Planning for district mental health services in South Africa: a situational analysis of a rural district site
Inge Petersen,Arvin Bhana,Arvin Bhana,Victoria Campbell-Hall,Sithembile Mjadu,Crick Lund,Sharon Kleintjies,Victoria Hosegood,Alan J. Flisher,Alan J. Flisher +9 more
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TLDR
It is suggested that, in a similar vein to other low- to middle-income countries, deinstitutionalization and comprehensive integrated mental health care in South Africa is hampered by a lack of resources for mentally health care within the primary health care resource package, as well as the inefficient use of existing mental health resources.Abstract:
The shift in emphasis to universal primary health care in post-apartheid South Africa has been accompanied by a process of decentralization of mental health services to district level, as set out in the new Mental Health Care Act, no. 17, of 2002 and the 1997 White Paper on the Transformation of the Health System. This study sought to assess progress in South Africa with respect to deinstitutionalization and the integration of mental health into primary health care, with a view to understanding the resource implications of these processes at district level. A situational analysis in one district site, typical of rural areas in South Africa, was conducted, based on qualitative interviews with key stakeholders and the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). The findings suggest that the decentralization process remains largely limited to emergency management of psychiatric patients and ongoing psychopharmacological care of patients with stabilized chronic conditions. We suggest that, in a similar vein to other low- to middle-income countries, deinstitutionalization and comprehensive integrated mental health care in South Africa is hampered by a lack of resources for mental health care within the primary health care resource package, as well as the inefficient use of existing mental health resources.read more
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Scale up of services for mental health in low-income and middle-income countries.
Julian Eaton,Layla McCay,Maya Semrau,Sudipto Chatterjee,Florence Baingana,Ricardo Araya,Christina Ntulo,Graham Thornicroft,Shekhar Saxena +8 more
TL;DR: Assessment of progress in scaling up mental health services worldwide using a systematic review of literature and a survey of key national stakeholders in mental health suggested that successful strategies can be adopted to overcome barriers to scaling up.
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Public sector mental health systems in South Africa: inter-provincial comparisons and policy implications
TL;DR: There remains widespread inequality between provinces in the resources available formental health care; a striking absence of reliable, routinely collected data that can be used to plan services and redress current inequalities; the continued dominance of mental hospitals as a mode of service provision; and evidence of substantial unmet need for mental health care.
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Collaboration between traditional practitioners and primary health care staff in South Africa: developing a workable partnership for community mental health services.
Vicky Campbell-Hall,Inge Petersen,Arvin Bhana,Sithembile Mjadu,Victoria Hosegood,Alan J. Flisher +5 more
TL;DR: Perceptions of service users and providers of current interactions between the two systems of care and ways in which collaboration could be improved in the provision of community mental health services are explored.
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Mental Health Policy Development and Implementation in Four African Countries
Alan J. Flisher,Crick Lund,Michelle Funk,Mwanza Banda,Arvin Bhana,Victor Doku,Natalie Drew,Fred Kigozi,Martin Knapp,Mayeh Omar,Inge Petersen,Andrew Green +11 more
TL;DR: The research programme undertakes an analysis of existing mental health policies in four African countries, and will carry out and evaluate interventions to assist in the development and implementation of mental Health policies in those countries, over a five-year period.
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Mental health service delivery in South Africa from 2000 to 2010: One step forward, one step back
Inge Petersen,Crick Lund +1 more
TL;DR: There has been some progress in the decentralisation of mental health service provision, but substantial gaps in service delivery remain and intervention research is needed to provide evidence of the organisational and human resource mix requirements and cost-effectiveness of a culturally appropriate, task shifting and stepped care approach for severe and common mental disorders at primary healthcare level.
References
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