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Paper short abstract:

Motivated Ethnography as a methodology to support case study exploring the realities of community mental health services within a rural South African Community in the era of Global mental health.

Paper long abstract:

The movement for global mental health's (Patel et al., 2011) continued efforts to scale up availability of mental health services has met with moderate successes. Investigations have pointed towards the value of task shifting, integrated services, and multi-disciplinary collaborations to support the mental health needs of underserved communities in many African contexts (Kasuma et al., 2011). However, there a need to evaluate how these very different approaches play out within the spaces demarcated by policy, material limitations, and symbolic and spatial complexities. Arguably, the realities through which policy and service delivery processes are lived are best viewed through ethnographic approaches (Lewis and Mosse, 2005) which remain underutilized within mental health research. This paper reports on findings from a case study of rural community mental health services in South Africa, which employed a motivated ethnographic approach (Duveen & Lloyd, 1993) in order to explore the lived realities of policy aligned with global movement recommendations for task shifting and multi-disciplinary integrated services for mental health at a district hospital. Findings indicate that the policy itself remains the primary barrier to effective service delivery, based on contingencies that are impossible to meet within the contexts of rural poverty stricken communities. Implications for future policy recommendations are discussed.