Psychosocial rehabilitation of persons with chronic mental illness has received increasing research attention over the past three decades. It is now widely accepted that pharmacotherapy alone is insufficient to treat persons with chronic mental illness. Additionally, there has been a paradigm shift towards the integration of evidence-based rehabilitation models and recovery models, which focus on collaborative approaches to care. This article reviews research findings relating to psychosocial rehabilitation interventions and models, and considers the implementation of psychosocial rehabilitation policies and practices in the South African healthcare context. Challenges to implementation and recommendations are presented.

Sexuality constitutes a central feature of what it is to be human, yet health practitioners, families, and caregivers frequently perceive romantic and sexually intimate relationships among persons with intellectual disabilities to be inappropriate tending to regard such individuals as either ‘asexual’ or ‘hyper-sexed’. A number of myths, stereotypes, and prejudices intersect in a manner that has deleterious consequences for persons with intellectual disabilities. This article reviews the literature on sexuality and barriers to sexual expression among persons with intellectual disabilities. Relevant legislative frameworks and human rights issues, in particular, the tensions between protecting persons with intellectual disabilities from exploitation, and the promotion of sexual autonomy also receive consideration. In addition, the article explores issues relating to competency to consent to sexual acts and concludes with a synthesis of the current knowledge.

While it is well known that people with an intellectual disability experience the same needs for intimacy as those without an intellectual disability, a number of developmental, structural, environmental, and attitudinal barriers circumvent the expression of sexuality in people with an intellectual disability – particularly in institutional and residential health care settings. People with an intellectual disability generally have lower levels of sexual knowledge than those without an intellectual disability, and sexual exploration and expression is frequently viewed with concern by mental health care practitioners and caregivers, who may regard people with an intellectual disability as being ‘nonsexual’ or ‘hypersexual’. However, the rights of people with an intellectual disability to sexual expression have been established in policy and legislation. Service providers are required at times to make determinations regarding the ability of people with an intellectual disability to consent to sexual intercourse in a number of health care settings. There is a dearth of published literature on psychometric instruments to assess sexual knowledge and consent capacity. This article briefly reviews the more commonly used sexual knowledge and consent assessments for people with mild to moderate intellectual disability and advances recommendations in this regard.

Like other aspects of life in South Africa, clinical psychology internships have undergone changes within the country's social and political history. Considering the formalised 12-month internship is in its fourth decade, the authors undertook an analysis of trends over a 30-year period of intern training in their programme at KwaZulu-Natal's largest mental health complex. The trends in intern demographics, as well as various programmatic variables, including clinical rotations, and related training issues were examined for the period commencing January 1981. The findings showed notable shifts in the intern demographics, and programme content. These are discussed within the context of the country's socio-political history, mental health care needs, and future training concerns and priorities.

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