Decentralised responsibility--a way forward for 'homeland' mental health care?
A case study of mental health services in Mhala, a district of the Gazankulu homeland area in South Africa, is reported; it is argued that more comprehensive mental health care could be promoted by transferring certain basic mental health functions (repeat prescriptions for stable psychosis and epilepsy) from the single itinerant community psychiatric nurse to general health nurses in the 22 clinics in the district. This would improve access to and continuity of care, and through the new 'freedom' of the community psychiatric nurse, allow for the introduction of mental health functions that are presently neglected. Training to safe levels of competence is attainable, and the additional load on clinics would be very small.
Freeman
M
M
Department of Community Health, University of the Witswaterarand, Johannesburg.
D003156:Community Mental Health Services; D009729:Nursing; D011568:Psychiatric Nursing; D012424:Rural Population; D013019:South Africa; D000078329:Workforce