Comprehensive integrated primary mental health care in South Africa. The need for a shift in the discourse of care

In this article. I argue that the add on approach to integrated primary men tal health care, characterised by the training of primary health care perso nnel in the identification and management of psychiatric disorders, will ra il 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 characteris es the primary health care relationship. To this end, an alternative discou rse of care, shaped by an integration of cultural and critical understandin gs of illness and healing, is advanced.