Mkhize H
Department of Applied Psychology, University of the Witwatersrand, Johannesburg, South Africa.
Med Law. 1994;13(1-2):193-203.
This study explores the complex nature of mental health challenges and priorities in a post-apartheid South Africa. Special reference is made to indigenous people's experiences of poverty, racism, sexism and the machinery of political repression as critical bases for determining the priorities in mental health services. Whilst the provision of mental health services for all is sought by mental health professionals and legal systems in Western countries and other African states, South Africa has not developed a coherent sociolegal policy which aims at preventing, alleviating and healing mental health problems for all its citizens. Research gathered through a phenomenological approach amongst the oppressed seeks to define the terrain of people's psychological problems. Although data used are deduced mainly from the 'oppressed' on one white owned farm, questions raised and conclusions drawn address national as opposed to regional solutions, and also facilitate thinking about mental health priorities for all South Africans living under similar conditions. Commonly experienced problems are the effects of organized violence, child and adolescent problems, the prevalence of alcohol and drug use, depression, lack of facilities for the disabled and psychological care for homeless children, families and the youth. Participants were ignorant about mental health services, they experienced them as inaccessible and they were generally suspicious of an lacked faith in mental health workers. The author proposes broad future mental health options, like the restoration of family life in oppressed communities, the training of lay counsellors and the introduction of community mental health programmes. A suggestion is made that health workers in community mental health centres should adopt an advocacy position against all forms of unfair practices and violence and lobby for the protection of human rights.
本研究探讨了后种族隔离时代南非心理健康挑战的复杂本质及优先事项。特别提及了原住民在贫困、种族主义、性别歧视以及政治镇压机制方面的经历,这些是确定心理健康服务优先事项的关键依据。尽管西方国家和其他非洲国家的心理健康专业人员及法律体系都在寻求为所有人提供心理健康服务,但南非尚未制定一项连贯的社会法律政策,旨在预防、缓解和治愈其所有公民的心理健康问题。通过对受压迫者采用现象学方法收集的研究,试图界定人们心理问题的范围。尽管所使用的数据主要源自一个白人拥有的农场上的“受压迫者”,但所提出的问题和得出的结论涉及全国性而非地区性的解决方案,也有助于思考所有生活在类似条件下的南非人的心理健康优先事项。常见的问题包括有组织暴力的影响、儿童和青少年问题、酒精和药物使用的普遍性、抑郁症、残疾人设施匮乏以及对无家可归儿童、家庭和青年的心理关怀缺失。参与者对心理健康服务一无所知,他们觉得难以获得这些服务,并且普遍对心理健康工作者持怀疑态度且缺乏信任。作者提出了未来广泛的心理健康选择,比如恢复受压迫社区的家庭生活、培训非专业咨询师以及引入社区心理健康项目。有人建议社区心理健康中心的卫生工作者应采取倡导立场,反对所有形式的不公平做法和暴力行为,并游说争取人权保护。