South African mental health care service user views on priorities for supporting recovery: implications for policy and service development.
OBJECTIVE
The paper documents the views of South African mental health care service users on policy directions and service developments that are required to support their recovery.


METHODS
Semi-structured interviews were conducted with forty service users and service user advocates. A framework analysis approach was used to analyse the qualitative data.


RESULTS
Service user priorities included addressing stigma, discrimination and disempowerment, and the links between mental health and poverty. They suggested that these challenges be addressed through public awareness campaigns, legislative and policy reform for rights protection, development of a national lobby to advocate for changes, and user empowerment. Users suggested that empowerment can be facilitated through opportunities for improved social relatedness and equitable access to social and economic resources.


CONCLUSIONS
This study suggests three strategies to bridge the gap between mental health care service users rights and needs on one hand, and unsupportive attitudes, policies and practices on the other. These are: giving priority to service user involvement in policy and service reform, creating empathic alliances to promote user priorities, and building enabling partnerships to effect these priorities.
Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa. sharon.kleintjes@uct.ac.za
Sharon
S
Kleintjes
Crick
C
Lund
Leslie
L
Swartz
D001294:Attitude to Health; D003254:Consumer Advocacy; D003258:Consumer Behavior; D004192:Discrimination, Psychological; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D010358:Patient Participation; D011209:Power, Psychological; D036301:Qualitative Research; D057545:Social Stigma; D013019:South Africa