Mental health reforms in limbo 3 years since Esidimeni tragedy

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Some experts are calling for mental health reforms in South Africa following shocking figures presented in parliament and a new report on mental health spending.

Some experts are calling for mental health reforms in South Africa following shocking figures presented in parliament and a new report on mental healthSouth Africa, like many other countries, is failing to achieve universal health coverage for mental disorders mostly due to budget and human resource constraints, stigma and often just a lack of political will.

Health Minister Zweli Mkhize recently presented new figures in answer to a parliamentary question showing almost half of hospitals in South Africa offering mental health services do not have a single psychiatrist. In the article Patel notes that in low-income countries treatment gaps for mental conditions like mood disorders exceed 90%.

The study also found huge disparities between provinces in spending on mental health services and against a context of a 90% treatment gap for mental conditions such as mood disorders in low-income countries – this is reason for concern. The Western Cape department of health provided figures for budgets of psychiatric hospitals and community based mental health services that show the department in the current financial year budgeted R24.7 billion and R23 billion in the previous financial year.

Even so, according to the UCT/MRC study and based on 2016/17 data, the Western Cape spent the most compared to other provinces per mental health patient and Mpumalanga’s spending was the lowest at R58.50 for that year. In the Western Cape the minister’s figures show there are 37 psychiatrists and 31 clinical psychologists.

Integrating mental health services into primary care is not a new idea but countries have been getting it wrong for decades, argues Patel.

 

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