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This study investigates mental health care deficits in South Africa and explores an alternative intervention strategy that promotes an integrated community-based intervention model to reach the vulnerable majority living with the debilitating consequences of mental illness. The research is grounded in human rights, empowerment and human scale development theories. A mixed-methods research design consisting of a dominant quantitative methodology complemented by a qualitative methodology was adopted. The research design was carried out in three sequential phases. The first phase of the study involved an online survey with 19 mental health professionals employed at State psychiatric facilities and 90 social workers at 17 mental health non-government organisations. The second phase involved 5 focus group discussions with a total of 40 mental health service users from the Western Cape, Eastern Cape, KwaZulu-Natal, Northern Cape and Limpopo Provinces. The third and final phase of the study involved telephonic interviews with two key informants, using a semi-structured interview guide. Purposive sampling procedures were used to recruit respondents from all nine provinces in South Africa. Findings indicate that less than half of the mental health professionals (49%, n=53) reported that the National Mental Health Policy Framework and Strategic Plan 2013‒2020 is a very good policy, whereas 42.6% (n=46) agreed that the policy is highly appropriate for a developing country. The Chi-square test showed a significant relationship between respondents’ perceptions of a good policy and its appropriateness for mental health care in South Africa [χ² (9, n=109) = 120.5, p

This study investigates the training offered to community-based rehabilitation workers in the field of mental handicap to ascertain whether the training provided has been perceived as appropriate in assisting with their tasks and functions. Further investigation is done into the underlying theoretical approaches used in training, curricula designs, training objectives, location and training periods, the community-based rehabilitation workers level of participation and involvement in planning of the training programme, and whether creative, pragmatic and participatory training methods, techniques and materials were used. The nature of supervision was also explored. The historical development of community-based rehabilitation, the lack of trained personnel, and the disparity in the provision of services in South Africa and the function of the community-based rehabilitation are discussed. It is against this background that the historical emergence and need for training of community-based rehabilitation workers are highlighted. Different theoretical approaches to the development and presentation of training are discussed due to the considerable influence they have on the value base upon which training programmes are built. This includes an overview of the philosophy of Paulo Freire. The research method used is of a qualitative nature. The researcher employs an exploratory - descriptive design to gain insight into an area which is relatively uninvestigated. By using this design, the researcher hopes to build a foundation of ideas and tentative theories which could later be tested through more complex methods. The first population chosen included the total population of community-based rehabilitation workers employed at the South African Christian Leadership Assembly Health Project, (seven) and Cape Mental Health Society (two). The second population were the trainers associated with these organisations and the specific projects in which the community-based rehabilitation workers are employed. One trainer from each organisation was included. Both organisations chosen are engaged in direct service delivery to the mentally handicapped in socially deprived communities in the Western Cape. The primary source of data collection was acquired in two phases:- Phase one - An interview schedule which included structured & unstructured questions was administered by the researcher to the community - based rehabilitation workers. The information was gathered with the assistance of an interpreter. Phase two - A detailed self-administered, semi-structured questionnaire was completed by the trainers. The data in these two phases was presented in a descriptive manner due to the size of the population. The study found that there is no consensus regarding appropriate training models. Courses are often loosely structured with no theoretical base. A comprehensive-generic approach which includes promotive, curative, preventative, and rehabilitative aspects is suggested. In this study, the course focused mainly on curative and rehabilitative aspects to assist with tasks while promotive and preventative skills were neglected. No prescribed training period can be stipulated. Constraints of distance and location would determine the duration of the training while the location of training should be within the confines of the community to prevent isolation and an unnatural environment. More creative and pragmatic methods and techniques should be carefully selected. All components of supervision should be given priority and provided regularly in pragmatic and innovative ways. Furthermore, trainers, trainees and communities need to have equal participation and involvement in all spheres of training.