Gaps in mental health

STRATEGIC PLAN: PROVISION OF QUALITY CARE FACES NEW CHALLENGES

System must be clear about the care of patients and how providers will be identified and paid.

South Africa has taken steps towards strengthening mental health care in the last 20 years. These include reforming the Mental Health Care Act 2002 and developing a National Mental Health Policy Framework and Strategic Plan 2013 – 2020.

The plan aims to integrate mental health into general health services to reduce the burden of untreated mental health conditions. It also aims to transform the system to provide quality mental health services.

The failure to implement the public policy on mental health was brought to light by the Life Esidimeni tragedy in 2017. Nearly 150 patients died after being moved from the Life Esidimeni Hospital to unlicensed facilities.

New challenges are arising with the planned introduction of the National Health Insurance (NHI) scheme, which is intended to move South Africa closer to universal health coverage. But early evidence from NHI pilot districts show an inconsistency with the strategic plan and limited integration of mental health. If the relevant priorities aren’t explicitly reflected in the policies and activities supporting the NHI, mental health is likely to remain on the back-burner.

The system must be clear about the care that mental health patients are entitled to and how providers will be identified and paid. Mental healthcare has to be recognised as an integral part of the health care system.

We evaluated the costs of mental health services and programmes for the 2016-17 financial year. We also evaluated the resources and constraints to inform a rational approach to improve mental health service delivery.

Our findings offer a reflection of the state of mental health spending. They draw attention to inefficiencies and constraints in mental health investments in the country.

Sumaiyah Docrat: health economist in the Alan J Flisher Centre for Public Mental Health, University of Cape Town

Crick Lund: professor in the Alan J Flisher Centre for Public Mental Health, department of psychiatry and mental health, University of Cape Town

Republished from TheConversation.co.za