South Africa’s political history has led to a marginalizing of all languages except for English and Afrikaans. Many clinicians cannot speak the languages spoken by patients. We attempt to understand the slow progress towards achieving greater access to mental health services on the basis of language. The administrative constraints of an overburdened and bureaucratized health system lead to language and communication playing a relatively small part in clinical practice. Resistance to learning other languages may relate to the emotional risks involved in this learning. A psychological understanding of the barriers to linguistic change may help us develop further changes.
Abbott, A. (1988). The system of the professions: An essay on the division of expert labor. Chicago, IL: Chicago University Press.
2.
Binedell, J. (1993). Methods and madness: Researching community health workers’ perceptions of mental illness in Khayelitsha and Nyanga. Unpublished masters dissertation, University of Cape Town, Cape Town.
3.
Casey, P. R., Dillon, S., & Tyrer P. J. (1984). The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychological Medicine, 14, 673–683.
4.
Crawford, A. (1999). ‘We can’t all understand the whites’ language’: An analysis of monolingual health services in a multilingual society. International Journal of the Sociology of Language, 136, 27–45.
5.
Cushway, D. (1997). Stress in trainee psychotherapists. In V. P. Varma (Ed.), Stress in psychotherapists(pp. 24–43). London: Routledge.
6.
Dale, F. (1997). Stress and the personality of the psychotherapist. In V. P. Varma (Ed.), Stress in psychotherapists(pp. 11–23). London: Routledge.
7.
De Grandpre, R. J. (1999). Ritalin nation: Rapid-fire culture and the transformation of human consciousness. New York: Norton.
8.
Desjarlais, R., Eisenberg, L., Good, B., & Kleinman, A. (1995). World mental health: Problems and priorities in low-income countries. New York: Oxford University Press.
9.
Diller, L. H. (1998). Running on Ritalin: A physician reflects on children, society and performance in a pill. New York: Bantam Doubleday Dell.
10.
Drennan, G. (1998). Language and the role of interpreting in South African psychiatry: A study of institutional practice in the Western Cape. Unpublished doctoral thesis, University of Cape Town, Cape Town.
11.
Drennan, G. (1999). Psychiatry, post-apartheid integration and the neglected role of language in South African institutional contexts. Transcultural Psychiatry, 36, 5–22.
12.
Foucault, M. (1973a). Madness and civilization. New York: Vintage.
13.
Foucault, M. (1973b). The birth of the clinic: An archaeology of medical perception. New York: Vintage.
14.
Freeman, M., & Pillay, Y. (1997). Mental health policy – plans and funding. In D. Foster, M. Freeman, & Y. Pillay (Eds.), Mental health policy issues for South Africa(pp. 32–54). Cape Town: MASA Multimedia.
15.
Gelman, T. (1999). The prevalence and detection of possible minor psychiatric morbidity in students attending the student health services at the University of Cape Town. A pilot study. Unpublished masters dissertation, University of Cape Town, Cape Town.
16.
Gillis, L. S. (1992). Depression in newly-urbanised elderly South Africans. Southern African Journal of Gerontology, 1, 20–24.
17.
Helman, C. (1994). Culture, health and illness: An introduction for health professionals(3rd ed.). Oxford, UK: Butterworth-Heinemann.
18.
Ingleby, D. (Ed.). (1981). Critical psychiatry. Harmondsworth, UK: Penguin.
19.
Kaufert, J. M. (1990). Sociological and anthropological perspectives on the impact of interpreters on clinician/client communication. Sante Culture Health, 7, 209–235.
20.
Kaufert, J. M., & Koolage, W. W. (1984). Role conflict among ‘culture brokers’: The experience of native Canadian medical interpreters. Social Science & Medicine, 18, 283–286.
21.
Kaufert, J. M., Koolage, W. W., Kaufert, P. L., & O’Neil, J. O. (1984). The use of ‘trouble case’ examples in teaching the impact of sociocultural and political factors in clinical communication. Medical Anthropology, 8, 36–46.
22.
Kaufert, J. M., Lavallee, M., Koolage, W., & O’Neil, J. (1996). Culture and informed consent: The role of aboriginal interpreters in patient advocacy in urban hospitals. Issues in the North, 1, 89–93.
23.
Kaufert, J. M., & O’Neil, J. (1995). Cultural mediation of dying and grieving among native Canadian patients in urban hospitals. In L. A. DeSpelder & A. L. Strickland (Eds.), The path ahead: Readings in death and dying(pp. 59–74). Mountain View, CA: Mayfield.
24.
Kaufert, J. M., & Putsch, R. W. (1997). Communication through interpreters in health care: Ethical dilemmas arising from differences in class, culture, language and power. The Journal of Clinical Ethics, 8, 71–87.
25.
Kleinman, A. (1988). Rethinking psychiatry: From cultural category to personal experience. New York: Free Press.
26.
Kramer, P. (1993). Listening to Prozac: A psychiatrist explores antidepressant drugs and the remaking of the self. New York: Viking
27.
Kuipers, E. (1996). The management of difficult to treat patients with schizophrenia, using non-drug therapies. British Journal of Psychiatry, 169(Suppl. 31), 41–51.
28.
Leff, J. (Ed.). (1997). Care in the community: Illusion or reality?Chichester, UK: Wiley.
29.
Littlewood, R. (1994). Symptoms, struggles and functions: What does the overdose represent? In M. McDonald (Ed.), Gender, drink and drugs(pp. 77–98). Oxford, UK: Berg.
30.
Littlewood, R., & Lipsedge, M. (1997). Aliens and alienists: Ethnic minorities and psychiatry(3rd ed.). London: Routledge.
31.
Lyon, M. L. (1996). C. Wright Mills meets Prozac: The relevance of ‘social emotion’ to the sociology of health and illness. In V. James & J. Gabe (Eds.), Health and the sociology of emotions(pp. 55–78). Oxford, UK: Blackwell.
32.
Malady, R. G., Rogler, L. H., & Constantino, G. (1987). Ethnocultural and linguistic bias in mental health evaluation of Hispanics. American Psychologist, 42, 228–234.
33.
Marks, S. (1994). Divided sisterhood: Race, class and gender in the South African nursing profession. New York: St Martin’s Press.
34.
McDonald, M. (1994). Introduction: A social–anthropological view of gender, drink and drugs. In M. McDonald (Ed.), Gender, drink and drugs(pp. 1–31). Oxford, UK: Berg.
35.
Mesthrie, R. (Ed.). (1995). Language and social history: Studies in South African sociolinguistics. Cape Town: David Philip.
36.
Mezzich, J. E., Kleinman, A., Fabrega, H. Jr, & Parron, D. L. (Eds.). (1996). Culture and diagnosis: A DSM-IV perspective. Washington, DC: American Psychiatric Press.
37.
Miller, T., Swartz, L., & Rumble, S. (1991). Psychological factors in primary health care in Mamre. Paper presented at the Epidemiological Society of South Africa Conference, University of the Western Cape, July.
38.
Mizrahi, T. (1987). Getting rid of patients: Contradictions in the socialization of internists to the doctor–patient relationship. Sociology of Health and Illness, 7, 214–235.
39.
Mossman, D. (1997). Deinstitutionalization, homelessness and the myth of psychiatric abandonment: A structural anthropology perspective. Social Science & Medicine, 44, 71–83.
40.
Ormel, J., Koeter, M. W. J., Van den Brink, W., & Van de Willige, G. (1991). Recognition, management and course of anxiety and depression in general practice. Archives of General Psychiatry, 48, 700–706.
41.
Phillips, A. (1995). Terrors and experts. London: Faber and Faber.
42.
Rhodes, L. A. (1991). Emptying beds: The work of a psychiatric emergency psychiatric unit. Berkeley: University of California Press.
43.
Roth, A., & Fonagy, P. (1996). What works for whom: A critical review of psychotherapy research. New York: Guilford.
44.
Roth, L., & Swartz, L. (1992). The integration of two psychotherapeutic units: Staff experiences of the first six months. South African Journal of Occupational Therapy, 22(2),6–11.
45.
Rumble, S., Swartz, L., Parry, C., & Zwarenstein, M. (1996). Prevalence of psychiatric morbidity in the adult population of a rural South African village. Psychological Medicine, 26, 997–1007.
46.
Storr, A. (1968). The concept of cure. In C. Rycroft (Ed.), Psychoanalysis observed (pp. 48–68). Harmondsworth, UK: Penguin.
47.
Susser, E., Valencia, E., Conover, S., Felix, A., Tsai, W. Y., & Wyatt, R. J. (1997). Preventing recurrent homelessness among mentally ill men: A ‘critical time’ intervention after discharge from a shelter. American Journal of Public Health, 87, 256–262.
48.
Swartz, L. (1989). Aspects of culture in South African psychiatry. Unpublished doctoral thesis, University of Cape Town, Cape Town.
49.
Swartz, L. (1991). The reproduction of racism in South African mental health care. South African Journal of Psychology, 21, 240–246.
50.
Swartz, L. (1996). Culture and mental health in the rainbow nation: Transcultural psychiatry in a changing South Africa. Transcultural Psychiatric Research Review, 33, 119–136.
51.
Swartz, L. (1998a). Culture and mental health: A southern African view. Cape Town: Oxford University Press.
52.
Swartz, L. (1998b). Mental health in South Africa. Paper presented at the Conference Change: Psycho-Analytic Perspectives, Cape Town, 2–5April.
53.
Swartz, L., Drennan, G., & Crawford, A. (1997). Changing language policy in mental health services: A matter of interpretation?. In D. Foster, M. Freeman, & Y. Pillay (Eds.), Mental health policy in South Africa(pp. 166–180). Cape Town: MASA Multimedia.
54.
Swartz, L., & Foster, D.(1984). Images of culture and mental illness: South African psychiatric approaches. Social Dynamics, 10, 17–25.
55.
Szasz, T. (1961). The myth of mental illness. New York: Hoeber and Harper.
56.
Szasz, T. (1971). The manufacture of madness. London: Routledge and Kegan Paul.
57.
Van der Walt, H. (1998). Nurses and their work in the tuberculosis control programme in the Western Cape: Too close for comfort. Unpublished doctoral dissertation, University of Cape Town, Cape Town.
58.
Van der Walt, H., & Swartz, L. (in press). Isabel Menzies Lyth revisited: Institutional defenses in public health nursing in South Africa during the nineties. Psychodynamic Counselling.
59.
Von Korff, M., Shapiro, S., Burke, J. D., Teitlebaum, M., Skinner, E. A., German, P.,Turner, R. W., Klein, L., & Burns, B. (1987). Anxiety and depression in a primary care clinic: Comparison of DIS, GHQ and practitioner assessment. Archives of General Psychiatry, 44, 152–156.
60.
Westermeyer, J. (1990). Working with an interpreter in psychiatric assessment and treatment. Journal of Nervous and Mental Disease, 178, 745–749.
61.
Westermeyer, J., & Janca, A. (1997). Language, culture and psychopathology: Conceptual and methodological issues. Transcultural Psychiatry, 34, 291–311.
62.
Winnicott, D. (1984). Playing and reality. Harmondsworth, UK: Penguin.
63.
Wolf, E. S. (1988). Treating the self: Elements of clinical self psychology. New York: Guilford.
64.
Wurtzel, E. (1994). Prozac nation. Boston: Houghton Mifflin.
65.
Zung, L. S., Magill, M., Moore, J. T., & George, T. (1983). Recognition and treatment of depression in a family medicine practice. Journal of Clinical Psychiatry, 44, 1–3.
