My aim in this paper is to analyse community psychology and public health and distinguish between the two approaches. Community Psychology focuses on economic, environmental, political and social factors that influence the way in which people all over the world live their lives. It also touches on social factors that contribute or causes problems in various societies. Public Health on the other hand, according to Tutorial Letter 102/0/2014, is defined as being concerned with “preventing disease and distress” in the community as a whole, not just the individual, before they occur. It promotes healthy living and with the prevention of illness linked with lifestyle.
To compare these two concepts, one should first have a basic understanding of the origins and historical development of community psychology and public health.
Community Psychology are very much linked with the mental health reform movements in the USA. The three most important reform movements were; ‘Moral Treatment’, ‘The Mental Hygiene’ and ‘Deinstitutionalisation’. Each of these movements have led to the establishment of particular types of institution: In the Moral Treatment era, we got therapeutic mental hospitals, the Mental Hygiene era gave us Child Guidance Clinics and the establishment of Community Health Centers came in the Deinstitutionalisation era (Tutorial Letter 102/0/2014).
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Public health, like community psychology, focuses on prevention of disease. It is defined as “the science and practice of protecting and improving the health of a community as by preventative medicine; health education; control of communicable diseases. It is increasingly becoming the leading structure through which all attempts to prevent injuries due to accidents and violence are designed and implemented.
With regards to both approaches in South Africa, it is no coincidence that the initiation of Community Psychology in SA and its beginning in the USA follow a similar pattern. In the wake of the social upheaval in both countries (the 1960’s civil rights era in the USA and the general political struggle against apartheid during the 1970’s and the 1980’s in SA), a growing reaction was expressed about how existing psychological service delivery maintained the status quo.
Lazarus and Seedat (1995) identify 4 main purposes that define community psychology within the South African context. Community Psychology is an agency to:
1) Extend mental health services to all citizens, and in particular, to the historically unserved, underserved and oppressed sectors of our society;
2) Transform the way in which the etiology and development of psychosocial problems is conceptualised and understood;
3) Include a contextual analysis that takes cognisance of social issues so as to transform the praxis of psychological service delivery to include prevention initiatives that strengthen the resilience and protective functioning of high risk and vulnerable groups within disadvantaged communities in particular, and that address environmental stressors; and
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4) Redefine the role of psychologists towards a broader public health portfolio that embraces the functions of advocacy, lobbying, community mobilisation, community networking, and policy formulation. 1
The public health approach was established in South Africa throughout the past 150 years, and can be divided into four regimes (or facets of the public health approach as a whole). The first regime was sanitary science (from the 1850’s to just after the First World War), and its main concern was the “management and movement of human waste products from the body into the environment, and from the environment into the human body”, (Tutorial Letter 102/0/2014). Microbes, which multiplied wherever there was dirt, especially human waste, were viewed as the primary cause of various diseases. Sanitary science focused on the prevention of microbes from breeding and passing into people’s bodies, this was done through prohibitive laws and regulations regarding individuals’ behaviour.
The next regime, social medicine, was established from around 1930’s to the 1950’s, in response to sanitary sciences’ failure to control individuals’ behaviours in the privacy of their own homes. Social medicine’s main focus was persuading individuals to take an interest in their own bodies and their own health (Tutorial Letter 102/0/2014), which was established though education and training.
The third regime, community health, was established in response to view indigenous ideas and practices about health and illness as serving the same function as western biomedical beliefs. It was upon understanding the behaviour of individuals as determined by the broader fabric of traditions, customs, and beliefs that were specific
1 (Naidoo, A.V. (2000). Community psychology: Constructing community, reconstructing psychology in South Africa. Inaugural Lecture. University of Stellenbosch).
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to different communities. The last regime, The New Public Health, came to the aid of the limitations of community health.
Therefore, one can say that both Community Psychology and the Public Health Approach are involved in creating settings for community involvement and the study of social support and manners in which to enhance this support. All change, regardless where it came from, the individual or collective, stems from discontent or dissatisfaction with the status quo. The 1940s through the 1960s gave rise to Community Health Psychology and The Public Health Psychology. Both these movements, main concern are prevention and the need to address social injustices and structures to include the community and society at large and not just the elitist minority. Neither Community Health nor the Public Health Model is self- contained within psychology alone, but draws on socio, economic and the political arenas when addressing cause and effect.