Abstract
M.A.
South Africa is a country characterised by inherent diversity of culture, language and race and is undergoing a process of reconstruction and development. This entails the establishment of a new national identity and socio-political structure based on integration, accommodation of difference and equity of access to the basic necessities for mental, physical, social and spiritual well-being for all its citizens within budgetary and personnel limitations. Mental health care needs and services have been shaped by socio-political and economic factors in the past. Further there has been unequal access to health care, which focused on psychiatric conditions and which provided curative, institutionalised care. Little provision was made for mental health care of children and mentally handicapped persons. A climate of unprecedented change and uncertainty also impacts on the mental health care of South Africans. A vital part of the Reconstruction and Development Programme is the reorientation of health care, which includes mental health, to a comprehensive health care approach with emphasis on primary preventive and promotive health care. An invaluable, economical yet untapped source of manpower to provide primary mental health care is the paraprofessional counsellor. Paraprofessional mental health workers can provide first level mental health care in the form of growth counselling which includes primary preventive and promotive care as well as some secondary and tertiary mental health care. In order to provide safe and effective care, this category of health worker needs to be carefully selected and trained and should work under the supervision of professional mental health care workers. The role of the latter needs to be re-evaluated in the context of South Africa. Effective and efficient care can be facilitated by the use of a simple yet comprehensive model for the selection and training of paraprofessionals and to guide their contribution to mental health care in South Africa. Two theoretical shifts have influenced mental health care. These are the paradigm shift from linear Cartesian-Newtonian thinking to the circular systems epistemology and the movement in psychological theories to ecosystemic theories. These developments have given rise to the bio-psycho-social model which does provide a basis for holistic health care but it excludes the spiritual dimension. This dissertation examines the concept of spirituality and argues for its inclusion in a truly holistic model of human functioning. The Pursuit of Wholeness model is proposed as a simply yet truly holistic tool to effect efficient, economical and ethical mental health care using , paraprofessionals. The model is described in detail and its use by paraprofessional counsellors in a growth counselling situation is discussed. An evaluative study was undertaken to test the use of the Pursuit of Wholeness model by paraprofessionals in three organisations. Results showed that the Pursuit of Wholeness model has the potential to enable paraprofessional counsellors through holistic growth counselling to contribute significantly to mental health care in South Africa.