Making consultation meaningful: Insights from a case study of the South African mental health policy consultation process

Abstract Background Mental health remains a neglected issue on the global health policy agenda, particularly in low- and middle-income countries (LMIC), and the translation of research evidence into policy and practice is slow. The new EVITA framework was developed to improve mental health evidence uptake and policy agenda-setting in LMICs. In addition, behavioural science methods may be able to support knowledge translation to policy. Methods Using a mixed-methods study design, we applied and tested the newly developed EVITA 1.1 framework against three case studies related to South Africa at the district, national and international levels. In-depth interviews with 26 experts were conducted between August and November 2019, transcribed, coded and analysed in NVivo, using iterative categorization. The data were analysed against both the EVITA framework and the MINDSPACE framework for behavioural insights. Results In our case study comparison, we found that (1) research translation to the policy agenda occurs in a complex, fluid system which includes multiple “research clouds”, “policy spheres” and other networks; (2) mental health research policy agenda-setting is based on key individuals and intermediaries and their interrelationships; and (3) key challenges and strategies for successful research to policy agenda impact are known, but are frequently not strategically implemented, such as including all stakeholders to overcome the policy implementation gap. Our data also suggest that behavioural science methods can be strategically applied to support knowledge translation to policy agenda-setting. Conclusion We found that the EVITA framework is useful for understanding and improving mental health research policy interrelationships to support evidence uptake to the policy agenda, and that behavioural science methods are effective support mechanisms. The revised EVITA 2.0 framework therefore includes behavioural insights, for improved mental health policy agenda-setting in LMICs. More research is needed to understand whether EVITA can be applied to other LMICs and to high-income contexts.

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Developing a National Mental Health Policy: A Case Study from Uganda

PLoS Medicine ◽

10.1371/journal.pmed.1001319 ◽

2012 ◽

Vol 9 (10) ◽

pp. e1001319 ◽

Cited By ~ 8

Author(s):

Joshua Ssebunnya ◽

Fred Kigozi ◽

Sheila Ndyanabangi

Keyword(s):

Mental Health ◽

Health Policy ◽

Mental Health Policy ◽

National Mental Health

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Policymaking through a knowledge lens: Using the embodied-enacted-inscribed knowledge framework to illuminate the transfer of knowledge in a mental health policy consultation process – A South African case study

PLoS ONE ◽

10.1371/journal.pone.0244940 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244940

Author(s):

Debra Leigh Marais ◽

Inge Petersen ◽

Michael Quayle

Keyword(s):

Mental Health ◽

Health Policy ◽

Mental Health Policy ◽

Experiential Knowledge ◽

Evidence Based ◽

Transfer Of Knowledge ◽

Consultation Process ◽

Knowledge Framework ◽

What Works ◽

Use Of Knowledge

Background Marrying principles of evidence-based policymaking, with its focus on what works, with principles of consultative policymaking, with its focus on what works for whom, means finding ways to integrate multiple knowledge inputs into policy decisions. Viewed through the lens of the embodied-enacted-inscribed knowledge framework, policy consultation is a site of knowledge enactment, where the embodied knowledge enacted by individuals engages with the inscribed knowledge contained in policy documents, creating new forms of embodied and inscribed knowledge that move beyond these spaces. Aim Using this knowledge framework, this study aimed to trace the movement of knowledge inputs through South Africa’s mental health policy consultation summit. Methods Breakaway group session transcripts from the national consultation summit were thematically analysed to identify the types of knowledge that participants explicitly drew on (experiential or evidence-based) during discussions and how these knowledge inputs were used, responded to, and captured. Findings Findings suggest that there was little explicit reference to either evidence-based or experiential knowledge in most of the talk. While slightly more evidence-based than experiential knowledge claims were made, this did not render these claims any more likely to be responded to or engaged with in group discussions, or to be inscribed in group recommendations. Discussion The importance of designing participatory processes that enable optimal use of knowledge inputs in these enacted spaces is discussed. Conclusion Attending to the specific ways in which knowledge is transformed and moved through a policy consultation process has the potential to enhance the value that consultation offers policymakers.

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