Mental health services in South Africa: taking stock

• Published in: African journal of psychiatry Vol. 15; no. 6; p. 402
• Main Authors: Lund, C, Petersen, I, Kleintjes, S, Bhana, A
• Format: Journal Article
• Language: English
• Published: United States 01-11-2012
• Subjects: Community Mental Health Services - organization & administration; Community Mental Health Services - trends; Cooperative Behavior; Cross-Sectional Studies; Developing Countries; Forecasting; Health Policy - trends; Health Services Accessibility - organization & administration; Health Services Accessibility - trends; Health Services Needs and Demand - organization & administration; Health Services Needs and Demand - trends; Hospitalization - trends; Humans; Interdisciplinary Communication; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - rehabilitation; Mental Health Services - organization & administration; Mental Health Services - trends; Social Stigma; South Africa; South Africa
• ISSN: 1994-8220
• DOI: 10.4314/ajpsy.v15i6.48

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.