SA men­tal health un­der­funded, ‘huge gaps’ in cov­er­age

The Star Late Edition - - NEWS - SIBONGILE MASHABA

PRO­VIN­CIAL health de­part­ments across the coun­try have in­ad­e­quate bud­get al­lo­ca­tions for men­tal health, a hear­ing into the sta­tus of men­tal health care 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, Jo­han­nes­burg, 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 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 deaths of more than 140 psy­chi­atric pa­tients re­moved from Life Esidimeni Health­care fa­cil­i­ties and placed in un­li­censed NGOs last year, when for­mer health MEC Qedani Mahlangu al­legedly ter­mi­nated the con­tract to “cut costs”.

The SAHRC said its de­ci­sion to con­vene 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, and 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 lived in ru­ral ar­eas yet they did not re­ceive health care ser­vices they needed. Only one in four peo­ple with men­tal dis­or­ders has ac­cess to treat­ment.

“Ru­ral ar­eas ac­count for al­most half of the coun­try’s pop­u­la­tion yet re­main at the mar­gin of po­lit­i­cal, eco­nomic and so­cial power cen­tres... The ne­glect of men­tal health ru­ral pop­u­la­tions of­ten re­sults in a bur­den on the lim­ited re­sources in ur­ban cen­tres,” Mor­gan said.

She said there was no bud­get for men­tal health.

“Fre­quent drug stock-outs lead 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 a lack of hu­man re­sources for men­tal health.

Mor­gan said there was 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 ser­vices closer to where peo­ple live is a pri­or­ity of the na­tional men­tal health pol­icy frame­work. We have all wit­nessed the dev­as­tat­ing ef­fects on pa­tients and their fam­i­lies when this is done with­out ad­e­quate plan- ning and co-or­di­na­tion,” she said.

“Events (at Life Esidimeni) in Gaut­eng are only the tip of an 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 what is hap­pen­ing ev­ery­where,” Mor­gan said.

The hear­ing con­tin­ued yes­ter­day with of­fi­cials from the nine pro­vin­cial health de­part­ments ex­pected to make pre­sen­ta­tions

Events at Life Esidimeni the tip of an ice­berg

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