Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2016

Open Access 01-12-2016 | Research

Bridging the gap: investigating challenges and way forward for intersectoral provision of psychosocial rehabilitation in South Africa

Authors: Carrie Brooke-Sumner, Crick Lund, Inge Petersen

Published in: International Journal of Mental Health Systems | Issue 1/2016

Login to get access

Abstract

Background

Intersectoral collaboration between government sectors such as Health and Social Development and non-governmental organisations (NGOs) in communities is crucial for provision of psychosocial rehabilitation (PSR) for those with severe mental illness. This study aims to provide recommendations for strengthening such intersectoral collaboration in South Africa and with relevance to other low and middle income countries (LMIC), particularly African countries.

Methods

Twenty-four in-depth semi-structured interviews were conducted with 16 key informants from the South African Department of Health, two key informants from the Department of Social Development, four key informants from the NGO sector and one key informant from a service user organisation at national level. Framework analysis was conducted with NVivo 10 software.

Results

Challenges to intersectoral work identified were lack of communication between sectors, problems delineating roles, and each sector’s perception of lack of support from other sectors. Participant-identified strategies for addressing these challenges included improving communication between sectors, promoting leadership from all levels and formalising intersectoral relationships through appropriate written agreements; as well as ensuring that the available resources for PSR are effectively re-directed to district level.

Conclusions

This study has outlined several directions for progress to address challenges for intersectoral working for PSR in South Africa. These may be of relevance to other LMIC, particularly those in Africa. Political will and a long-term view will be necessary to realise these strategies.
Literature
1.
WHO. Intersectoral action for health: a cornerstone for health-for-all in the twenty-first century. International conference on intersectoral action for health. Halifax: World Health Organization; 1997.
2.
Petersen I, Lund C. Mental health service delivery in South Africa from 2000–2010: one step forward, one step back. S Afr Med J. 2011;101(10):751–7.PubMed
3.
4.
Thornicroft G, Alem A, Antunes Dos Santos R, Barley E, Drake RE, Gregorio G, et al. WPA guidance on steps, obstacles and mistakes to avoid in the implementation of community mental health care. World Psychiatry. 2010;9(2):67–77.CrossRefPubMedPubMedCentral
5.
Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet. 2007;370(9593):1164–74.CrossRefPubMed
6.
Bhana A, Petersen I, Baillie KL, Flisher AJ. Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry. 2010;22(6):599–610. doi:10.​3109/​09540261.​2010.​536152.CrossRefPubMed
7.
8.
9.
Jenkins R, Baingana F, Ahmad R, McDaid D, Atun R. Health system challenges and solutions to improving mental health outcomes. Ment Health Fam Med. 2011;8(2):119–27.PubMedPubMedCentral
10.
11.
Bond GR, Drake RE, Mueser KT, Latimer E. Assertive community treatment for people with severe mental illness: critical ingredients and impact on patients. Dis Manag Health Outcomes. 2001;9(3):141–59.CrossRef
12.
13.
14.
15.
DOH. National Mental Health Policy Framework and Strategic Plan 2013–2020. Pretoria: Department of Health Republic of South Africa; 2013.
16.
Saraceno B, van Ommeren M, Batniji R, Cohen A, Gureje O, Mahoney J, et al. Barriers to improvement of mental health services in low-income and middle-income countries. Lancet. 2007;370(9593):1164–74.CrossRefPubMed
17.
Lund C, Kleintjes S, Kakuma R, Flisher AJ. Public sector mental health systems in South Africa: inter-provincial comparisons and policy implications. Soc Psychiatry Psychiatr Epidemiol. 2010;45(3):393–404. doi:10.​1007/​s00127-009-0078-5.CrossRefPubMed
18.
Coetzee D, Kemp R. Community-based rehabilitation in the service area of Stikland Hospital–the problem defined. S Afr Med J. 1982;61(20):751–4.PubMed
19.
Lund C, Oosthuizen P, Flisher AJ, Emsley R, Stein DJ, Botha U, et al. Pathways to inpatient mental health care among people with schizophrenia spectrum disorders in South Africa. Psychiatr Serv. 2010;61(3):235–40.CrossRefPubMed
20.
Ministry of social development: Policy on disability. Ministry of social development.
21.
Thornicroft G, Alem A, Antunes Dos Santos R, Barley E, Drake RE, Gregorio G, et al. WPA guidance on steps, obstacles and mistakes to avoid in the implementation of community mental health care. World Psychiatry. 2010;9(2):67–77.CrossRefPubMedPubMedCentral
22.
23.
Lund C, Petersen I, Kleintjes S, Bhana A. Mental health services in South Africa: taking stock. Afr J Psychiatry. 2012;15(6):402–5.CrossRef
24.
van Deventer C, Couper I, Wright A, Tumbo J, Kyeyune C. Evaluation of primary mental health care in North West province; a qualitative view. S Afr J Psychiatry. 2009;14(4):1360140.
25.
26.
Mahomed OH, Asmall S, Freeman M. An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa. J Health Care Poor Underserved. 2014;25(4):1723–9. doi:10.​1353/​hpu.​2014.​0176.CrossRefPubMed
27.
28.
Brooke-Sumner C, Lund C, Selohilwe O, Petersen I. Process evaluation of a community-based psychosocial rehabilitation programme for schizophrenia service users in the North West Province of South Africa. BMC Psychiatry. 2015;In Press.
29.
Lund C, Tomlinson M, Da Silva M, Fekadu A, Shidhaye R, Jordans M, Petersen I, Bhana A, Kigozi F, Prince M, Thornicroft G, Hanlon C, Kakuma R, McDaid D, Saxena S, Chisholm D, Honikman S, Fairall L, Patel V. PRIME: a programme to reduce the treatment gap for mental disorders in five low and middle-income countries. PLoS Med. 2012;9(12):e1001359. doi:10.​1371/​journal.​pmed.​1001359.CrossRefPubMedPubMedCentral
30.
31.
Petersen I FL, Bhana A, Kathree T, Selohilwe O, Brooke-Sumner C, Faris G, Breuer E, Sibanyoni N, Lund C, Patel V. Integrating mental health into chronic care in South Africa: the development of a district mental health plan. Br J Psychiatry. In Press.
32.
Brooke-Sumner C, Lund C, Petersen I. Perceptions of psychosocial disability amongst service users and caregivers’, African. Afr J Disability. 2014;3(1):1–10. doi:10.​4102/​ajod.​v3i1.​146.
33.
34.
35.
Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Ba Burgess, editor. Analysing qualitative data. London: Routledge; 1994. p. 173–94.CrossRef
36.
Lacey A, Luff D. Trent focus for research and development in primary health care: an introduction to qualitative analysis. Trent Focus Group; 2001.
37.
38.
WHO. Health equity through intersectoral action: an analysis of 18 country case studies. Geneva: World Health Organization; 2008.
39.
40.
41.
Chappell P, Johannsmeier C. The impact of community based rehabilitation as implemented by community rehabilitation facilitators on people with disabilities, their families and communities within South Africa. Disabil Rehabil. 2009;31(1):7–13. doi:10.​1080/​0963828080228042​9.CrossRefPubMed
42.
IP. At the heart of development: an introduction to mental health promotion and the prevention of mental disorders in scarce—resource contexts. In: Petersen I, Bhana A, Flisher A, Swartz L, Richter L (eds). Strengthening mental health promotion. Cape Town: Human resources social council; 2010.
43.
44.
45.
46.
de Menil V, Knapp M, McDaid D, Raja S, Kingori J, Waruguru M, et al. Cost-effectiveness of the mental health and development model for schizophrenia-spectrum and bipolar disorders in rural Kenya. Psychol Med. 2015;45(13):2747–56. doi:10.​1017/​S003329171500071​9.CrossRefPubMed
47.
48.
Bhana A, Petersen I, Baillie KL, Flisher AJ, The Mhapp Research Programme Consortium. Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: a situation analysis of three African countries: Ghana, South Africa and Uganda. Int Rev Psychiatry. 2010;22(6):599–610. doi:10.​3109/​09540261.​2010.​536152.CrossRefPubMed
49.
50.
Draper CE, Lund C, Kleintjes S, Funk M, Omar M. Mental health policy in South Africa: development process and content. Health Policy Plan. 2009;24:342–56.CrossRefPubMed
51.
Vega J, Irwin A. Tackling health inequalities: new approaches in public policy. Bull World Health Organ. 2004;82(7):482.PubMedPubMedCentral
52.
53.
Government BF. Direct financial transfers to states and municipalities for Psychosocial Network. Rio de Janeiro: Brazil Federal Government; 2013.
54.
Metadata
Title
Bridging the gap: investigating challenges and way forward for intersectoral provision of psychosocial rehabilitation in South Africa
Authors
Carrie Brooke-Sumner
Crick Lund
Inge Petersen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2016
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-016-0042-1

Other articles of this Issue 1/2016

International Journal of Mental Health Systems 1/2016 Go to the issue

Research

Comprehensive psychometric examination of the attitudes towards suicide (ATTS) in South Korea

Research

Comorbidity of depression and diabetes: an application of biopsychosocial model

Research

Validating the Edinburgh Postnatal Depression Scale as a screening tool for postpartum depression in Kathmandu, Nepal

Research

Utilization of a mental health collaborative care model among patients who require interpreter services

Erratum

Erratum to: Pathways to psychiatric care for mental disorders: a retrospective study of patients seeking mental health services at a public psychiatric facility in Ghana

Research

Day clinic and inpatient psychotherapy of depression (DIP-D): qualitative results from a randomized controlled study