Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis
| dc.contributor.author | Mokitimi, Stella | |
| dc.contributor.author | Schneider, Marguerite | |
| dc.contributor.author | de Vries, Petrus J | |
| dc.date.accessioned | 2018-07-02T07:05:55Z | |
| dc.date.available | 2018-07-02T07:05:55Z | |
| dc.date.issued | 2018-06-26 | |
| dc.date.updated | 2018-07-01T04:33:59Z | |
| dc.description.abstract | Background Mental health problems represent the greatest global burden of disease among children and adolescents. There is, however, lack of policy development and implementation for child and adolescent mental health (CAMH), particularly in low- and middle-income countries (LMICs) where children and adolescents represent up to 50% of populations. South Africa, an upper-middle income country is often regarded as advanced in health and social policy-making and implementation in comparison to other LMICs. It is, however, not clear whether this is the case for CAMH. The national child and adolescent mental health policy framework of 2003 was developed to guide the establishment of CAMH policies provincially, using a primary care and intersectoral approach. This policy provided a framework for the nine South African provinces to develop policies and implementation plans, but it is not known whether this has happened. The study sought to examine the history and current state of CAMH policy development and implementation, and to perform a systematic analysis of all available CAMH service-related policies. Methods A comprehensive search was performed to identify all provincial mental health and comprehensive general health policies across South African provinces. The Walt and Gilson policy triangle framework (1994) was used for analysis. Results No South African province had a CAMH policy or identifiable implementation plans to support the national CAMH policy. Provincial comprehensive general health policies addressed CAMH issues only partially and were developed mainly to address the challenges with HIV/AIDS, TB, maternal and child mortality and adherence to the millennium development goals. The process of policy development was typically a consultative process with internal and external stakeholders. There was no evidence that CAMH professionals and/or users were included in the policy development process. Conclusions In spite of South Africa’s upper-middle income status, the absence of any publically-available provincial CAMH policy documents was concerning, but in keeping with findings from other LMICs. Our results reinforce the neglect of CAMH even at policy level in spite of the burden of CAMH disorders. There is an urgent need to develop and implement CAMH policies in South Africa and other LMICs. Further research will be required to identify and explore the barriers to policy development and implementation, and to service development and scale-up in CAMH. | |
| dc.identifier.apacitation | Mokitimi, S., Schneider, M., & de Vries, P. J. (2018). Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis. <i>International Journal of Mental Health Systems</i>, http://hdl.handle.net/11427/28275 | en_ZA |
| dc.identifier.chicagocitation | Mokitimi, Stella, Marguerite Schneider, and Petrus J de Vries "Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis." <i>International Journal of Mental Health Systems</i> (2018) http://hdl.handle.net/11427/28275 | en_ZA |
| dc.identifier.citation | International Journal of Mental Health Systems. 2018 Jun 26;12(1):36 | |
| dc.identifier.ris | TY - Journal Article AU - Mokitimi, Stella AU - Schneider, Marguerite AU - de Vries, Petrus J AB - Background Mental health problems represent the greatest global burden of disease among children and adolescents. There is, however, lack of policy development and implementation for child and adolescent mental health (CAMH), particularly in low- and middle-income countries (LMICs) where children and adolescents represent up to 50% of populations. South Africa, an upper-middle income country is often regarded as advanced in health and social policy-making and implementation in comparison to other LMICs. It is, however, not clear whether this is the case for CAMH. The national child and adolescent mental health policy framework of 2003 was developed to guide the establishment of CAMH policies provincially, using a primary care and intersectoral approach. This policy provided a framework for the nine South African provinces to develop policies and implementation plans, but it is not known whether this has happened. The study sought to examine the history and current state of CAMH policy development and implementation, and to perform a systematic analysis of all available CAMH service-related policies. Methods A comprehensive search was performed to identify all provincial mental health and comprehensive general health policies across South African provinces. The Walt and Gilson policy triangle framework (1994) was used for analysis. Results No South African province had a CAMH policy or identifiable implementation plans to support the national CAMH policy. Provincial comprehensive general health policies addressed CAMH issues only partially and were developed mainly to address the challenges with HIV/AIDS, TB, maternal and child mortality and adherence to the millennium development goals. The process of policy development was typically a consultative process with internal and external stakeholders. There was no evidence that CAMH professionals and/or users were included in the policy development process. Conclusions In spite of South Africa’s upper-middle income status, the absence of any publically-available provincial CAMH policy documents was concerning, but in keeping with findings from other LMICs. Our results reinforce the neglect of CAMH even at policy level in spite of the burden of CAMH disorders. There is an urgent need to develop and implement CAMH policies in South Africa and other LMICs. Further research will be required to identify and explore the barriers to policy development and implementation, and to service development and scale-up in CAMH. DA - 2018-06-26 DB - OpenUCT DP - University of Cape Town J1 - International Journal of Mental Health Systems LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis TI - Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis UR - http://hdl.handle.net/11427/28275 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s13033-018-0213-3 | |
| dc.identifier.uri | http://hdl.handle.net/11427/28275 | |
| dc.identifier.vancouvercitation | Mokitimi S, Schneider M, de Vries PJ. Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis. International Journal of Mental Health Systems. 2018; http://hdl.handle.net/11427/28275. | en_ZA |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Division of Child and Adolescent Psychiatry | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights.holder | The Author(s) | |
| dc.source | International Journal of Mental Health Systems | |
| dc.source.uri | https://ijmhs.biomedcentral.com/ | |
| dc.subject.other | Child | |
| dc.subject.other | Adolescent | |
| dc.subject.other | Mental health | |
| dc.subject.other | Policy development | |
| dc.subject.other | South Africa | |
| dc.title | Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis | |
| dc.type | Journal Article | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image |