“I Want to Stop Using Substances, But I Cannot”: Lived Experiences of Mental Health Care Users with Substance-Induced Psychosis

Abstract

Substance-induced psychosis presents a significant mental health challenge in resource-constrained communities in Limpopo Province, South Africa, where poverty, unemployment, stigma and limited support may complicate recovery following psychiatric care. Although research has largely emphasised neurobiological relationships between substance use and psychosis, this focus may inadequately explain recurrent post-discharge relapse when the social conditions shaping mental illness and recovery remain unaddressed. This qualitative exploratory study examined how mental health care users experience substance-induced psychosis, treatment, relapse and recovery within these conditions. Five participants were purposively selected to enable an in-depth, idiographic exploration of their direct experiences, and data were generated through semi-structured interviews. Findings revealed a recurring cycle of psychiatric stabilisation followed by relapse after discharge, as participants returned to environments marked by substance availability, unemployment, stigma and limited opportunities for social reintegration. Beyond difficulties discontinuing substance use, participants experienced disrupted identities, strained relationships and diminished social acceptance associated with psychosis and repeated psychiatric admission. Participants nevertheless expressed aspirations for recovery, dignity and belonging. Informed by Bourdieu’s theory of practice and Moltmann’s theology of hope, the study demonstrates that addressing social conditions alongside clinical treatment is important for understanding relapse and strengthening sustained recovery and community reintegration after psychiatric discharge.