Mental care too costly

SA RANKS 25TH WORLDWIDE WITH GLARING NEEDS EXPOSED Country has 18 psychologists and 1.5 psychiatrists per 100 000 people.

Nearly five out of 10 South Africans suffer from stress and one in four have some form of depression, but the high costs of mental healthcare leave those in need facing a black hole.

The Mental Health Index Price Index 2022, released yesterday, shows the cost of mental health treatment and medicines, stating which countries have the best mental healthcare provisions and infrastructure.

With the US placed at number one, South Africa was far below, ranked 25 out of 50 countries. It scored 76.55 out of 100 for mental healthcare provisions and infrastructure.

Sweden charged the highest for therapy, averaging R3 050 for an hour session. South Africans, however, pay an average of just over R800.

However, the index found that out of a population of 100 000, 46 000 South Africans suffered from stress, followed by 4 132 suffering from depression and 3 625 from anxiety.

A total of 541 out of 100 000 people were diagnosed with bipolar and 221 with schizophrenia.

Mental health conditions have worsened since the pandemic, including in children, said psychologist Dr Lerato Mokgethi.

“There has definitely been an increase in patients lately. Since 2020, there has been a huge uptake in patients with issues of grief, loss, loss of income, a lot of mental difficulties across the board, including depression and suicidal ideation.

“Patients are getting younger and younger, too. Pupils face issues of bullying and there are self-worth aspects due to social media as children are exposed to a whole lot more due to online platforms,” Mokgethi said.

“This includes pornography. Children are now watching pornography.”

The price index showed alarming figures when it came to the availability of mental health practitioners: South Africa has 18 psychologists and 1.5 psychiatrists per 100 000 people.

This was due to the training demands for mental healthcare practitioners, with universities having a limit of those who can get accepted for a masters’ degree to practice psychology, said psychologist Dr Helena Niedinger.

“Universities which offer the masters’ programme have a lot of applications and a bottleneck and they only select very few. Some have studied for four years but can’t practice because of this.” Clinical psychologist Dr Charity Mkone said universities often train a maximum of 13 psychologists and professionals. “This is because of the training demands. It is a oneon-one focused training,” Mkone said.

While the index has found that medication for anxiety and depression have decreased by 2.36% and 1.96% respectively, those who need an hour of therapy should expect to pay around R830 per session.

But this figure was unlikely, said Mokgethi. “That R830 is the least and people are less likely to get that rate for a session with a psychologist.”

The high cost of mental healthcare and consultation was regulated by the Board of Healthcare Funders and in line with the Health Professions Council of South Africa (HPCSA), which put a cap of a minimum of 50-minute sessions.

According to the regulations by the HPCSA, each psychologist can see a maximum of seven patients in a day for a one-hour consultation session, said Mkone.

The same applies with a psychiatrist, who takes between 90 minutes to two hours for an initial assessment.

“That is a considerable amount of time because they need a thorough history in terms of dispensing medication to a patient. That is also a huge time constraint and the remuneration of a psychiatrist needs to be in accordance with the time spent with a patient,” she said.

According to Niedinger, a patient’s hospital stay was dependent on their medical aid cover and patients are often discharged once their funds run out.

“The medical aid determines when the patient has to leave, not the doctors or psychologists. It is generally short admissions – about a week or two.”

Despite public hospitals and clinics offering psychology and psychiatry treatment and tollfree helplines, patients face waiting lists and lack of long-term telephonic treatment.

If you need help, phone SA Depression and Anxiety Group’s toll-free helpline at 0800-12-1314.

Patients face waiting lists and lack of long-term treatment