In this article, I argue that the add on approach to Integrated primary mental health care, characterised by the training of primary health care personnel in the identification and management of psychiatric disorders, will fail to deliver the vision of comprehensive mental health care that has been struggled for over the years in South Africa. I suggest that what is needed is a paradigm shift in the dominant biomedical discourse which characterises the primary health care relationship. To this end, an alternative discourse of care, shaped by an integration of cultural and critical understandings of illness and healing, is advanced.
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