Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers
| dc.contributor.author | Mokitimi, Stella | |
| dc.contributor.author | Jonas, Kim | |
| dc.contributor.author | Schneider, Marguerite | |
| dc.contributor.author | de Vries, Petrus J | |
| dc.date.accessioned | 2022-10-24T10:47:51Z | |
| dc.date.available | 2022-10-24T10:47:51Z | |
| dc.date.issued | 2022-07-14 | |
| dc.date.updated | 2022-07-17T03:16:08Z | |
| dc.description.abstract | Background Current work in the field point to the need to strengthen child and adolescent mental health services (CAMHS) globally, and especially in low- and middle-income countries (LMICs). Policy development, planning and service provision must be relevant to the needs of stakeholders at grassroots level, and should include their perspectives. This study set out to explore the perspectives and lived experiences of service providers, including their recommendations to strengthen CAMHS in South Africa. Methods Using focus group discussions (FGDs) and semi-structured individual interviews (SSIIs), qualitative data were collected from 46 purposefully selected multidisciplinary health service providers across the Western Cape, one of the nine provinces of South Africa. Audio-recorded data were entered into NVivo 11 (QSR), and thematic analysis was performed by two independent raters. Results Results highlighted a significant lack of CAMH resources, poor intersectoral collaboration, limited access to training, absence of consistency and uniformity in service delivery, weak support for staff, and high rates of negative attitudes of staff. External factors contributing to poor CAMHS identified by service providers included poor socioeconomic circumstances, high rates of HIV/AIDS, substance use and stigma. The eight recommendations to strengthen CAMHS included a need to (1) increase CAMH staffing, (2) provide dedicated CAMHS at secondary care and child-friendly infrastructure at primary care, (3) review current service focus on number of patients seen versus quality of care provided to children, (4) formalise intersectoral collaborations, (5) increase learning opportunities for trainees, (6) employ a lead professional for CAMHS in the province, (7) increase support for staff, and (8) acknowledge staff initiatives. Conclusions Findings underlined the need for quality improvement, standardisation and scale-up of mental health services for children and adolescents in South Africa. Whilst we used the Western Cape as a ‘case study’, we propose that our findings may also be relevant to other LMICs. We recommend that the perspectives of service users, including children and adolescents, be sought to inform service transformation. | en_US |
| dc.identifier.apacitation | Mokitimi, S., Jonas, K., Schneider, M., & de Vries, P. J. (2022). Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers. <i>Child and Adolescent Psychiatry and Mental Health</i>, 16(1), 57. http://hdl.handle.net/11427/36872 | en_ZA |
| dc.identifier.chicagocitation | Mokitimi, Stella, Kim Jonas, Marguerite Schneider, and Petrus J de Vries "Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers." <i>Child and Adolescent Psychiatry and Mental Health</i> 16, 1. (2022): 57. http://hdl.handle.net/11427/36872 | en_ZA |
| dc.identifier.citation | Mokitimi, S., Jonas, K., Schneider, M. & de Vries, P.J. 2022. Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers. <i>Child and Adolescent Psychiatry and Mental Health.</i> 16(1):57. http://hdl.handle.net/11427/36872 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Mokitimi, Stella AU - Jonas, Kim AU - Schneider, Marguerite AU - de Vries, Petrus J AB - Background Current work in the field point to the need to strengthen child and adolescent mental health services (CAMHS) globally, and especially in low- and middle-income countries (LMICs). Policy development, planning and service provision must be relevant to the needs of stakeholders at grassroots level, and should include their perspectives. This study set out to explore the perspectives and lived experiences of service providers, including their recommendations to strengthen CAMHS in South Africa. Methods Using focus group discussions (FGDs) and semi-structured individual interviews (SSIIs), qualitative data were collected from 46 purposefully selected multidisciplinary health service providers across the Western Cape, one of the nine provinces of South Africa. Audio-recorded data were entered into NVivo 11 (QSR), and thematic analysis was performed by two independent raters. Results Results highlighted a significant lack of CAMH resources, poor intersectoral collaboration, limited access to training, absence of consistency and uniformity in service delivery, weak support for staff, and high rates of negative attitudes of staff. External factors contributing to poor CAMHS identified by service providers included poor socioeconomic circumstances, high rates of HIV/AIDS, substance use and stigma. The eight recommendations to strengthen CAMHS included a need to (1) increase CAMH staffing, (2) provide dedicated CAMHS at secondary care and child-friendly infrastructure at primary care, (3) review current service focus on number of patients seen versus quality of care provided to children, (4) formalise intersectoral collaborations, (5) increase learning opportunities for trainees, (6) employ a lead professional for CAMHS in the province, (7) increase support for staff, and (8) acknowledge staff initiatives. Conclusions Findings underlined the need for quality improvement, standardisation and scale-up of mental health services for children and adolescents in South Africa. Whilst we used the Western Cape as a ‘case study’, we propose that our findings may also be relevant to other LMICs. We recommend that the perspectives of service users, including children and adolescents, be sought to inform service transformation. DA - 2022-07-14 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Child and Adolescent Psychiatry and Mental Health KW - Child and adolescent mental health KW - Health systems KW - Western Cape KW - South Africa KW - Perspectives KW - Service providers KW - Low- and middle-income countries LK - https://open.uct.ac.za PY - 2022 T1 - Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers TI - Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers UR - http://hdl.handle.net/11427/36872 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s13034-022-00491-w | |
| dc.identifier.uri | http://hdl.handle.net/11427/36872 | |
| dc.identifier.vancouvercitation | Mokitimi S, Jonas K, Schneider M, de Vries PJ. Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers. Child and Adolescent Psychiatry and Mental Health. 2022;16(1):57. http://hdl.handle.net/11427/36872. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Division of Child and Adolescent Psychiatry | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | Child and Adolescent Psychiatry and Mental Health | en_US |
| dc.source.journalissue | 1 | en_US |
| dc.source.journalvolume | 16 | en_US |
| dc.source.pagination | 57 | en_US |
| dc.source.uri | https://capmh.biomedcentral.com/ | |
| dc.subject | Child and adolescent mental health | en_US |
| dc.subject | Health systems | en_US |
| dc.subject | Western Cape | en_US |
| dc.subject | South Africa | en_US |
| dc.subject | Perspectives | en_US |
| dc.subject | Service providers | en_US |
| dc.subject | Low- and middle-income countries | en_US |
| dc.title | Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers | en_US |
| dc.type | Journal Article | en_US |