A framework for the expansion of psychosocial rehabilitation and support services in the Western Cape: towards occupational justice and societal well-being

Aim The Western Cape Department of Health and Wellness has responded to increasing mental health service pressures by developing an expanded psychosocial rehabilitation framework. Initiated in 2023, this framework aims to address the needs of individuals with mental disorders while also promoting mental well-being across the broader population. Central to this approach is the concept of occupational justice, which upholds the right of every individual, regardless of socio-economic status, disability, or other barriers, to engage in meaningful activities that support mental health and social inclusion. The aim of this paper is to outline the process employed by the Department to develop this framework and to illustrate the benefits of framing mental health around the principles of occupational justice. Method Consultative workshops were held with health workers from across the care continuum to identify service gaps and opportunities for expanding psychosocial rehabilitation services. Thematic analysis of the feedback informed the development of the expanded framework, with occupational justice positioned as a core protective factor for mental health and well-being. Results A bouquet of psychosocial interventions was developed, consisting of five key components: (1) building community resilience by promoting equitable access to basic services through a multi-sectoral response; (2) psychosocial support to promote mental health and prevent decline among those who are healthy or at risk; (3) psychosocial care and rehabilitation for individuals with diagnosed mental disorders to support optimal functioning and community re-integration; (4) palliative psychosocial support for clients and families to enhance quality of life; and (5) employee resilience through access to support services and training for healthcare staff. The framework recognises mental health as a continuum and promotes differentiated levels of psychosocial support tailored to an individual’s needs through inter-disciplinary and multi-sectoral collaboration. Conclusion This expanded framework redefines psychosocial interventions in the Western Cape by situating occupational justice at its core. It recognises psychosocial support as part of a continuum of care and emphasises the role of multi-sectoral and inter-disciplinary stakeholders as change agents collaborating to strengthen rehabilitation and support services, and to promote overall societal well-being.