The South African Society of Psychiatrists (SASOP) and SASOP State Employed Special Interest Group (SESIG) position statements on psychiatric care in the public sector

Abstract

<p><strong>Executive summary.</strong> National mental health policy: SASOP extends its support for the process of formalising a national mental health policy as well as for the principles and content of the current draft policy.</p><p><strong> Psychiatry and mental health:</strong> psychiatrists should play a central role, along with the other mental health disciplines, in the strategic and operational planning of mental health services at local, provincial and national level.</p><p><strong>Infrastructure and human resources:</strong> it is essential that the state takes up its responsibility to provide adequate structures, systems and funds for the specified services and facilities on national, provincial and facility level, as a matter of urgency.</p><p><strong>Standard treatment guidelines (STGs) and essential drug lists (EDLs)</strong>: close collaboration and co-ordination should occur between the processes of establishing SASOP and national treatment guidelines, as well as the related decisions on EDLs for different levels.</p><p><strong>HIV/AIDS in children:</strong> national HIV programmes have to promote awareness of the neurocognitive problems and psychiatric morbidity associated with HIV in children.</p><p><strong>HIV/AIDS in adults:</strong> the need for routine screening of all HIV-positive individuals for mental health and cognitive impairments should also be emphasised as many adult patients have a mental illness, either before or as a consequence of HIV infection, constituting a ‘special needs’ group.</p><p><strong> Substance abuse and addiction:</strong> the adequate diagnosis and management of related substance abuse and addiction problems should fall within the domain of the health sector and, in particular, that of mental health and psychiatry.</p><p><strong>Community psychiatry and referral levels:</strong> the rendering of ambulatory specialist psychiatric services on a community-centred basis should be regarded as a key strategy to make these services more accessible to users closer to where they live.</p><p><strong>Recovery and re-integration:</strong> a recovery framework such that personal recovery outcomes, among others, become the universal goals by which we measure service provision, should be adopted as soon as possible.</p><p><strong> Culture, mental health and psychiatry:</strong> culture, religion and spirituality should be considered in the current approach to the local practice and training of specialist psychiatry, within the professional and ethical scope of the discipline.</p><p><strong> Forensic psychiatry:</strong> an important and significant field within the scope of state-employed psychiatrists, with 3 recognised groups of patients (persons referred for forensic psychiatric observation, state patients, and mentally ill prisoners), each with specific needs, problems and possible solutions.</p><p><strong> Security in psychiatric hospitals and units:</strong> it is necessary to protect public sector mental healthcare practitioners from assault and injury as a result of performing their clinical duties by, among others, ensuring that adequate security procedures are implemented, appropriate for the level of care required, and that appointed security staff members are appropriately trained and equipped.</p>

Identifying factors associated with the discharge of male State patients from Weskoppies Hospital

“… 4 Most South African psychiatric facilities designated for SPs are exceeding their maximum capacity. 5 Prolonged inpatient admission comes at a significant financial and human resources cost. Alleviating this burden requires limiting the duration of inpatient care without compromising patient or community safety.…”

Referral and collaboration between South African psychiatrists and religious or spiritual advisers: Views from some psychiatrists

“…The protection of individuals with psychiatric conditions within traditional and other religious/spiritual healing systems, however, needs to be ensured and all forms of abuse in this context, or neglect and delay with regard to appropriate psychiatric care, should be identified and prevented. ' [56] It should also be noted here that it appears that different faith traditions are not currently considered equally in terms of their role in the formal health sector. African traditional health practice, for example, seems to be awarded a disproportionately large space in this regard, as a controlling council has been legislated and constituted for African traditional health practitioners.…”

Contributions from the South African Society of Psychiatrists (SASOP) to the National Mental Health Action Plan

“…The result was 12 position statements on psychiatric care in the public sector. [1] In December 2012, when the Deputy Minister's task team invited SASOP to provide inputs into the development of the national MHAP, SASOP took this meeting into account, as wells as the following introductory statements in its submission:…”

“…This situation will allow for specific time frames, definitions of care at different levels, norms and standards of care, resources to be allocated, as well as the routine monitoring and auditing of mental healthcare programmes to be established in conjunction with psychiatrists on all levels. ' [1] In terms of the specialty status of psychiatry (PS10), SASOP's main business remains to promote, maintain and protect the honour and interest of its members and of the discipline of psychiatry as a medical specialty. The board will continue to pursue the following outcomes:…”

“…Twelve SASOP position statements were formulated as a result, which were subsequently (August 2012) published as a supplement to The South African Journal of Psychiatry. [1] • 'The SASOP endorses the Ekurhuleni Declaration on Mental Health of April 2012, as an active participant in the NMHS on 11 and 12 April 2012, as well as the process of the development of national mental health policy' . [4][5] • 'While mental health is currently included in the structure of the DoH as a component of the sub-programme Non-Communicable Diseases of Programme 4 (i.e.…”