Community-based mental health care for adults with psychosocial disabilities in South Africa through a right to health lens

Simple item page
dc.contributor.advisorLiebenberg, Sandraen_ZA
dc.contributor.authorBooyens, Marietjieen_ZA
dc.contributor.otherStellenbosch University. Faculty of Law. Dept. of Public Law.en_ZA
dc.date.accessioned2022-03-07T07:27:42Z
dc.date.accessioned2022-04-29T09:22:15Z
dc.date.available2022-03-07T07:27:42Z
dc.date.available2022-04-29T09:22:15Z
dc.date.issued2022-03
dc.descriptionThesis (LLM)--Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Wêreldwyd word institutionalisering, voorheen die primêre respons op psigososiale gestremdheid, vervang met ’n sisteem van gemeenskapsgebaseerde geestesgesondheidsorg. Hierdie tesis stel vas tot watter mate die wetlike en beleidsraamwerke wat gemeenskapsgebaseerde geestesgesondheidsorg vir volwassenes met psigososiale gestremdhede in Suid-Afrika reguleer, voldoen aan grondwetlike en internasionale reg standaarde wat van toepassing is op die reg op gesondheid. Eerstens, deur die reg op toegang tot gesondheidsorg in artikel 27 van die SuidAfrikaanse Grondwet te ontleed, word relevante norme vir gemeenskapsgebaseerde geestesgesondheidsorg vasgestel. Verder word die negatiewe en positiewe grondwetlike verpligtinge in verband met die reg op toegang tot gesondheidsorg vasgestel. Na aanleiding van die analise van die grondwetlike norme en verpligtinge, word vier belangrike streeks- en internasionale menseregte-instrumente ontleed, met die reg op gesondheid as die primêre lens. ‘n Kern-aspek van hierdie analise is die oorweging van twee raamwerke: die normatiewe standaarde van “beskikbaarheid”, “toeganklikheid”, “aanvaarbaarheid” en “kwaliteit”; en die verpligtinge om die reg te “eerbiedig”, te “beskerm”, en te “verwesenlik”. Hierdie grondwetlike en internasionale regstandaarde word dan toegepas om die wetgewing, beleid en praktyk wat verband hou met gemeenskapsgebaseerde geestesgesondheidsorg, te evalueer – naamlik, die Wet op Geestesgesondheidsorg 17 van 2002, die Nasionale Geestesgesondheidsorgbeleidsraamwerk en Strategiese Plan 2013-2020, en die Witskrif oor die Regte van Persone met Gestremdhede van 2016. Na aanleiding van hierdie evaluasie, word daar bevind dat die raamwerk wel tot ’n groot mate in ooreenstemming is met die grondwetlike en internasionale reg standaarde. Daar word egter verder bevind dat daar ernstige tekortkominge is in terme van die implementering van hierdie raamwerk. Hierdie tekortkominge sluit in: die afwesigheid van effektiewe moniterings- en inligtingstelsels; onvoldoende hulpbrontoewysing; die ongelyke verspreiding van goedere, fasiliteite en dienste; onduidelikheid oor die toepaslike standaarde in verband met die kwaliteit en etiese vlakke van sorg; en swak funksionerende oorsig- en aanspreeklikheidsmeganismes. Gevolglik sluit hierdie tesis af deur aanbevelings te maak om Suid-Afrika se sisteem van gemeenskapsgebaseerde geestesgesondheidsorg in ooreenstemming te bring met grondwetlike en internasionale regstandaarde.af_ZA
dc.description.versionMastersen_ZA
dc.format.extent151 pagesen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/124611
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectCommunity mental health services -- Law and legislationen_ZA
dc.subjectPsychosocial disabilityen_ZA
dc.subjectRight to health -- South Africaen_ZA
dc.subjectUCTDen_ZA
dc.titleCommunity-based mental health care for adults with psychosocial disabilities in South Africa through a right to health lensen_ZA
dc.typeThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
booyens_mental_2022.pdf
Size:
1.67 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters Degrees (Public Law)