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Planning for district mental health services in South Africa: a situational analysis of a rural district site.
Health Policy Plan. 2009 Mar; 24(2):140-50.HP

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.

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Authors+Show Affiliations

Petersen I
University of KwaZulu-Natal, Durban, South Africa. peterseni@ukzn.ac.za
Bhana A
No affiliation info available
Campbell-Hall V
No affiliation info available
Mjadu S
No affiliation info available
Lund C
No affiliation info available
Kleintjies S
No affiliation info available
Hosegood V
No affiliation info available
Flisher AJ
No affiliation info available
Mental Health and Poverty Research Programme Consortium
No affiliation info available

MeSH

Attitude of Health PersonnelDeinstitutionalizationDelivery of Health Care, IntegratedEmergency Services, PsychiatricHealth Plan ImplementationHealth ResourcesHealth Services AccessibilityHumansInterviews as TopicMental Health ServicesOrganizational Case StudiesPoliticsPrimary Health CareProgram EvaluationQualitative ResearchRegional Health PlanningRural Health ServicesSocial SupportSouth Africa

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19147698

Citation

Petersen, Inge, et al. "Planning for District Mental Health Services in South Africa: a Situational Analysis of a Rural District Site." Health Policy and Planning, vol. 24, no. 2, 2009, pp. 140-50.
Petersen I, Bhana A, Campbell-Hall V, et al. Planning for district mental health services in South Africa: a situational analysis of a rural district site. Health Policy Plan. 2009;24(2):140-50.
Petersen, I., Bhana, A., Campbell-Hall, V., Mjadu, S., Lund, C., Kleintjies, S., Hosegood, V., & Flisher, A. J. (2009). Planning for district mental health services in South Africa: a situational analysis of a rural district site. Health Policy and Planning, 24(2), 140-50. https://doi.org/10.1093/heapol/czn049
Petersen I, et al. Planning for District Mental Health Services in South Africa: a Situational Analysis of a Rural District Site. Health Policy Plan. 2009;24(2):140-50. PubMed PMID: 19147698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Planning for district mental health services in South Africa: a situational analysis of a rural district site. AU - Petersen,Inge, AU - Bhana,Arvin, AU - Campbell-Hall,Victoria, AU - Mjadu,Sithembile, AU - Lund,Crick, AU - Kleintjies,Sharon, AU - Hosegood,Victoria, AU - Flisher,Alan J, AU - ,, Y1 - 2009/01/15/ PY - 2009/1/17/entrez PY - 2009/1/17/pubmed PY - 2009/4/28/medline SP - 140 EP - 50 JF - Health policy and planning JO - Health Policy Plan VL - 24 IS - 2 N2 - 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. SN - 0268-1080 UR - https://www.unboundmedicine.com/medline/citation/19147698/Planning_for_district_mental_health_services_in_South_Africa:_a_situational_analysis_of_a_rural_district_site_ L2 - https://academic.oup.com/heapol/article-lookup/doi/10.1093/heapol/czn049 DB - PRIME DP - Unbound Medicine ER -