Susan Kriegler

Options and Directions for Psychology within a Framework for Mental Health Services in South Africa

Structural problems in mental health services conjoined with attitudinal barriers are the cause of inadequate mental health care in South Africa. However, the major reason for the failure of psychology to address the needs of the majority lies in training deficiencies. In spite of the potential cost benefits of psychotherapy and prevention by way of counselling and educative interventions, psychologists are not perceived or employed as primary members of mental health teams. In schools they are rapidly losing ground. The profession is disempowered to position itself strategically to become a significant roleplayer in the ‘new’ South Africa. Affirmative action for psychology is needed. Ways in which the state may help are suggested, including the creation of more posts and training opportunities in health care settings, as well as use of the school as a locus for health and mental health care delivery. The author concludes with a call to the profession to get its own house in order by way of self-regenerating actions in the areas of training, addressing political and cross-cultural issues, and service delivery.

A critical engagement with the DSM-5 and psychiatric diagnosis

Classifications in psychiatry can result in the reification of hypothetical approaches, arbitrary categorisation and social injustice. This article applies a social constructivist approach to critique the DSM-5 as a neurobiological model of psychiatric diagnosis which ignores psychosocial factors such as poverty, unemployment and trauma as causes of mental distress. It challenges the universality of psychiatric diagnosis and proposes that cultural psychiatrys framing of ‘culture-bound syndromes,’ or ‘cultural case formulation’ guidelines, is oversimplified. Use of the DSM in the South African context risks perpetuating injustice by labelling and stigmatising people who have in the past been racially stigmatised by apartheid. In culturally diverse South Africa, psychiatric diagnosis should take into account alternative explanatory models that provide a more balanced view of the complex and dynamic relationship between biological and sociocultural forces in the manifestation of psychopathology.

Educators' perceptions of homophobic victimisation of learners at private secondary schools

Heteronormativity is a foundational source of human oppression, resulting in heterosexism and homophobic attitudes, thus creating a hostile climate for non-heterosexual people. Despite a constitution that prohibits discrimination against anyone on the grounds of sexual orientation, homophobic victimisation of learners at secondary schools still occurs. The objective of this research project was to investigate educators’ perceptions of homophobic victimisation against homosexual learners at private secondary schools. We adopted a phenomenological approach. The research design was qualitative and of an exploratory, descriptive, and contextual nature. We gathered data by means of an open-ended, structured questionnaire and, with the assistance of an independent coder, we employed Tesch’s eight-step method of data analysis. We identified six themes: culture of acceptance; the need for policies; understanding of homosexuality; perception of homosexual learners; social difficulties and acts of verbal, physical, and emotional victimisation; and the learners’ feelings. These themes were organised under three categories, namely, school context, educators’ perceptions, and learners’ difficulties.