Challenges of implementing psychiatric rehabilitation services: a low- and middle-income country case example

This article aims to explore the barriers and challenges of implementing psychiatric rehabilitation services at a psychiatric hospital in Iran. We performed an internal mixed-methods evaluation by adopting a multi-method approach. The data were organised, analysed and interpreted by the evaluation team. A low participation rate, administrative issues, low fidelity to protocols and incomplete documentation were the main findings.

Implementing and maintaining rehabilitation services in low- and middle-income country settings requires more than a mere transfer of models of psychiatric rehabilitation; it needs adaptation to the local context as well as continuous evaluation and quality improvement in an iterative fashion, given the rapidly changing contexts with scarce resources.

Strengthening the National Health Insurance Bill for mental health needs: response from the Psychological Society of South Africa

This article summarizes the findings of a consultation process initiated at the 25th congress of the Psychological Society of South Africa in September 2019 to submit a response to the national public participation process on the National Health Insurance Bill, 2019. While the Psychological Society of South Africa supports the overall purpose of the Bill, to provide universal health coverage in South Africa, this article critically discusses eight core concerns related to the Bill, including the need to: (1) integrate mental health more effectively into the National Health Insurance Bill; (2) ensure equitable access to health services for all people; (3) improve human resources for mental health; (4) clarify accreditation standards and contractual conditions for service providers; (5) improve utilization of private practitioners within an integrated health system; (6) include mental health expertise in the advisory structures of the National Health Insurance Bill; (7) set out a robust accountability framework within the National Health Insurance Bill; and (8) include mental health indicators in the National Health Insurance information system. Taken together, this article contributes to the ongoing deliberations about strengthening the National Health Insurance system to ensure that it is responsive to mental health care needs.

The challenge to prioritise infant mental health in South Africa

Despite clear evidence that infant mental health intervention is imperative, mental health services for infants and their caregivers worldwide remain under-prioritised, under-funded, and inaccessible to most populations. South Africa is no exception. This article proposes some potential explanations for this, exploring both practical constraints and possible resistances within the currents of our collective unconscious.

Towards the development of a forensic psychology training curriculum in South Africa

With the growing need for forensic mental health services and the call for increasing rigour in clinical practice, the development of specialised training programmes appears to be increasing globally. In South Africa, the licencing authority has also been focusing on this issue, and its task group has been investigating specialty training models in regard to future developments in licensure, training, qualifications, and related registration matters. The present investigation was undertaken as a way of informing this process, especially in the area of curriculum content and development. The authors undertook a survey of existing accredited forensic psychology training programmes in the United States, the United Kingdom, Australia, and Canada. The aim was to examine the qualification level, period of study, admission criteria, online study option, field placement, and the module content. The results are presented for the 62 programmes surveyed and discussed with reference to the South African context and local needs.

Is deinstitutionalisation a cheap alternative to chronic mental health care?

Worldwide, there has been a dominant belief that the deinstitutionalisation of the mentally ill is a cost-saving approach, leading health authorities to embark on such initiatives without adequate community-based health and social service resources and supports. These have resulted in disaster, even in high-income countries, when insufficient planning and preparation have been effected. The recent experience in South Africa that saw the deaths of approximately 100 people with chronic mental illness within 1 year of being moved from a mental health facility is further evidence of the need for more concerted and deliberate planning and resourcing of mental health care services. The article examines various issues relating to deinstitutionalisation and urges authorities to re-examine their approach to mental health care and especially the priority accorded to this marginalised group.