<p>The development of mental health services in the Eastern Cape Province is inextricably entwined in South Africa’s colonial history and the racist policy of apartheid. Prior to the development of mental hospitals, mental health services were provided through a network of public and mission hospitals. This paper explores the development of early hospital and mental health services in the Eastern Cape from the time of the Cape Colony to the dissolution of apartheid in 1994, and highlights the influence of colonialism, race and legislation in the development of mental health services in this province. The objective is to provide a background of mental health services in order to identify the historical factors that have had an impact on the current shortcomings in the provision of public sector mental health services in the province. This information will assist in the future planning and development of a new service for the province without the stigma of the past. This research indicates that one lesson from the past should be the equitable distribution of resources for the provision of care for all that inhabit this province, as enshrined in South Africa’s constitution.</p><div> </div>
<p><strong>Background. </strong>The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service. </p><p><strong>Objective. </strong>To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province.</p><p><strong>Method. </strong>In this descriptive cross-sectional study, an audit questionnaire was submitted to all public sector mental health facilities. Norms and indicators were calculated at provincial and district level. This article investigates staff and bed distribution only.</p><p><strong>Results. </strong>Results demonstrated that within the province, only three of its seven districts have acute beds above the national baseline norm requirement of 13/100 000. The private mental health sector provides approximately double the number of medium- to long-stay beds available in the public sector. Only two regions have staff/population ratios above the baseline norm of 20/100 000. However, there are significant differences in this ratio among specific staff categories. There is an inequitable distribution of resources between the eastern and western regions of the province. When compared with the western regions, the eastern regions have poorer access to mental health facilities, human resources and non-governmental organisations. </p><p><strong>Conclusion. </strong>Owing to the inequitable distribution of resources, the provincial authorities urgently need to develop an equitable model of service delivery. The province has to address the absence of a reliable mental health information system.</p>
Objectives. Part I of this research article presents a needs-based analysis for the management of schizophrenia, bipolar mood disorder and major depression for the Eastern Cape (EC) Province, South Africa. This part of the research paper focuses on quantifying human resources and bed needs for these three severe mental illnesses. Human resource expenditure is calculated for nursing staff at acute, ambulatory and medium-to-long-stay services. A further objective was to conduct a gap analysis for human resources and beds for the EC in order to assist mental health planners in the commissioning of services. Methods. Data from previous research conducted in the province, and international and national epidemiological studies were utilised to quantify the requirements for human resources (psychiatrists, medical officers/registrars, psychologists, nurses, occupational therapists and social workers) and beds for acute, medium-to-long-stay and ambulatory services at provincial and regional levels, to provide mental healthcare. The authors focused on three of the eight priority conditions set by the World Health Organization. A target coverage rate of 80% was used in all calculations. A gap analysis was conducted to demonstrate deficits and excesses, utilising available data on human resources and beds available in the province. Results. The results showed that the districts of Alfred Nzo and Ukhahlamba have no human resources or beds for the provision of mental health services. The province has a deficit of 23 psychiatrists and 243 nurses trained in psychiatry, and an oversupply of 486 other nurses. The results also clearly demonstrated an inequitable distribution of resources in the province. Conclusions. This is the first study that has provided detailed estimates of human resource and bed deficits in the EC. The study demonstrates that the areas of greatest need in terms of bed and human resource requirements are in the eastern regions of the province, which includes the former homelands of the Transkei and Ciskei. This study will assist provincial mental health planners/commissioners in developing an equitable mental health delivery programme.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.