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.