Assessment of functional disability and associated factors among people with severe mental illness attending care at public hospitals in Harar town, Eastern Ethiopia: a cross-sectional study

BMJ Open. 2025 Aug 10;15(8):e088681. doi: 10.1136/bmjopen-2024-088681.

ABSTRACT

OBJECTIVE: This study aimed to assess functional disability and associated factors among people with severe mental illness attending public hospitals in Harar town, Eastern Ethiopia.

SETTING: An institution-based cross-sectional study was conducted in public hospitals found in Harar town, Eastern Ethiopia, from 1 April to 10 May 2023.

PARTICIPANTS: A total of 342 patients with severe mental illness attending public hospitals in Harar town, Eastern Ethiopia, were included.

OUTCOME MEASURE: The main outcome of this study was functional disability, which was measured using a 12-item version of the WHO Disability Assessment Schedule.

RESULTS: In this study, the mean (±) score of functional disability among patients with severe mental illness was 31.8 (±9.6) (95% CI: 30.7 to 32.8). The multiple linear regression model revealed that unemployment (β: 1.93; 95% CI: 0.28 to 3.59), total illness duration (5-10 years and above 10 years) (β: 3.71; 95% CI: 1.95 to 5.48 and β: 4.51; 95% CI: 2.41 to 6.62, respectively), age at illness onset (β: -0.37; 95% CI: -0.45 to -0.28), having drug side effects (β: 3.05; 95% CI: 1.46 to 4.63), medication non-adherence (β: 6.15; 95% CI: 4.56 to 7.73) and having high perceived stigma (β: 2.27; 95% CI: 0.72 to 3.82) were significantly associated with functional disability.

CONCLUSION: Patients with severe mental illness had a high mean functional disability score. Unemployment, age at onset of mental illness, total duration of illness, medication side effects, medication non-adherence and higher perceived stigma were factors that were associated with functional disability. Given the mean functional disability score observed among respondents, a multipronged intervention strategy that prioritises early detection and management of severe mental illness, particularly targeting individuals at risk, is recommended to mitigate disability and enhance quality of life.

PMID:40784782 | DOI:10.1136/bmjopen-2024-088681