Making consultation meaningful: Insights from a case study of the South African mental health policy consultation process

Abstract

Background It is widely recognised that mental health policies should be developed in consultation with those tasked with their implementation and the users affected by them. In the South African legislative context public participation in policymaking is assumed, with little guidance on how to conduct consultation processes, nor how to use consultation inputs in policy decisions. Methods The South African Mental Health Policy Framework and Strategic Plan was adopted in 2013 after an extensive consultation process. Focussing on the 2012 provincial and national consultation summit, this case-study conducted key informant interviews and undertook documentary analysis to explore the process through which consultation inputs were-or were not-transferred to inform this policy. Between 2013 and 2016 seven interviews were conducted, and 11 documents (policy drafts and summit outputs) and transcripts of 23 audiorecorded sessions from the national summit were analysed. Results Findings revealed that no substantive changes were made to the mental health policy following the consultation summits. There do not seem to have been systematic processes for facilitating and capturing knowledge inputs, or for transferring these inputs between provincial and national levels. There was also no further consultation regarding priorities identified for implementation prior to finalisation of the policy, with participants highlighting concerns about policy implementation at local levels as a result. This represents a lost opportunity for greater involvement of service users in policy development.

Masculine norms and mental health of African men: what can psychology do?

“…Africa is a diverse society with a varying culture that elevates masculine norms with a negative perception of mental health challenges that would benefit from policies or models that is concise and clear. However, while taking into account the fact that most Africa countries do not have functional mental health policies and often operate dated ones (Gureje and Alem, 2000;Marais et al, 2020), it is expected that the proposed model in this chapter will take an inclusive standpoint as argued by Hall et al (2020), and can be built on to bolster positive wellbeing among African men. Below is the proposed inclusive model with four levels.…”

Policymaking through a knowledge lens: Using the embodied-enacted-inscribed knowledge framework to illuminate the transfer of knowledge in a mental health policy consultation process – A South African case study

“…Through analysis of key informant interviews, policy documents, and consultation summit transcripts, it addressed the question of how the consultation process enabled or constrained movement of knowledge from enacted to inscribed forms. The findings of this study are detailed in a previous paper [ 21 ]. The analysis showed that no substantive changes were made to the mental health policy document following the consultation summits and suggested that the consultation may have been a rubberstamping exercise, although this was not explicitly communicated to consultation participants [ 21 ].…”

“…The findings of this study are detailed in a previous paper [ 21 ]. The analysis showed that no substantive changes were made to the mental health policy document following the consultation summits and suggested that the consultation may have been a rubberstamping exercise, although this was not explicitly communicated to consultation participants [ 21 ].…”

“…The development of this policy included an extensive consultation process, involving consultation summits in eight of the nine provinces and culminating in a national consultation summit, in April 2012, where input was invited on the draft policy document. The consultation process and follow through from provincial to national summits has been described in detail elsewhere [ 21 ]. The ten group breakaway sessions held over two days at the national consultation summit is the focus of the current paper.…”

“…A previous study, described in [ 21 ], focused on procedural aspects of the consultation summits, as well as detail regarding summit participants. Through analysis of key informant interviews, policy documents, and consultation summit transcripts, it addressed the question of how the consultation process enabled or constrained movement of knowledge from enacted to inscribed forms.…”