The political economy of mental illness in South Africa / Andre J. van Rensburg.

Format:

Book

Author/Creator:

Van Rensburg, Andre J., author.

Series:

Routledge studies in health in Africa ; 3.

Routledge studies in health in Africa ; 3

Language:

English

Subjects (All):

Mental health services--South Africa.

Mental health services.

South Africa--Social conditions--1994-.

South Africa.

Physical Description:

1 online resource (185 pages).

Edition:

1st ed.

Place of Publication:

London ; New York : Routledge, Taylor & Francis Group, 2021.

Summary:

The book describes key socio-political reforms that helped shape post-apartheid South Africa's mental health system. The author interrogates how reforms shaped public, community-based services for people living with severe mental illness, and how features of this care has been determined, in part at least, by the relations between actors and structures in the state, private for-profit health care, and civil society spheres. A description of the development of South Africa's post-apartheid health system, and the contentions that emerge therein, sets the stage for an analysis of the country's most tragic human rights failure during its democratic period, namely the Life Esidimeni tragedy. The roots of the tragedy are not only framed as a loss of life and dignity as a result of political corruption and administrative mismanagement, but as a power differential that ultimately highlights an unjust system that relegates its most vulnerable citizens to commodities, without voice and without agency. The book concludes that the commodification of severe mental illness has been a product of neoliberal discourses that have shaped the economistic ways in which the post-apartheid South African state have governed poverty and severe mental illness. This book will be of interest to scholars of health, social and economic policy in South Africa.

Contents:

Cover

Half Title

Series Information

Title Page

Copyright Page

Dedication

Table of contents

Prologue

Acknowledgment

1 Introduction

What is meant by "severe mental and neurological conditions"

Making sense of mental health care in contemporary times

Structure of the book

Note

2 The governance of mental health care in South Africa

Introduction

State-provided mental health care during pre-democratic South Africa

The Smith Mitchell and Co arrangement

Public mental health care in post-apartheid South Africa

Towards a democratic public health system

Private sector growth

The role of the non-profit sector

Mental health care's post-apartheid journey

Global mental health and subsequent explosion in research

National policy

Civil society

Contemporary mental health system

Notes

3 Collaboration between state and non-state mental health services

Methods

Setting

Approach and design

Instrument development

Data gathering

Data management and analysis

Ethical considerations

Study findings

Extent of collaboration

Nature of state and non-state mental health service collaboration

Range of services offered

Referrals

Reasons for mental health service collaboration

Power dynamics

Quality, effectiveness and efficiency of care

Discussions

Limitations

Recommendations

Conclusion

4 Collaboration between the state and civil society: An uneasy coalition

Post-apartheid policy contexts shaping CSO activities

The roles and responsibilities of CSOs

Finding a vocation in the New South Africa

Oversight and advocacy

Increasingly fuzzy borders of independence

The NAWONGO court case

2010

2011-2013

2014 and aftermath

What do the NAWONGO events mean for mental health care?.

SASSA grants scandal

5 Governance of state and civil society mental health care collaboration

Findings

Participants

Participants and formal authority

Participants and resources

Participants and discursive legitimacy

Process design

Process design: Formal authority and resources

Process design and discursive legitimacy

Content

Content and formal authority

Content and resources

Content and discursive legitimacy

Mental health stewardship

Mental health financing structures

Prioritisation

Strategic leadership

Information and monitoring system

Resistance

Discussion

6 When systems fail: Life Esidimeni and the meaning of justice

The Life Esidimeni crisis: A brief timeline

Unfolding of events

The Ombud Report

Public arbitration and beyond

A questionable justice

The TRC as a (unsatisfactory) blueprint for justice

Justice in a public sphere

Towards a distributive justice

7 Neoliberal mental health care in post-apartheid South Africa

What do we mean by neoliberalism?

Shifting responsibility to civil society

Costs and value

The local-global nexus of capital

The value of people with severe mental and neurological conditions

The centrality of death

8 Concluding thoughts

Postscript

References

Index.

Notes:

Description based on print version record.

ISBN:

0-429-20145-1

0-429-57467-3

9780429201455

OCLC:

1196822029