A community (dis)service: Reflections of a community service clinical psychologist

Abstract

In improving access to quality health care, the National Department of Health has made community service mandatory in South Africa for newly graduated health professionals. Largely informed by the shortage of health care professionals within the public health sector, the community service initiative can also be located within the larger global impetus of integrating mental health into primary health care. This article attempts to answer the question as to whether the author’s particular community service placement, located in the Overberg District Municipality, improved the access to quality mental health care services. The challenges inherent in this placement site are numerous. These include, but are not limited to, patients’ inability to access the service due to financial constraints and the lack of public transport, the burdensome work environment of generalised nursing personnel and their lack of training in mental health care, the absence of mental health specialists and a multidisciplinary health team, the provision of mental health care being embedded within the biomedical model, and a lack of institutional support. As the article will argue, these weaknesses are largely reflective of the poorly integrated health system operative within the Overberg District Municipality. The author aims to provide recommendations as to how these can be addressed so as to ensure that the strategic thrust, as envisioned by the National Department of Health with the introduction of the community service initiative, comes to fruition in that individuals can access quality health care services within their respective communities at the primary level of care.