The psychiatric paper-trail : a study of the continuity of psychiatric management from a community clinic perspective
Master Thesis
2000
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University of Cape Town
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Abstract
Mental health services in South Africa have historically been hospital-based and treatment focused. In 1997 the Department of Health committed itself to the transformation of mental health services in South Africa and adopted a District Health System model through which to shift the focus of mental health care from a hospital-based to a community-based service. This transition has been challenging on many levels, as attempts are made to develop the capacity of community mental health structures so as to render a comprehensive mental health service at the community clinic level. Given the infancy of this change, very little literature exists about the current struggles facing public community mental services, making the process of establishing an integrated mental health service at these sites all the more difficult. This study will explore the current mental health services offered at a community clinic, highlighting the limited capacity of this service site to offer a comprehensive psychiatric management service. After providing a historical overview outlining the context from which mental health services in South Africa have emerged, a situational analysis of a hospital-based and a community-based psychiatric service site is presented, highlighting some basic requirements of a psychiatric service and identifying shortfalls at a community clinic level in terms of these requirements. An audit of clinical work conducted at the community clinic is presented; illustrating that there is insufficient biopsychosocial information at the community clinic level in order to render an effective psychiatric service. A single-case study is then presented and ued to substantiate the claim that psychiatric management constitutes a specialist mental health service and as such, requires a mulit-disciplinary team approach. A possible model for community psychiatric management is presented based on the intervention strategy used in the single-case ana an argument is developed for a potential role for clinical psychology in the development and management of an effective community-base psychiatric service.
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Bibliography: leaves 45-46.
Reference:
Haupt, P. 2000. The psychiatric paper-trail : a study of the continuity of psychiatric management from a community clinic perspective. University of Cape Town.