Mental health care user participation in mental health policy development and implementation in South Africa

Abstract

This paper describes current support for mental health care user participation in policy development and implementation in South Africa and suggests strategies for improving participation. The World Health Organization (WHO) Mental Health Policy Checklist and WHO Mental Health Legislation Checklist were completed. Between August 2006 and August 2009 96 semi-structured interviews with national, regional and district stakeholders were conducted. Most respondents felt that inclusion of user perspectives in policy processes would improve policy development. In practice, mental health care user consultation in policy development and implementation has been limited during the 16 years of democracy in South Africa. Strategies to create a supportive environment for user participation include social action directed at reducing stigma, advocating for acceptance of users' rights to participate in decision making, crafting a supportive regulatory framework to promote participation, and equipping providers and policy makers to support inclusion. User capacity for participation could be strengthened through early and effective access to treatment and support, development of a national user lobby, skills training and practical exposure to the policy and service development environment.

The experiences of parents of children with mental disability regarding access to mental health care

“…For example, focus group discussions have been frequently used by the Mental Health and Poverty Project (MHaPP) to collect data. 31,32,33,34 Focus group discussions have also been used by other researchers to assess mental health needs in a variety of contexts. 35,36,37,38,39,40 The ability to speak English to a fair standard was a requirement to participate in the study.…”

Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers

“…However, there have been very few reports of efforts to involve service users and caregivers in mental health system strengthening in LMICs . Participatory policy-making and planning is of particular importance in the field of mental health, where service users are uniquely vulnerable with regard to the care they receive due to the nature of their condition (Kleintjes et al 2010). To avoid tokenistic inclusion of service users and caregivers in planning, and to facilitate patient-centric care and evidence-based co-design (Rose & Thornicroft, 2010;Robert et al 2015;WHO, 2016), it is necessary for professionals to work with representative organisations and facilitate effective contributions.…”

The role of communities in advancing the goals of the Movement for Global Mental Health

“…According to the World Health Organisation, globally, 32% of all years-livedwith-disability are due to neuropsychiatric conditions, most commonly unipolar depression (11.8%), alcohol use disorder (3.3%), schizophrenia (2.8%), bipolar depression (2.4%) and dementia (1.6%) (WHO, 2005a). Mental disorders are said to be highest in economically marginalised populations, especially the least educated, women and youth (Saxena, Thornicroft, Knapp, & Whiteford, 2007), with poverty, low education and food insecurity identified as key drivers (Lund et al, 2010;2011). Yet mental health is neglected in country health budgets resulting in worrying ''treatment gaps''.…”