Browsing by Author "Booyens, Marietjie"

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    Community-based mental health care for adults with psychosocial disabilities in South Africa through a right to health lens
    (Stellenbosch : Stellenbosch University, 2022-03) Booyens, Marietjie; Liebenberg, Sandra; Stellenbosch University. Faculty of Law. Dept. of Public Law.
    ENGLISH ABSTRACT: There has been a shift, globally, from institutionalisation as the primary response to psychosocial disability, to community-based mental health care. This thesis sets out to determine the extent to which the legal and policy frameworks which govern community-based mental health care for adult persons with psychosocial disabilities in South Africa comply with constitutional and international law standards relevant to the right to health. First, by analysing the right of access to health care services in section 27 of the South African Constitution, relevant normative standards for community-based mental health care are established. Further, the negative and positive constitutional obligations in respect of the right of access to health care services are discussed. Following the analysis of constitutional norms and obligations, four key regional and international human rights instruments are analysed, with the right to health as the primary lens. A key part of this analysis is the consideration of two frameworks: the normative standards of “availability”, “accessibility”, “acceptability”, and “quality”; and the obligations to “respect”, “protect” and “fulfil”. These constitutional and international law standards are then applied to evaluate the mental health care legislation, policy and practice relevant to community-based mental health care – specifically, the Mental Health Care Act 17 of 2002, the National Mental Health Policy Framework and Strategic Plan 2013-2020, and the White Paper on the Rights of Persons with Disabilities of 2016. On the basis of this evaluation, this thesis finds that the framework does generally align with the constitutional and international law standards. However, the translation of this framework into practice is deficient in a number of ways. These deficiencies include: the absence of effective monitoring and information systems; insufficient resource allocation; the inequitable distribution of goods, facilities and services; a lack of clarity on the applicable standards for quality, ethical care; and poorly functioning oversight and accountability mechanisms. Consequently, this thesis concludes by making recommendations to improve the alignment of South Africa’s system of community-based mental health care with constitutional and international law standards.