Browsing by Author "Morrison, Claire"
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- ItemThe makings of madness: how is the ‘problem’ of mental health represented in South African health policy?(Stellenbosch : Stellenbosch University, 2021-12) Morrison, Claire; Fourie, Pieter Paul; Adams-Jack, Ubanesia; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Political Science.ENGLISH ABSTRACT: This study critically analyses the problem representations found within South African mental health policy documents. It provides insight as to how mental health is problematised in South African public policy. The study makes explicit the embedded assumptions within the policy, and reveals the context in which mental health is conceptualised. The policy documents used for analysis are: The White Paper for the Transformation of the Health System in South Africa of 1997; the National Mental Health Care Act 17 of 2002; the National Child and Adolescent Mental Health Policy Guidelines of 2003; and the National Mental Health Policy Strategic Framework for 2013-2020. Carol Bacchi’s ‘What’s the problem represented to be?’ (WPR) approach is used as the analytical tool with which to identify the dominant problem represen- tations of mental health. Problem representations are referred to by Bacchi as the explicit and implicit statement of a ‘problem’ in any policy. This analytical tool is based upon Foucauldian, post-structuralist principles that centre around the construction of meaning through discourse and social practices. These principles direct the study in the process of analysing how mental health is shaped by discourse and interventions. The thesis considers the various conceptuali- sations of mental health that frame the context in which mental health is understood. The con- ceptualisation of mental health will greatly influence how it is framed and managed in policy. A review of the research already conducted on South African public policy shows that the focus of the literature is invariably centred around the implementation of the policies and the resulting service delivery gaps. The literature does not examine how mental health is conceptualised and constructed in mental health policy, revealing a gap in the research that this study fills. The critical analysis of the four policy documents reveals five dominant problem representations, namely: the separation of mental health services from general health services; poor intersec- toral collaboration in mental health care services; the disconnect between communities and mental health care services; the link between poverty and mental health problems; and the rights of those with mental health problems being infringed upon. The dominant problem rep- resentations are expressed both explicitly and implicitly. The identification of the dominant problem representations reveals the assumptions that underpin how mental health is problem- atised. The study emphasises the understanding of mental health as a socio-economic problem, providing solutions centred around poverty alleviation and economic development.