title: Mental health care user participation in mental health policy development and implementation in South Africa.
abstract: This paper describes current support for mental health care user participation in policy development and implementation in South Africa and suggests strategies for improving participation. The World Health Organization (WHO) Mental Health Policy Checklist and WHO Mental Health Legislation Checklist were completed. Between August 2006 and August 2009 96 semi-structured interviews with national, regional and district stakeholders were conducted. Most respondents felt that inclusion of user perspectives in policy processes would improve policy development. In practice, mental health care user consultation in policy development and implementation has been limited during the 16 years of democracy in South Africa. Strategies to create a supportive environment for user participation include social action directed at reducing stigma, advocating for acceptance of users' rights to participate in decision making, crafting a supportive regulatory framework to promote participation, and equipping providers and policy makers to support inclusion. User capacity for participation could be strengthened through early and effective access to treatment and support, development of a national user lobby, skills training and practical exposure to the policy and service development environment.
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa. sharon.kleintjes@uct.ac.za
authors.forename: Sharon
authors.initials: S
authors.lastname: Kleintjes
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
authors.forename: Leslie
authors.initials: L
authors.lastname: Swartz
authors.forename: Alan
authors.initials: A
authors.lastname: Flisher
mesh_terms: D003256:Community Participation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006806:Human Rights / Q000193:education* / Q000331:legislation & jurisprudence; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D010353:Patient Education as Topic; D036301:Qualitative Research; D012939:Social Planning; D057545:Social Stigma; D012944:Social Support; D013019:South Africa