Comprehensive integrated primary mental health care for South Africa. Pipedream or possibility?

Petersen, Inge

doi:10.1016/s0277-9536(99)00456-6

Cited by 95Psychiatric care and mental health servicesMental Health Treatment and AccessPrimary Care and Health Outcomes

Comprehensive integrated primary mental health care for South Africa. Pipedream or possibility?

Petersen, Inge·2000·Social Science & Medicine

DOI 10.1016/s0277-9536(99)00456-6

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Abstract

While the vision for restructuring health care in South Africa is based on a comprehensive primary health care system, care at the primary level remains largely biomedical in orientation. Given this, I argue that whilst adding mental health care to primary level care may increase accessibility of psychiatric care. it will not, however, provide for comprehensive integrated primary mental health care as planned. This would require a paradigm shift towards a comprehensive discourse of care which includes mental health care. While efforts towards reorienting health care personnel in South Africa towards the primary health care approach have been initiated, an examination of the primary health care system in one sub-district in South Africa, reveals that the delivery of biomedical care is sustained by a number of factors within the primary health care system as well as within the macro-context. A shift in the paradigm of care provided would therefore require the transformation of the system on many fronts. Of central importance would be the restructuring of the primary health care system to be supportive of emotional labour, health promotion, empowerment of service users and of care which takes the subjectivity of the illness experience for the patient into account.

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Authors: Petersen, I.
Corresponding author: Petersen, Inge
ORCID: Petersen, Inge
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2000-08
Volume: 51
Issue: 3
Pages: 321-334
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/s0277-9536(99)00456-6
OpenAlex: W2017045008
Cited by: 95
References: 46
Citations by year: 2025: 2 · 2022: 4 · 2021: 8 · 2020: 2 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 2 · 2014: 6 · 2013: 3 · 2012: 4
FWCI: 3.59
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords: comprehensive primary health care, South Africa, biomedical care, health care reform, emotional labor, health promotion, service user empowerment, illness experience, health care delivery
MeSH terms: Culture, Delivery of Health Care, Health Services Research, Humans, Mental Health Services, Primary Health Care, South Africa

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Comprehensive integrated primary mental health care for South Africa. Pipedream or possibility?

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