Abstract
In this study the expectations of consumers of public sector psychiatric care in South Africa were identified, and formulated in the form of 13 standards, each with a set of criteria. During this phase input from the literature was incorporated, and expectations were validated with different groups of consumers, so that rural/urban, ethnicity and regional differences were taken into account. Based on the comprehensive set of standards and criteria, four instruments were developed to measure attainment of these standards. These included a questionnaire to consumers and one to the Director of Mental Health. It also included two schedules to be filled in by observers during site visits to hospital units and clinics. The observer teams included community members and consumers. The content validity of the instruments was established by setting out the items measuring each criterium, and validating that with a group of experts. The instruments were then tested in one province. The inter-rater reliability of the site visit schedules was calculated as 0.94, and the coding of the Director questionnaire by different coders was also tested. The average performance on all criteria was calculated, using items from all four data collection instruments. In the process items were revised, coding instructions developed, and criteria adjusted.
Highlights
In a summary by Freeman (1992) the incidence ofmental illness in the South African population varies between 12% and 39% in communities in South Africa
With a population of 40,7 million (Sunday Times, 1994), this gives a minimum figure of 4,9 million consumers or potential consumers of psychiatric care
Strong consumer movements have developed since the 1970s. This probably has been a direct result of the de-institutionalization movement, which pushed psychiatric patients into the community without adequate support
Summary
In a summary by Freeman (1992) the incidence ofmental illness in the South African population varies between 12% and 39% in communities in South Africa. Similar to the other consumer groups NAMI, composed primarily of families of seriously mentally ill people, is dedicated to advocacy, education, mutual support and resource development It has become extremely powerful at all levels of government, and has lead to significandy increased participation of consumers in planning of mental health services. One of their activities over the last decade has been a regular rating of state programmes for the seriously mentally ill (Torrey, Wolfe and Flynn, 1988). Psychiatric care is an expensive service which is funded mainly by tax payers It is an important function of provincial governments in the new South Africa, and there is no better time to initiate a regular consumer rating system. This will provide a valuable tool for the consumer movement to organize themselves, and for the health service managers to involve them constructively
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