title: Understanding the local context for the application of global mental health: a rural South African experience.
abstract: BACKGROUND
  The global mental health movement has supplied ample evidence of treatment gaps for mental health care in low and middle-income countries. It is also clear that substantial progress has been made in developing an evidence base for innovative treatments which have been shown to work. It is only through rich and detailed understandings of local contexts and individual experiences that the challenges global mental health faces can be fully appreciated.
  
  
  METHODS
  In this article, we use a single, qualitative case study from one context and of one family affected by mental disorder. This is to elucidate core issues which we regard as key to further developments in the global mental health agenda.
  
  
  RESULTS
  Core issues are poor mental health literacy, transport and lack of outreach, limitations of formal health care, challenges at the interface with indigenous health care and lack of follow-up and rehabilitation.
  
  
  CONCLUSIONS
  We propose shifting the focus of mental health care from cure to promotion and prevention, using an interdisciplinary team of lay and trained health workers from the professional, folk and popular sectors. The challenges are complex, as this small study shows, but it is only by looking closely at local conditions that it is possible to develop interventions which are contextually appropriate and make optimal use of local resources.
authors.affiliation: Stellenbosch University, Department of Psychology, Private Bag X1, Matieland 7602, South Africa.
authors.forename: Stine Hellum
authors.initials: SH
authors.lastname: Braathen
authors.forename: Richard
authors.initials: R
authors.lastname: Vergunst
authors.forename: Gubela
authors.initials: G
authors.lastname: Mji
authors.forename: Hasheem
authors.initials: H
authors.lastname: Mannan
authors.forename: Leslie
authors.initials: L
authors.lastname: Swartz
mesh_terms: D000368:Aged; D003906:Developing Countries; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D038622:Internationality; D016488:Medicine, African Traditional; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D011203:Poverty; D036301:Qualitative Research; D012424:Rural Population; D012959:Socioeconomic Factors; D013019:South Africa
keywords: Community mental health; Mental disorder; Mental health service; Poverty; Rural; South Africa