Abstract
Mental illnesses are increasingly recognized to be a serious health burden within the South African context. Although there has been some progress in the decentralization of mental healthcare provision significant gaps in the delivery of care persist. Despite the significant progress in mental health policy development in South Africa, there have been a number of challenges in policy implementation. In addition, there is a demand for research that is tailored to the South African context needs. An often neglected but significant factor in shaping systems is the very structure of the implementation system. Framed by a theory of ‘street level bureaucracy’, Michael Lipsky’s theory of street level bureaucracy seeks to explain the working practices and beliefs of frontline workers in public services and the ways in which they endorse public policy in their routine work. The study reports on recognizing that mental health policies cannot be understood in isolation from how they are implemented. In response to this, the current study is designed to understand the extent to which mental health policies are understood, interpreted and implemented by mental health practitioners in a rural South African setting. The study used semi structured interviews to gain an in-depth understanding of policy implementation and procedures with twenty-three facility practitioners in the Eastern Cape region of South Africa. Participants were selected using purposive criterion sampling. Data was audio recorded, transcribed and analysed using thematic content analysis. ..
M.A. (Psychology)