Men­tal health cash woes

Top of­fi­cial ad­mits plenty gaps in fund­ing


PRO­VIN­CIAL health de­part­ments across the coun­try have in­ad­e­quate bud­get al­lo­ca­tions for men­tal health, a hear­ing into the sta­tus of men­tal health­care in South Africa has been told. The South African Hu­man Rights Com­mis­sion (SAHRC) is hold­ing na­tional in­ves­tiga­tive hear­ings into the sta­tus of men­tal health care in the coun­try over two days.

Mak­ing pre­sen­ta­tions at the com­mis­sion’s of­fices in Braam­fontein, Joburg, the na­tional De­part­ment of Health ad­mit­ted to this.

Deputy di­rec­tor-gen­eral for pri­mary health care Jeanette Hunter said: “The as­sess­ment we did in the nine prov­inces in terms of the ex­tent to which the pol­icy frame­work and strate­gies im­ple­mented in the nine prov­ince – this as­sess­ment we did in May – showed a num­ber of gaps.

“What we have dis­cov­ered is that prov­inces do not have a men­tal health care bud­get in one place so that you can de­ter­mine what is be­ing spent on men­tal health… Prov­inces have to de­ter­mine what ex­actly they are cur­rently spend­ing on men­tal health on all lev­els,” Hunter said.

She said pro­vin­cial de­part­ments would also have to de­ter­mine whether the gap could be “over­come by cor­rect­ing in­ef­fi­cien­cies in the sys­tem or whether a larger bud­get is re­quired”.

The hear­ings come af­ter the tragic deaths of more than 140 psy­chi­atric pa­tients who were re­moved from Life Esidimeni Health­care fa­cil­i­ties and placed in var­i­ous un­li­censed NGOs last year when for­mer health MEC Qedani Mahlangu al­legedly ter­mi­nated the con­tract to “cut costs”.

The SAHRC said its de­ci­sion for con­ven­ing the hear­ings was in­formed by “the po­ten­tial for vul­ner­a­ble men­tal health care users to be af­fected by com­pounded hu­man rights vi­o­la­tions, the need to iden­tify struc­tural is­sues that ham­per men­tal health care, the duty of the SAHRC and to pro­vide rec­om­men­da­tions to ad­dress sys­temic non-com­pli­ance with hu­man rights stan­dards”.

Ru­ral Re­hab South Africa chair­per­son Shan­non Mor­gan said 43% of the coun­try’s pop­u­la­tion lives in ru­ral ar­eas yet they did not re­ceive the health care ser­vices they needed.

She said one in four peo­ple with men­tal dis­or­ders had ac­cess to treat­ment. “Ru­ral ar­eas ac­count for al­most half of the coun­try’s pop­u­la­tion yet re­main at the mar­gin and pe­riph­ery of po­lit­i­cal, eco­nomic and so­cial power cen­tres… The ne­glect of the men­tal health of ru­ral pop­u­la­tions of­ten re­sults in a bur­den in the lim­ited re­sources si­t­u­ated in ur­ban cen­tres,” Mor­gan said. She said there was no bud­get for men­tal health. “Fre­quent drug stock-outs lead­ing to high re­lapse rates… How do you check that one per­son is com­ing back again and again and again? How do we mon­i­tor that,” she said, adding that there was lack of hu­man re­sources for men­tal health.

Mor­gan said there was also a pre­vail­ing stigma and dis­crim­i­na­tion. She asked whether the coun­try could “do with men­tal health care what we did with HIV?”

“De­in­sti­tu­tion­al­i­sa­tion and bring­ing men­tal health care ser­vice closer to where peo­ple live is a pri­or­ity of the na­tional men­tal health pol­icy frame­work. We have all wit­nessed the dev­as­tat­ing ef­fects of pa­tients and their fam­i­lies when this is done with­out ad­e­quate plan­ning and co-or­di­na­tion,” she said.

“… events (like Life Esidimeni) in Gaut­eng are only the tip of the ice­berg. All over the coun­try and es­pe­cially in ru­ral ar­eas, men­tal health care users have lit­tle or no ac­cess to the ser­vices that they need, re­sult­ing in some dev­as­tat­ing ef­fects on in­di­vid­u­als and fam­i­lies. That is why we say that the Life Esidimeni tragedy is not an aber­ra­tion. It sim­ply places in the spot­light on what is hap­pen­ing ev­ery­where.”

The hear­ing con­tin­ues to­day with of­fi­cials from the nine pro­vin­cial health de­part­ments ex­pected to make pre­sen­ta­tions.

Newspapers in English

Newspapers from South Africa

© PressReader. All rights reserved.