances.
Parents who have given consent to participate in the study.
Parents who are either male or female.
Parents who are able to communicate in English, Xitsonga or Sesotho.
In-depth, phenomenological interviews, observation and field notes are the data collection methods that were used until data saturation was reached. Saturation of data occurs when additional sampling provides no new information, only redundancy of previously collected data (Gray et al.
With the qualitative methodology, data collection and analysis occur at the same time (Creswell
Each interview with the parents of adolescent abusing substances lasted for 45–60 min. The interviews were conducted in a conducive environment free from distractions and noise, and the interviews were audio-recorded with permission from the participants. Observations and field notes were made as part of the data collection methods. The researcher’s observations were retained by using field notes to record activities as well as the researcher’s interpretations of those activities (LoBiondo-Wood & Haber
The transcribed interviews and field notes collected during the interviews on the experiences of parents with an adolescent abusing substances admitted to a mental health institution in Giyani were reduced and organised to give meaning to the data. An independent coder, experienced in qualitative research, was utilised to analyse the data separately from the researcher. The researcher and the independent coder met for a consensus discussion on the results of the data analysis. The researcher used the thematic coding method (Creswell
Guba’s model (Lincoln & Guba
Transferability was enhanced by providing a dense description of the results with direct quotations from the participants’ interviews. A clear and detailed demographic description of the selected samples was provided to transfer the findings to similar contexts. The researcher also triangulated multiple sources of data.
Dependability was enhanced by means of a dense description of the research methodology, where all aspects of the research were fully described. The researcher conducted in-depth, phenomenological, individual interviews and wrote field notes, and she ensured the audit trail by audio recording the interviews. The interviews and field notes were then coded and recoded.
Confirmability was applied through an audit trail of the methods, data and analytical processes presented as a decision trail, subjected to an external audit by a reviewer introduced towards the end of the study. The transcripts, audio-records and field notes will be kept for 2 years as proof of the chain of evidence.
The researcher obtained approval from the ethics committees of the University of Johannesburg, Faculty of Health Sciences Research Ethics Committee (Rec-241112-035) and Limpopo Department of Health Research Ethics Committee (Ref: LP2018), as well as the management of the institution (Ref: S4/2/2), where she worked before the study commenced. The researcher contacted the parents to arrange interviews with them in their home settings. The following four ethical principles governed the study: autonomy, non-maleficence, beneficence and justice (Dhai & McQuoid-Mason
The principle of autonomy was respected by treating participants as autonomous agents who have the freedom to conduct their lives as they choose without external control. The participants were allowed to make an informed decision before signing an informed consent form. Moreover, their confidentiality was respected throughout the study by the researcher not exposing their names.
The principle of non-maleficence was adhered to by conducting interviews in a private place to promote the comfort and confidentiality of the participants. The risk–benefits ratio of the participants was assessed prior to their involvement in this study. Participants were referred to a social worker for debriefing sessions should they have needed it after the interview.
To ensure the principle beneficence, the researcher was sensitive to any signs of emotional discomfort and scheduled individual emotional support as needed. The researcher asked appropriate questions to avoid discomfort that could have occurred throughout the interviews.
To ensure the principle of justice, the researcher guaranteed the fair selection of the participants in the study. The researcher excluded social, cultural, racial and sexual biases in the society (Gray et al.
Eight parents with adolescents abusing substances admitted to a mental health institution in Giyani participated in the primary study. The parents were between the ages of 42–52. They were all black South Africans and met the sampling criteria. The in-depth, phenomenological interviews, which lasted for 45–60 min each, were conducted in Tsonga, and direct quotations were translated into English (Hlungwani
The analysis findings of the transcribed in-depth interviews are summarised in
Themes.
Themes | Description |
---|---|
Theme 1 | Parents experienced uncontrolled thoughts regarding their adolescent abusing substances. |
Theme 2 | Parents experienced not being able to control their adolescent abusing substances through discipline. |
Theme 3 | Parents experienced negative feelings regarding their adolescent abusing substances. |
Theme 4 | Parents experienced negative consequences regarding their adolescent abusing substance. |
The themes are discussed based on those presented in
From the eight interviews that were conducted, it was evidenced that the participants had difficult parental experiences that led to their uncontrolled thoughts. The parents reported that they were fearful that their adolescents would kill them or they would be killed because of their behaviour. This was supported by the following quotation:
‘I fear that when he is under influence of dagga he can kill me. He changed after consuming dagga, I fear him.’ (P4, 52 years old, mother)
Another participant said:
‘I’m not lying that day I was frightened, if he did want to kill me he should have killed me.’ (P7, 48 years, mother)
The participants experienced thoughts of not being good enough parents related to their adolescents abusing substances. Their anxiety could be related to relational conflict, social relationships, lack of cooperation, aggression and experiencing financial strain. This was evidenced by the following:
‘I can’t do anything about it because God gave me this kind of a child.’ (P1, 51 years old, father)
Another participant said:
‘I find it very difficult for me because I’m failing to control him.’ (P2, 49 years old, mother)
The participants experienced wishful thinking regarding their adolescent abusing substances. Parents experienced that the more they pushed their adolescents to work towards a goal, the more the adolescents dug their heels in and resisted them. One of the participants verbalised that she wished her adolescent would die. This was supported by the following quotations:
‘You know what mam those people who beat him at the stadium the time I found him at the hospital, they should have killed him by this time I would’ve forgot.’ (P4, 52 years old, mother)
Another participant also shared:
‘Now is better, I wish that he could stay at the hospital, and never come back.’ (P8, 42 years old, mother)
Participants experienced their adolescents as misbehaving as displayed by their adolescents abusing substances. Participants shared:
‘When he comes back home late he will be singing, making noise and swearing at people on his way home when I try to talk him he promise to beat me.’ (P1, 51 years old, father)
‘You know what, when he comes back he chase us all. We run and hide at our neighbourhood.’ (P4, 52 years old, mother)
Participants experienced that they were unable to discipline their adolescent because there were no recreational facilities and drugs were easily accessible. The following participant alludes to a parent’s expectation of a child who is obedient within a nurturing environment:
‘I find it very difficult because he is my only son and is not listening to me.’ (P6, 46 years old, mother)
Another participant said:
‘Each and every parent when giving birth to the child he/she expects the child to have good behaviour so that she can take good care of him or herself.’ (P4, 52 years old, mother)
Parents experienced various kinds of emotions because of the events that occurred with their adolescents. Participants confirmed that they struggled to understand what was happening to their adolescents. They did not know how to manage their emotions and blamed themselves, as illustrated by the following quotations:
‘Eish, you know what if it was possible to throw the child away I should have done it so that I can get rest.’ (P3, 48 years old, mother)
‘I think maybe there is something wrong I have done when he grow up.’ (P5, 45 years old, mother)
Participants experienced negative feelings, which depicted feelings of helplessness. This was supported by the following direct quotations:
‘Which school, he dropped out of school at grade 11. Can you imagine a person leaving school at grade 11, he was very intelligent everything is over because of dagga and alcohol.’ (P8, 42 years old, mother)
‘As a parent, I was expecting my child to grow like any other child. Going to school so that he can take care of himself when I’m dead.’ (P1, 51 years old, father)
Parents explained that they were shocked by their adolescent’s behaviour. This is revealed in the following quotation:
‘You know the day I realised that he is smoking dagga, my body and my head changed I was feeling somehow.’ (P7, 48 years old, mother)
She continued:
‘Eish, you know I was not expecting something from his educational side, he is a hard worker and can do something amazing with his hands.’ (P7, 48 years old, mother)
Parents stated that they invested a lot in their adolescents, and it was shocking to see them throwing away their future.
Some participants verbalised that they looked for emotional escape as they were unable to express their emotions of sadness. This emotional escape resulted in unhealthy coping mechanisms. Participants explained:
‘Aaa, I’m very sad because first of all when I call his father so we can help each other as parents, maybe he can respect his father he don’t respond well.’ (P3, 48 years old, mother)
‘I expected my child to go to school so that he can take care of himself when I’m gone, so he left school this makes me sad.’ (P5, 45 years old, mother)
Finally, these parents experienced shame that resulted from disappointment and loss of respect. This is supported by the following direct quotations:
‘My neighbours are blaming me that I’m not giving my children rules.’ (P1, 51 years old, father)
Another participant demonstrated this by saying:
‘He took everything he comes across inside the house and sells it for drugs. The TV that we were having we don’t know where it went. He also sold my utensils.’ (P4, 52 years old, mother)
It was clear from the primary study that negative consequences were the effects, results or outcomes from adolescents abusing substances. The participants noted that their health was compromised. Parents with an adolescent abusing substances also mentioned that they were dealing with stress and anxiety caused by the behaviour of their adolescents. Some even had to rely on chronic medication.
Participants thus experienced negative consequences for themselves. Parents experienced a loss of respect, humiliation and embarrassment to the family and the community. This was supported by the following quotations:
‘I was not taking any treatment but since I heard that he is taking drugs I started taking treatment.’ (P6, 46 years old, mother)
‘I took treatment for a long time, not knowing the problem, I realised that it was him who was causing me stress.’ (P5, 45 years old, mother)
‘I did not expect him to drink alcohol and smoke dagga this way, eeee.’ (P6, 46 years old, mother)
Parents experienced negative consequences of impaired family dynamics and impaired family relationships. One of the participants mentioned that the adolescent was very dangerous whilst abusing substances, and the family members were afraid of him. She said:
‘We use to fight each other in this house because of his behaviour.’ (P4, 52 years old, mother)
Other participants expressed:
‘Now we are teaming up as a family and fight against him.’ (P2, 59 years old, mother)
‘When he comes back home he started arguing with us, he found the knife in the kitchen and he wanted to stab his brother. My children are not safe.’ (P7, 48 years old, mother)
Parents experienced negative consequences from the community. This was supported by the following:
‘As a leader in the community people expect my child to be highly disciplined.’ (P1, 51 years old, father)
Another participant revealed:
‘The stigma is affecting the whole family because of this one child who is abusing substances.’ (P6, 42 years old, mother)
Another participant said:
‘My life has changed here in the community there is this saying that says charity begins at home I just wish that my boy one day could quit the drugs.’ (P2, 49 years old, mother)
The objective of this study was to explore and describe the experiences of parents with an adolescent abusing substances admitted to a mental institution in Giyani. In this study, the parents with an adolescent abusing substances experienced uncontrolled thoughts regarding their adolescent abusing substances. They also experienced not being able to control their adolescent abusing substances through discipline, as well as negative feelings regarding their adolescent abusing substances. The participants also expressed experiencing negative consequences regarding their adolescent abusing substances.
Uncontrolled thoughts are unwanted thoughts or images that a person finds distressing and/or disturbing. Uncontrolled thoughts, in the context of this study, included unwanted thoughts that were experienced by parents that caused them great distress and seemed to be about their adolescents who were abusing substances.
Parents wanted to talk about intrusive thoughts in terms of how they could arise, the impact they had on them and what they could do to stop them. This fear pervaded their thoughts. It is alluded by Orfort et al. (
The parents shared their feelings of guilt about failing the adolescent, and they believed that they were responsible for their adolescent’s behaviour. They also said that they were perhaps absent when their adolescents needed them most. Self-blame thus came out very strongly as parents experienced guilt and anger at themselves about their adolescents. They thought that neglect might be what led to the adolescent’s abuse of substances. Parents were also emotionally drained as they were obligated to rescue their adolescents in one way or another, and they continued to blame themselves, saying that they should have been better parents to the adolescents (Kirst-Ashman
The participants who were interviewed articulated that seeing their adolescents destroying their future by dropping out of school caused them stress and really affected them badly. They had dreams of seeing their adolescents with a brighter future. Some parents said that they wished their adolescents did not come back from the psychiatric hospital because their lives were safe, and there was peace in the family when they were absent. Choate (
Parents experienced not being able to control their adolescent abusing substances through discipline. Parents experienced a sense of worthlessness and powerlessness in terms of controlling their adolescent abusing substances. Discipline with love and respect in the family is crucial for any individual’s upbringing.
Parents were miserable because of the behaviour displayed by their adolescents abusing substances. Parents were shocked when their adolescent’s behaviour changed towards them. Some of the parents verbalised how their adolescents became moody and aggressive when they talked to them. According to the study conducted by Dreyer (
Parents discussed their concern about the bad behaviour of their adolescents, in particular the way they are talking to them. Adolescents abusing substances were not listening to their parents when they told them to do something good. The participants experienced an inability to discipline their adolescents abusing substances. Parents’ roles in the family environment include preparing children for adulthood through rules and discipline (Hoskins
Parents experienced negative feelings regarding their adolescent abusing substances. Parents experienced negative emotions from time to time, as they were dealing with their adolescents who are abusing substances. Participants expressed sadness and disappointment as they had higher hopes for their children. Parents wanted to see their adolescents being successful in life and able to take care of themselves when they were dead. Parents were unable to transform these negative emotions into positive emotions and behaviour, as their adolescents were not listening to them. Parents also shared their frustration on how treatment had failed them after all the support they gave their adolescents. The study conducted by Hoeck and Van Hal (
Orfort et al. (
Waini (
Dreyer (
Parents experience negative consequences regarding their adolescent abusing substances. Hoeck and Van Hal (
Participants demonstrated that they wanted progress in their adolescents’ lives. In the study by Masombuka (
It is evidenced from this research that parents with an adolescent abusing substances admitted to a mental health institution in Giyani face a number of challenges in terms of promoting, maintaining and restoring their mental health. The research was conducted in a rural area with parents to gain a richer understanding of the phenomenon under study. There is a need for further exploration regarding how psychiatric nurses can support parents of adolescents abusing substances in other areas. There is also a need for psychiatric nurses to educate communities about substance abuse amongst the adolescents. School health programmes focussing on substance abuse would be beneficial. Further research studies can also be conducted in other villages to gain a greater understanding of those parents’ experiences with an adolescent abusing substances. It is necessary to manage the mental health of the parents holistically as human beings with mind, body and spirit, who also interact with their external environment physically, mentally, socially and spiritually (University of Johannesburg
This research had limitations, including the difficulty experienced in getting willing participants as some feared to verbalise their experiences. The researcher faced constraints regarding the scheduling of appointments with the participants. Participants had busy schedules at their work and home environments. Another limitation that the researcher noted was anxiety; participants were anxious initially but relaxed as the interviews proceeded. The audio recording also added to the participants’ anxiety during interviews. The limitation of unavailability of sufficient time was addressed by means of prolonged engagement to accommodate the participants’ busy schedules. The study was undertaken at the homes of participants, and therefore findings are not representative of all parents with an adolescent abusing substances in Giyani. The author who initially conducted the research on which this article is based also addressed this limitation by indicating that the results are based on the context of this study.
The findings showed that parents with an adolescent abusing substances faced a number of challenges, as evident from their shared experiences. The results displayed that there was poor social support for these individuals; however, there was no doubt that social support is highly valued by the parents. Participants displayed signs of stress and strain and were employing various coping strategies to try to respond to their situation. There was strong evidence of emotionally burdened experiences by the parents because of their adolescent abusing substance. This emphasises the need for further research to be conducted in developing a model for the facilitation of their mental health. It is evident from their nature of challenges and difficulties experienced that these parents need external interventions to facilitate their mental health.
The authors thank Leatitia Romero for language editing of the manuscript.
The authors have declared that no competing interest exists.
All authors contributed equally to this work.
This research received funding from the University of Johannesburg Supervisor grant.
Dara sharing is not applicable to this article as no new data were created or analysed in this study.
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors.