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Isabell Schierenbeck, Peter Johansson, Lena M. C. Andersson, Dalena van Rooyen
Health and Human Rights 2013, 15/2
The right to the enjoyment of the highest attainable standard of physical and mental health is enshrined in many international human rights treaties. However, studies have shown that people with mental disabilities are often marginalized and discriminated against in the fulfillment of their right to health. The aim of this study is to identify and reach a broader understanding of barriers to the right to mental health in the Eastern Cape Province in South Africa. Eleven semi-structured interviews were carried out with health professionals and administrators. The researchers used the Availability, Accessibility, Acceptability, and Quality (AAAQ) framework from the UN Committee on Economic, Social and Cultural Rights to structure and analyze the material. The framework recognizes these four interrelated and partly overlapping elements as necessary for implementation of the right to health. The study identifies eleven barriers to the enjoyment of the right to health for people with mental disabilities. Three categories of barriers relate to availability: lack of staff, lack of facilities, and lack of community services and preventive care. Four barriers relate to accessibility: lack of transport, lack of information, stigmatization, and traditional cultural beliefs of the community. Two barriers relate to acceptability: lack of cross-cultural understanding among staff and traditional cultural beliefs of staff. Finally, two barriers relate to quality: lack of properly trained staff and lack of organizational capacity. The results, in line with earlier research, indicate that the implementation of the right to health for people with mental disabilities is far from achieved in South Africa. The findings contribute to monitoring the right to mental health in South Africa through the identification of barriers to the right to health and by indicating the importance of building monitoring procedures based on the experiences and knowledge of staff involved in mental health care provision.