Mental Health Care has its Day in Parliament

Parliament recently acknowledged World Mental Health Day (10 October 2013) by inviting mental healthcare experts to brief the Health Portfolio Committee on mental health challenges and their suggestions on how these can be addressed.

The Department of Health gave the Committee some sobering statistics on the state of mental health care in the country. One in six South Africans, every year, will suffer from a diagnosable mental health disorder, while only 25% of people with mental disorders have access to formal mental health services. Other challenges include weak institutional capacity, old infrastructure, too few specialist practitioners, difficulty in retaining them in the public sector, and challenges in accessing technology, equipment and medicines.

Perhaps the saddest revelation came from the South African Federation for Mental Health, who said that mental health gets a very small proportion of the health budget when in actual fact psychiatric disorder is the third highest cause of the health burden in South Africa.

Representatives from the Programme for Improving Health Care (PRIME) informed the Committee that schizophrenia, depression, and alcohol use disorder are the top three mental problems. Psycho-social rehabilitation for people with schizophrenia was lacking. People with depression were less likely to engage in healthy behaviour and adhere to self-care and register for treatment. This affects the impact of ARV treatment. It was crucial to integrate depression care with chronic disease care. They also explained that mental disorders and poverty interact in a vicious cycle that increases the risk of mental disorders among the poor, and increases poverty among those with mental disorders through multiple pathways. They urged the Committee to consider implementing a mental health services strategy that was pro-poor, pro-development and pro-human rights.

However, it was not all bleak news. There is a National Drug Master Plan that was approved this year, which will run from 2013-2017. It has three pillars: demand reduction, supply reduction (law enforcement) and harm reduction (prevention and treatment). The Department of Social Development is embarking on an awareness campaign on mental health with the department of health, the NGO sector and community-based organisations. Treatment centres have been established around the country, especially in the rural areas. There are 47 private treatment centres, and government funds 25 of these. Government has gone further to combat substance abuse with an inter-ministerial committee. The government is also dealing with alcohol outlets around the country to fight alcohol abuse in South Africa. Currently, 2 135 beds are available for psychiatric patients in the Western Cape. There are plans to provide 216 more beds over the next two years. The South African Depression and Anxiety Group (SADAG) also offers voluntary assistance for mental therapy.

There will be ongoing discussions about supporting churches, which have been helping people with mental health prevention and treatment. One of the suggestions made by the Committee was whether government could provide licensed traditional and divine healers for patients who prefer to be treated by them.

It was agreed that although there had been an improvement in the mental health sector, more had to be done, as there are still insufficient resources and services in the community. Mental health could not be dealt with until mental health problems were addressed directly.