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Planning for district mental health services in South Africa: a situational analysis of a rural district site

Petersen, Inge, Bhana, Arvin, Campbell-Hall, Victoria, Mjadu, Sithembile, Lund, Crick, Kleintjies, Sharon, Hosegood, Victoria and Flisher, Alan 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), pp. 140-150. (doi:10.1093/heapol/czn049). (PMID:19147698).

Record type: Article


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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Published date: March 2009
Keywords: primary mental health care, de-institutionalization, district, south africa


Local EPrints ID: 181779
ISSN: 0268-1080
PURE UUID: 650a6bca-b583-414d-aa9a-2677fc057bd8
ORCID for Victoria Hosegood: ORCID iD

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Date deposited: 04 May 2011 13:39
Last modified: 18 Jul 2017 11:58

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Author: Inge Petersen
Author: Arvin Bhana
Author: Victoria Campbell-Hall
Author: Sithembile Mjadu
Author: Crick Lund
Author: Sharon Kleintjies
Author: Alan J. Flisher

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