The State of Mental Health Care in South Africa: What we need

The statement “There is no health without mental health” made by the World Health Organization highlights the importance of taking care of both our mental and physical health. Health services in South Africa are improving for many physical health problems but remain weak and limited for mental health services.

Mental health in SACurrently the majority of the budget for mental health services is spent on institutions catering primarily for severe mental disorders, such as severe mood disorders and psychosis. Providing services for all mental disorders at local health centres is urgently needed through an integrated service that is supported by a strong district mental health team.

The clinic-level services should include accurate screening and detection of problems such as depression, brief counselling interventions provided at clinic level, and an effective referral system from the primary to more specialised services when required. Provision of integrated and effective mental health services within a general health care service addresses a number of concerns. People with chronic conditions, such as HIV, diabetes and cardiovascular diseases, often have comorbid depression and/or anxiety affecting adherence to their treatment.

Providing mental health care services assists people to find ways to cope more effectively with their chronic conditions and can reduce poverty levels.

Furthermore, mental disorders are strongly associated with poverty. Providing mental health care services assists people to find ways to cope more effectively with their chronic conditions and can reduce poverty levels. Addressing mental health care needs will reduce the health and economic burden of mental health disorders. In South Africa, and other low- and middle-income countries, there are a growing number of efforts to integrate mental health into general health care. Examples include screening and counselling for depressed pregnant women, providing a brief counselling intervention for people with injuries related to alcohol and drug abuse presenting at emergency departments at hospitals in the Western Cape, and addressing mental health disorders of people attending chronic disorder clinics.

Read more about how the the Alan J Flisher Centre for Public Mental Health suggests mental health care should be integrated into primary healthcare settings in the South African Health Review 2016 here.