Mental Health Services in South Africa: Taking stock

Abstract

There is new policy commitment to mental health in South Africa, demonstrated in the national mental health summit of April 2012. This provides an opportunity to take stock of our mental health services. At primary care level key challenges include-training and supervision of staff in the detection and management of common mental disorders, and the development of community-based psychosocial rehabilitation programmes for people with severe mental illness (in collaboration with existing non-governmental organizations). At secondary level, resources need to be invested in 72-hour observation facilities at designated district and regional hospitals, in keeping with the Mental Health Care Act. At tertiary level, greater continuity of care with primary and secondary levels is required to prevent "revolving door" patterns of care. There are major challenges and also opportunities related to the high level of comorbidity between mental illness and a range of other public health priorities, notably HIV/AIDS, cardiovascular disease and diabetes. The agenda for mental health services research needs to shift to a focus on evaluating interventions. With current policy commitment, the time to act and invest in evidence-based mental health services is now.

Integrating mental health care services in primary health care clinics: a survey of primary health care nurses’ knowledge, attitudes and beliefs

“…18 Integration of mental health services into PHC is supported by the WHO on the Optimal Mix of Services for Mental Health because the person can be treated as a whole and seeking care is less stigmatised. 19 Integration of mental health into general PHC services ensures that all PHC health workers involved in the management of a psychiatric patient have a shared understanding of the patient's progress and compliance with medication regimens.…”

Women's mental health: coping mechanisms in the context of poverty

“…Given that there is a current international commitment by the South African mental health policy (Lund, Petersen, Kleintjes, & Bhana, 2012), the evidence for coping mechanisms presented in this article is important when addressing mental health promotion, particularly in scarceresource communities where there is limited public or state care. What is obvious is that mental health promotion is not just about mental health services and should not be sector specific.…”

Public sector antiretroviral treatment programme in South Africa: health care workers' attention to mental health problems

“…Thus, further research is needed to determine why almost all of the health care workers in the Free State had observed signs and symptoms of anxiety, depression or other mental illnesses among ART patients, but only half of them screened and diagnosed. Possible explanations might be that the ART patients' mental health symptoms were sub-clinical, or the health care workers did not have sufficient training to correctly diagnose and therefore refer ART patients showing signs or symptoms of mental illness (Lund, Petersen, Kleintjes, & Bhana, 2012;Mall et al, 2012). Both nurses and lay workers reported observing a high frequency of signs and symptoms of anxiety, depression or other mental illnesses in ART patients.…”