Wits School of Governance (ETDs)

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Start date: 2011End date: 2019

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    Implementation of the mental health care act in psychiatric hospitals
    (2017) Mulutsi, Eva Nkeng
    Introduction Mental illness is prevalent in all regions of the world and contributes significantly to premature mortality, high morbidity and loss of economic productivity (Baxter, Whiteford, Vos, & Norman, 2011; Charlson, Baxter, Cheng, Shidaye, & Whiteford, 2016). In South Africa, the Mental Health Care Act (No 17 of 2002) was promulgated in 2004 in response to the high burden of mental illness and to improve mental health service delivery, within a human rights framework. Aims and Objectives: The overall aim of this PhD study was to examine the implementation of the Mental Health Care Act in psychiatric hospitals in South Africa. The specific objectives were to: explore stakeholders’ involvement in the implementation of the Act; examine the policy processes followed in the implementation of the Act; determine whether Mental Health Review Boards execute their prescribed roles and functions; examine the implementation of legal procedures for involuntary admissions of psychiatric patients; and identify factors that influenced the implementation of the Act. Methods: The study was approved by the Human Research Ethics Committee of the University of Witwatersrand, Johannesburg. Sixteen psychiatric hospitals were selected in nine provinces, through stratified random sampling. Using an adapted conceptual framework with policy implementation theory as its foundation, the overall study approach was qualitative in nature, complemented with a record review of involuntary patient admissions in the selected hospitals. The qualitative component consisted of 35 in-depth interviews with: the drafter of the Act (n=1); provincial mental health coordinators (n=9); a psychiatrist at each of the selected hospitals (n=16); and the chair of a Mental Health Review Board in each of the provinces (n=9). At each selected psychiatric hospital, five patient records were selected randomly (n=80), focusing on compliance with the legal procedures for involuntary admissions. The qualitative data were analysed using thematic content analysis and MAXQDA® 11 while STATA® 12 was used to analyse the data from the record reviews. Results: South Africa’s political transition created a window of opportunity for the implementation of the Act. Wide-spread stakeholder support for the spirit and intention of the Act, advocacy for human rights, the broader transformation of the health system, and the need for enhanced governance and accountability in mental health, facilitated the implementation of the Act. However, implementation was hindered by: the relatively low prioritisation of mental health; stigma and discrimination; poor planning and preparation for implementation; resource constraints; and suboptimal stakeholder consultation. The study found that the majority of involuntary psychiatric patients admitted during (the year) 2010 were single (93.8%), male (62.5%), and unemployed (85%), predominantly black African (80%), with a median age of 32.5 years. The primary diagnoses were schizophrenia (33/80), substance-induced psychosis (16/80), bipolar mood disorders (15/80) and acute psychosis (9/80). There was poor compliance with the prescribed procedures for involuntary psychiatric admissions, exacerbated by suboptimal governance by, and functioning of, the Mental Health Review Boards, thus resulting in de facto illegal detention of patients. Conclusion and Recommendations: The Mental Health Care Act is an important policy lever to address the burden of mental illness and ensure quality mental health service delivery in South Africa. However, the enabling potential of the Act can only be realised if the following issues are addressed: improved, and dedicated resources for mental health; training and capacity building of health professionals and hospital managers on key aspects of the Act; improved governance, leadership and accountability through well-functioning Mental Health Review Boards; and improving mental health infrastructure and community-based services.
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    Human Resources Development at Tumela Mine
    (University of the Witwatersrand, Johannesburg, 2014-01-21) Mphahlele, Matuku
    In the context of the South African mining and mineral sector this study explores the human resource development measures to transform mentoring programmes at Tumela Mine. Despite the legislative stipulations that seek to promote equitable access to participation in the creation, development and sharing of the South African economy and natural resources through the establishment of a workplace environment conducive for learning to take place, little is known on how Tumela Mine implements mentoring programmes to foster effective human resource development. The study explored and analysed participants’ perceptions regarding the implementation of the Tumela Mine Mentoring Programme. The research was conducted through the use of a case study approach, and primary data was collected from respondents, and secondary data was gathered from relevant policies, minutes of meetings and company annual reports. The research questioned the successful aspects in the Human Resource Development unit, challenges and management’s responses to impediments to the implementation of mentoring programmes at Tumela Mine. The findings indicate that two key issues to improve implementation of mentoring programmes at the Tumela Mine are a transformational style of management and strategic repositioning of the mentoring programmes. The research argues that although company corporate strategic policy formulation and planning seek to promote equal participation of all employees in mentoring relationships, programme interventions at an operational level make it difficult to promote mentoring programmes. The key recommendation is that in order to implement effective mentoring programmes the company should review the corporate business strategy focused on strategic repositioning of mentoring programmes and inspire visionary leadership to implement a transformational style of management.
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    Human Resources Development at Tumela Mine
    (University of the Witwatersrand, Johannesburg, 2014-01-21) Mphahlele, Matuku
    In the context of the South African mining and mineral sector this study explores the human resource development measures to transform mentoring programmes at Tumela Mine. Despite the legislative stipulations that seek to promote equitable access to participation in the creation, development and sharing of the South African economy and natural resources through the establishment of a workplace environment conducive for learning to take place, little is known on how Tumela Mine implements mentoring programmes to foster effective human resource development. The study explored and analysed participants’ perceptions regarding the implementation of the Tumela Mine Mentoring Programme. The research was conducted through the use of a case study approach, and primary data was collected from respondents, and secondary data was gathered from relevant policies, minutes of meetings and company annual reports. The research questioned the successful aspects in the Human Resource Development unit, challenges and management’s responses to impediments to the implementation of mentoring programmes at Tumela Mine. The findings indicate that two key issues to improve implementation of mentoring programmes at the Tumela Mine are a transformational style of management and strategic repositioning of the mentoring programmes. The research argues that although company corporate strategic policy formulation and planning seek to promote equal participation of all employees in mentoring relationships, programme interventions at an operational level make it difficult to promote mentoring programmes. The key recommendation is that in order to implement effective mentoring programmes the company should review the corporate business strategy focused on strategic repositioning of mentoring programmes and inspire visionary leadership to implement a transformational style of management.
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    The Development of Social Capital in the Judiciary through mentorship
    (2011-04-06) Engelbrecht, Naomi Annette
    This study analyses the concept of mentoring as used in the South African Judiciary. Mentoring has been adopted by the South African judiciary in order to enhance the potential of acting Regional Magistrates to address their often repeated grievances regarding capacity building. The research attempts a quick evaluation of the process so far.