Journal articles: 'Mental health services – South Africa'

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Zabow, Tuviah. "Traditional healers and mental health in South Africa." International Psychiatry 4, no. 4 (October 2007): 81–83. http://dx.doi.org/10.1192/s174936760000521x.

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Psychiatric patients access both indigenous healers and services rendered by psychiatric facilities in South Africa. The various groups of healers which are available are clearly not all acceptable to the whole population and variable experiences are reported with different categories of healer and the different treatments provided. An increasing collaboration between psychiatric services and indigenous healers is becoming evident, as in other health services. Reports indicate that many African psychiatric patients seek treatment from indigenous healers while attending psychiatric clinics, in both rural and urban regions. This has led to much discussion and differing viewpoints as to the possible benefits and disadvantages of collaboration and simultaneous use of different treatment modalities. Included in this is the question of the medical competence of traditional healers and the possible neglect of serious conditions.

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Meyer, J. C., M. Matlala, and A. Chigome. "Mental health care - a public health priority in South Africa." South African Family Practice 61, no. 5 (October 28, 2019): 25–30. http://dx.doi.org/10.4102/safp.v61i5.4946.

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Mental health is an integral part of health and it includes an individual’s emotional, psychological and social well-being. Mental illness remains underreported and underdiagnosed, particularly in low- and middle-income countries, including South Africa. South Africa carries a huge burden of mental illnesses with the most prevalent being anxiety disorders, substance abuse disorders, mood disorders and depression. People with mental health conditions often face neglect in the health system as well as stigma and discrimination. This has resulted in poor health outcomes, isolation and high suicide rates, including amongst adolescents. The South African National Mental Health Policy Framework and Strategic Plan (2013–2020) aims to integrate mental health into the health system to provide quality mental health services that are accessible, equitable and comprehensive, particularly for community-based mental health. This article provides an overview of mental health care in South Africa, highlighting its public health importance.

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Lund, Crick, and Alan J. Flisher. "Norms for mental health services in South Africa." Social Psychiatry and Psychiatric Epidemiology 41, no. 7 (March 29, 2006): 587–94. http://dx.doi.org/10.1007/s00127-006-0057-z.

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Sehularo, Leepile Alfred. "A relevant practical course for mental health care providers in South Africa." International Journal of Scientific Reports 2, no. 8 (August 6, 2016): 210. http://dx.doi.org/10.18203/issn.2454-2156.intjscirep20162811.

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<p>The South African Mental Health Care Actdefines mental health care provider as a person providing mental health care services to mental health care users and includes mental health care practitioners. Mental health care practitioner means a nurse, psychiatrist or registered medical practitioner, psychologist, occupational therapist or social worker who has been trained at an accredited institution to provide prescribed mental health care, treatment and rehabilitation services. For a South African mental health provider to render high-quality mental health care, treatment and rehabilitation services, that mental health care provider should have been exposed to theory and practical teaching and learning in Intellectual Disability (ID). One of the most relevant practical courses for intellectual disability in South Africa is offered by the Sunshine Association.</p>

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Milne, Mary, and Brian Robertson. "Child Mental Health Services in the New South Africa." Child Psychology and Psychiatry Review 3, no. 3 (September 1998): 128–34. http://dx.doi.org/10.1017/s1360641798001646.

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Health departments in the new South Africa are undergoing major restructuring and, in some cases, severe financial cutbacks as new policies attempt to redress the inequities of the past. A district system is being phased in, with a shift in funding from academic hospitals to secondary and primary level care. The process is being undermined by the current recession, which also affects Welfare and Education facilities, and by widespread poverty, violence, and other adverse conditions. Child mental health services are discussed in the light of current human resources, epidemiological data, the effects of violence and cultural issues, together with some reflections on their future.

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Milne, Mary, and Brian Robertson. "Child Mental Health Services in the New South Africa." Child and Adolescent Mental Health 3, no. 3 (September 1998): 128–34. http://dx.doi.org/10.1111/1475-3588.00230.

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Burgess, Rochelle Ann. "Policy, power, stigma and silence: Exploring the complexities of a primary mental health care model in a rural South African setting." Transcultural Psychiatry 53, no. 6 (December 2016): 719–42. http://dx.doi.org/10.1177/1363461516679056.

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The Movement for Global Mental Health’s (MGMH) efforts to scale up the availability of mental health services have been moderately successful. Investigations in resource-poor countries like South Africa have pointed to the value of an integrated primary mental health care model and multidisciplinary collaboration to support mental health needs in underserved and underresourced communities. However, there remains a need to explore how these policies play out within the daily realities of communities marked by varied environmental and relational complexities. Arguably, the lived realities of mental health policy and service delivery processes are best viewed through ethnographic approaches, which remain underutilised in the field of global mental health. This paper reports on findings from a case study of mental health services for HIV-affected women in a rural South African setting, which employed a motivated ethnography in order to explore the realities of the primary mental health care model and related policies in South Africa. Findings highlighted the influence of three key symbolic (intangible) factors that impact on the efficacy of the primary mental health care model: power dynamics, which shaped relationships within multidisciplinary teams; stigma, which limited the efficacy of task-shifting strategies; and the silencing of women’s narratives of distress within services. The resultant gap between policy ideals and the reality of practice is discussed. The paper concludes with recommendations for building on existing successes in the delivery of primary mental health care in South Africa.

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Lund, Crick, and Alan J. Flisher. "A model for community mental health services in South Africa." Tropical Medicine & International Health 14, no. 9 (June 22, 2009): 1040–47. http://dx.doi.org/10.1111/j.1365-3156.2009.02332.x.

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Pillay, A. L., and M. R. Lockhat. "Developing community mental health services for children in South Africa." Social Science & Medicine 45, no. 10 (November 1997): 1493–501. http://dx.doi.org/10.1016/s0277-9536(97)00079-8.

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Landman, M. "TOWARDS IMPROVED CHILD MENTAL HEALTH CARE SERVICES IN SOUTH AFRICA." Southern African Journal of Child and Adolescent Mental Health 4, no. 1 (January 1992): 25–28. http://dx.doi.org/10.1080/16826108.1992.9631479.

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Bimerew, M. "Information systems for community mental health services in South Africa." International Journal of Africa Nursing Sciences 11 (2019): 100127. http://dx.doi.org/10.1016/j.ijans.2019.01.001.

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Siyothula, Evy-Terressah Busisiwe. "Clinical psychology service distribution and integration into primary health care in KwaZulu-Natal, South Africa." South African Journal of Psychology 49, no. 3 (December 3, 2018): 391–402. http://dx.doi.org/10.1177/0081246318815337.

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Inadequate investment in mental health care by the governments of both high- and low-income countries contributes to recurrent challenges of uneven distribution of and access to mental health services between urban and non-urban communities. While recent research has acknowledged the role of mental health in well-being and the cost of failure to invest in the sector, prioritising mental health to the same degree as physical health remains a challenge. This article highlights the unequal distribution of mental health services, and psychological services in particular, in KwaZulu-Natal. This is achieved by considering the background of psychology in South Africa and KwaZulu-Natal and then examining the ratio of clinical psychologists to the KwaZulu-Natal population. Furthermore, the article explores the geographical distribution of psychological services in KwaZulu-Natal and concludes with a discussion of the impact of uneven mental health service distribution on service provision and utilisation in non-urban areas of KwaZulu-Natal.

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Robertson, L. J., M. Y. H. Moosa, and F. Y. Jeenah. "Strengthening of district mental health services in Gauteng Province, South Africa." South African Medical Journal 111, no. 6 (May 31, 2021): 538. http://dx.doi.org/10.7196/samj.2021.v111i6.15633.

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Bain, Katherine. "The challenge to prioritise infant mental health in South Africa." South African Journal of Psychology 50, no. 2 (October 31, 2019): 207–17. http://dx.doi.org/10.1177/0081246319883582.

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Despite clear evidence that infant mental health intervention is imperative, mental health services for infants and their caregivers worldwide remain under-prioritised, under-funded, and inaccessible to most populations. South Africa is no exception. This article proposes some potential explanations for this, exploring both practical constraints and possible resistances within the currents of our collective unconscious.

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Nguse, Siphelele, and Douglas Wassenaar. "Mental health and COVID-19 in South Africa." South African Journal of Psychology 51, no. 2 (May 8, 2021): 304–13. http://dx.doi.org/10.1177/00812463211001543.

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COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2, has affected most parts of the globe since its first appearance in the city of Wuhan, China, in December 2019. As a result, the World Health Organization declared the virus a global public health crisis and a pandemic within 2 weeks, after the virus had spread to 114 countries with 118 000 recorded cases and 4291 deaths due to the virus and related complications. The World Health Organization declaration is indicative of the enormous impact of the pandemic on human life globally. South Africa has not been exempted from that impact. While the pandemic has affected all South Africans in various ways, the poor have been most affected due to structural inequality, poverty, unemployment, and lack of access to quality health care and other services. Furthermore, public mental health has also been negatively affected by the pandemic, and this comes against a backdrop of an ailing mental health care system. We argue that the psychology profession, as a mental health profession and behavioural science, working as part of a multidisciplinary team, ought to play a significant role in addressing the mental health ramifications of the pandemic. In so doing, lessons can be drawn from other countries while establishing contextual immediate and long-term interventions.

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Van Heerden, Margaretha S., Linda Hering, Carol Dean, and Dan J. Stein. "Providing psychiatric services in general medical settings in South Africa: Mental health-friendly services in mental health-friendly hoaspitals." South African Journal of Psychiatry 14, no. 1 (March 1, 2008): 3. http://dx.doi.org/10.4102/sajpsychiatry.v14i1.81.

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<div style="left: 72.6818px; top: 320.383px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.912637);" data-canvas-width="406.23000000000013">Neuropsychiatric disorders rank high on the list of the most</div><div style="left: 72.6818px; top: 342.044px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.937152);" data-canvas-width="405.9900000000002">disabling medical disorders in both the developed and</div><div style="left: 72.6818px; top: 363.705px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.939248);" data-canvas-width="120.255">developing worlds.</div><div style="left: 192.942px; top: 364.458px; font-size: 8.58333px; font-family: sans-serif;">1</div><div style="left: 198.109px; top: 363.716px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.928421);" data-canvas-width="280.77">Significant comorbidity also exists between</div><div style="left: 72.6785px; top: 385.377px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.909013);" data-canvas-width="360.06">neuropsychiatric disorders and general medical disorders;</div><div style="left: 432.767px; top: 386.125px; font-size: 8.58333px; font-family: sans-serif; transform: scaleX(0.96875);" data-canvas-width="7.75">2</div><div style="left: 440.636px; top: 385.383px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.87363);" data-canvas-width="38.265">this is</div><div style="left: 72.6863px; top: 407.044px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.916172);" data-canvas-width="406.18500000000006">key in the South African context where HIV/AIDS and substance</div><div style="left: 72.6863px; top: 428.705px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.890119);" data-canvas-width="225.66">use disorders are highly prevalent.</div><div style="left: 298.331px; top: 429.458px; font-size: 8.58333px; font-family: sans-serif; transform: scaleX(0.99359);" data-canvas-width="12.916666666666668">3,4</div><div style="left: 311.247px; top: 428.716px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.886674);" data-canvas-width="167.67000000000002">It has therefore become</div><div style="left: 72.6872px; top: 450.377px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.907169);" data-canvas-width="406.16999999999996">essential to provide mental health services in a range of settings,</div><div style="left: 72.6872px; top: 472.038px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.896854);" data-canvas-width="406.23">including those that focus on the delivery of general medical</div><div style="left: 72.6872px; top: 493.699px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.953214);" data-canvas-width="406.26">services. Furthermore, the Mental Health Care Act 17 of 2002</div><div style="left: 72.6872px; top: 515.36px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.910761);" data-canvas-width="406.24500000000006">underlines the importance of providing integrated, accessible</div><div style="left: 72.6872px; top: 537.021px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.898383);" data-canvas-width="258.35999999999996">mental health care in the local community.</div>

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Chipise, Ever-merry, Douglas Wassenaar, and Abigail Wilkinson. "Towards new ethics guidelines: the ethics of online therapy in South Africa." South African Journal of Psychology 49, no. 3 (November 14, 2018): 337–52. http://dx.doi.org/10.1177/0081246318811562.

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The burgeoning increase in Internet access and use in South Africa and globally has opened a new doorway for provision of mental health services online. This descriptive study focuses specifically on psychotherapeutic services provided by South African psychologists. Draft guidelines for online therapy were developed and a sample of South African registered psychologists was asked to review, rate, and comment on the draft guidelines via an online survey. The sample also identified key ethical dilemmas arising from the novel use of this modality in South Africa. The draft guidelines were positively appraised by the majority of participants supporting the value of such guidelines in South Africa. Key ethical dilemmas identified included confidentiality, competence, boundaries, technological limitations, emergency situations, nature of therapeutic process, security of records, payment, and verification of identity.

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Stein, D. J., K. Sorsdahl, and C. Lund. "Intellectual disability in South Africa: Addressing a crisis in mental health services." South African Medical Journal 108, no. 3 (February 27, 2018): 147. http://dx.doi.org/10.7196/samj.2017.v108i3.13171.

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Stein, D. J., K. Sorsdahl, and C. Lund. "Intellectual disability in South Africa: Addressing a crisis in mental health services." South African Medical Journal 108, no. 3 (February 27, 2018): 147. http://dx.doi.org/10.7196/samj.2018.v108i3.13171.

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Pillay, Anthony L., and Anita J. Kriel. "Mental health problems in women attending district-level services in South Africa." Social Science & Medicine 63, no. 3 (August 2006): 587–92. http://dx.doi.org/10.1016/j.socscimed.2006.01.031.

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Benjamin, Fatiema, Shelley A. Vickerman-Delport, and Nicolette V. Roman. "Mental health care services in rural South Africa: a human capabilities approach." Social Work in Mental Health 19, no. 5 (June 2, 2021): 365–80. http://dx.doi.org/10.1080/15332985.2021.1927283.

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Kriegler, Susan. "Options and Directions for Psychology within a Framework for Mental Health Services in South Africa." South African Journal of Psychology 23, no. 2 (June 1993): 64–70. http://dx.doi.org/10.1177/008124639302300203.

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Structural problems in mental health services conjoined with attitudinal barriers are the cause of inadequate mental health care in South Africa. However, the major reason for the failure of psychology to address the needs of the majority lies in training deficiencies. In spite of the potential cost benefits of psychotherapy and prevention by way of counselling and educative interventions, psychologists are not perceived or employed as primary members of mental health teams. In schools they are rapidly losing ground. The profession is disempowered to position itself strategically to become a significant roleplayer in the ‘new’ South Africa. Affirmative action for psychology is needed. Ways in which the state may help are suggested, including the creation of more posts and training opportunities in health care settings, as well as use of the school as a locus for health and mental health care delivery. The author concludes with a call to the profession to get its own house in order by way of self-regenerating actions in the areas of training, addressing political and cross-cultural issues, and service delivery.

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Wynchank, Sinclair, and Jill Fortuin. "Telepsychiatry in South Africa – present and future." South African Journal of Psychiatry 16, no. 1 (March 1, 2010): 4. http://dx.doi.org/10.4102/sajpsychiatry.v16i1.231.

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The recent progress in telepsychiatry results from advancing technology and videoconferencing as an effective alternative to classic face-to-face psychiatric interaction, in terms of both results and cost-effectiveness. The wide range of applications of telepsychiatry is outlined – in particular, emergency, forensic, prison and adolescent psychiatry. Attitudes of patients and the providers of psychiatric services are discussed, and a short account is given of the place of tele-education in psychiatric teaching. The advantages of telepsychiatry are outlined and its limitations. Lastly, the limited experience and relevance of telepsychiatry in South Africa (and hence for other developing countries) are presented. The conclusion is that telepsychiatry is well established, its successes documented, and that it should be applied in planning future public health services in South Africa.

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Stein, Dan J., Soraya Seedat, Allen Herman, Hashim Moomal, Steven G. Heeringa, Ronald C. Kessler, and David R. Williams. "Lifetime prevalence of psychiatric disorders in South Africa." British Journal of Psychiatry 192, no. 2 (February 2008): 112–17. http://dx.doi.org/10.1192/bjp.bp.106.029280.

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BackgroundData on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances.MethodA nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups.ResultsLifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).ConclusionsIn comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.

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Fauk, Nelsensius Klau, Anna Ziersch, Hailay Gesesew, Paul Ward, Erin Green, Enaam Oudih, Roheena Tahir, and Lillian Mwanri. "Migrants and Service Providers’ Perspectives of Barriers to Accessing Mental Health Services in South Australia: A Case of African Migrants with a Refugee Background in South Australia." International Journal of Environmental Research and Public Health 18, no. 17 (August 24, 2021): 8906. http://dx.doi.org/10.3390/ijerph18178906.

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International mobility has increased steadily in recent times, bringing along a myriad of health, social and health system challenges to migrants themselves and the host nations. Mental health issues have been identified as a significant problem among migrants, with poor accessibility and underutilisation of the available mental health services (MHSs) repeatedly reported, including in Australia. Using a qualitative inquiry and one-on-one in-depth interviews, this study explored perspectives of African migrants and service providers on barriers to accessing MHSs among African migrants in South Australia. The data collection took place during the COVID-19 pandemic with lockdown and other measures to combat the pandemic restricting face to face meetings with potential participants. Online platforms including Zoom and/or WhatsApp video calls were used to interview 20 African migrants and 10 service providers. Participants were recruited from community groups and/or associations, and organisations providing services for migrants and/or refugees in South Australia using the snowball sampling technique. Thematic framework analysis was used to guide the data analysis. Key themes centred on personal factors (health literacy including knowledge and the understanding of the health system, and poor financial condition), structural factors related to difficulties in navigating the complexity of the health system and a lack of culturally aware service provision, sociocultural and religious factors, mental health stigma and discrimination. The findings provide an insight into the experiences of African migrants of service provision to them and offer suggestions on how to improve these migrants’ mental health outcomes in Australia. Overcoming barriers to accessing mental health services would need a wide range of strategies including education on mental health, recognising variations in cultures for effective service provision, and addressing mental health stigma and discrimination which strongly deter service access by these migrants. These strategies will facilitate help-seeking behaviours as well as effective provision of culturally safe MHSs and improvement in access to MHSs among African migrants.

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Strümpher, J., R. M. Van Rooyen, K. Topper, L. M. C. Andersson, and I. Schierenback. "BARRIERS TO ACCESSING MENTAL HEALTH CARE IN THE EASTERN CAPE PROVINCE OF SOUTH AFRICA." Africa Journal of Nursing and Midwifery 16, no. 1 (September 10, 2016): 45–59. http://dx.doi.org/10.25159/2520-5293/1487.

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The aim of this study was to explore and describe the perceptions of professional nurses concerning barriers to care for people with mental illness in the Eastern Cape Province, South Africa. The study was based on a qualitative, explorative and descriptive design. A total of nine professional nurses working in primary, secondary and tertiary health care facilities were purposively selected. Unstructured interviews were conducted to collect data. Participants’ responses were captured on an audio recorder and later transcribed verbatim.Participants’ responses were then analysed thematically. Two main themes and their related sub-themes were identified. The first theme concerns the perceptions of professional nurses regarding the societal barriers that may hinder people with mental illness from accessing and utilising mental health services. These barriers include socioeconomic hardships, lack of knowledge and insight, lack of family support, embedded cultural beliefs and practices and stigma. The second theme highlights the barriers that professional nurses perceive within the health care system that influence access and utilisation of mental health services. These barriers include inadequate support from stakeholders and leaders in the mental health sector and lack of financial, human and infrastructure resources. Professional nurses made recommendations to improve mental health care. Those of high priority included enhanced mental health literacy among members of the public and a need for mental health stakeholders and leaders to increase their support of the mental health sector in an effort to improve access to mental health care.

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Apat, Daniel Kwai, and Wellington Digwa. "Mental health data: A case for the African communities in New South Wales." Australasian Review of African Studies 42, no. 1 (June 1, 2021): 64–80. http://dx.doi.org/10.22160/22035184/aras-2021-42-1/64-80.

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This paper examines mental health policies in relation to African communities residing in New South Wales, Australia and the attitudes of African communities toward mental disorders and mental health services. Current mental health policy frameworks have shown an inadequate inclusion of African communities. This may negatively affect the design of mental health interventions and how African communities engage with mental health services. The available mental health literature on African communities showed disjointed and uncoordinated data which focuses on specific community-groups within African communities. Insufficient mental health or suicide data, combined with African community members’ perception toward mental disorders and mental health services, makes it very difficult to progress engagement and interventions. There is a need for proper and sizable data on mental health related to people of African descent in NSW and Australia wide, if positive outcomes are to be realised.

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Chisholm, Dan, Soumitra Burman-Roy, Abebaw Fekadu, Tasneem Kathree, Dorothy Kizza, Nagendra P. Luitel, Inge Petersen, Rahul Shidhaye, Mary De Silva, and Crick Lund. "Estimating the cost of implementing district mental healthcare plans in five low- and middle-income countries: The PRIME study." British Journal of Psychiatry 208, s56 (January 2016): s71—s78. http://dx.doi.org/10.1192/bjp.bp.114.153866.

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BackgroundAn essential element of mental health service scale up relates to an assessment of resource requirements and cost implications.AimsTo assess the expected resource needs of scaling up services in five districts in sub-Saharan Africa and south Asia.MethodThe resource quantities associated with each site's specified care package were identified and subsequently costed, both at current and target levels of coverage.ResultsThe cost of the care package at target coverage ranged from US$0.21 to 0.56 per head of population in four of the districts (in the higher-income context of South Africa, it was US$1.86). In all districts, the additional amount needed each year to reach target coverage goals after 10 years was below $0.10 per head of population.ConclusionsEstimation of resource needs and costs for district-level mental health services provides relevant information concerning the financial feasibility of locally developed plans for successful scale up.

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Seedat, Mohamed, Piet Kruger, and Belinda Bode. "Analysis of Records from an Urban African Psychological Service: Suggestions for Mental Health Systems Research." South African Journal of Psychology 33, no. 1 (March 2003): 44–51. http://dx.doi.org/10.1177/008124630303300106.

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This article represents a modest attempt at encouraging mental health systems research with particular reference to South Africa. Despite the repeated calls for the logical inclusion of psychological services into Primary Health Care (PHC) in low to middle-income countries, such services remain absent or at best peripheral. A review of the literature, data analysis, and associated arguments, in this article, are therefore based on the view that health systems research is vital for informing policy decisions on health funding allocations and mental health service delivery. Accordingly, drawing on the records of a township-based counselling service we seek to investigate the strategic need for sound record management. Data on client service utilization patterns, client demographics, and presentation problems are instructive sources of information in considerations about the structure, management and funding of psychological services. Recognizing the methodological limitations of our study, we conclude our analysis with a broad motivation for further health systems research and a specific call for the establishment of a mental health information system that can provide routine quality data that may be used for multiple purposes.

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Evans, Dylan J., and Anthony L. Pillay. "Mental Health Problems of Men Attending District- Level Clinical Psychology Services in South Africa." Psychological Reports 104, no. 3 (June 2009): 773–83. http://dx.doi.org/10.2466/pr0.104.3.773-783.

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Over a 1-yr. period, 70 men attended district level clinical psychology services in Msunduzi, South Africa. The mean age was 35.9 yr., and 80% had secondary education. Only 65.7% attended of their own accord. 51% were unemployed, 71.4% had financial problems, 44.3% admitted to substance abuse, 74.3% reported relationship problems, and 14.3% admitted to being violent toward their partners, suicidal ideation was the commonest referral problem, while mood disorder was the most frequent diagnosis. Clinicians estimated that 75.7% of these men had low self-esteem. 45.8% (34) perceived their partner as disengaged, enmeshed, or oppressive.

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Tlou, Emmanuel R. "A South African Perspective on Culturally Congruent Mental Health Services." Journal of Black Psychology 39, no. 3 (May 21, 2013): 272–75. http://dx.doi.org/10.1177/0095798413480659.

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Mokwena, Kebogile Mokwena. "Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children’s Rights in South Africa." Children 8, no. 7 (July 19, 2021): 609. http://dx.doi.org/10.3390/children8070609.

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The intention of the South African Children’s Act 38 of 2005 is to provide guarantees for the protection and promotion of optimum health and social outcomes for all children. These guarantees are the provision of basic nutrition, basic health care and social services, optimal family or parental care, as well as protection from maltreatment, neglect and abuse services. However, despite these guarantees, child and maternal mortality remain high in South Africa. The literature identifies maternal depression as a common factor that contributes to negative health and social outcomes for both mothers and their children. Despite the availability of easy-to-use tools, routine screening for maternal depression is not carried out in public health services, which is the source of services for the majority of women in South Africa. The results are that the mothers miss out on being diagnosed and treated for maternal depression, which results in negative child outcomes, such as malnutrition, as well as impacts on mental, social and physical health, and even death. The long-term impacts of untreated maternal depression include compromised child cognitive development, language acquisition and deviant behaviors and economic disadvantage in later life. The author concludes that the neglect of screening for, and treatment of maternal depression therefore violates the constitutional rights of the affected children, and goes against the spirit of the Constitution. The author recommends that maternal and child health services integrate routine screening for maternal depression, which will not only satisfy the Constitutional mandate, but also improve the health and developmental outcomes of the children and reduce child mortality.

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Sukeri, Kiran, Orlando Alonso-Betancourt, and Robin Emsley. "Staff and bed distribution in public sector mental health services in the Eastern Cape Province, South Africa." South African Journal of Psychiatry 20, no. 4 (November 30, 2014): 6. http://dx.doi.org/10.4102/sajpsychiatry.v20i4.570.

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<p><strong>Background. </strong>The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service. </p><p><strong>Objective. </strong>To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province.</p><p><strong>Method. </strong>In this descriptive cross-sectional study, an audit questionnaire was submitted to all public sector mental health facilities. Norms and indicators were calculated at provincial and district level. This article investigates staff and bed distribution only.</p><p><strong>Results. </strong>Results demonstrated that within the province, only three of its seven districts have acute beds above the national baseline norm requirement of 13/100 000. The private mental health sector provides approximately double the number of medium- to long-stay beds available in the public sector. Only two regions have staff/population ratios above the baseline norm of 20/100 000. However, there are significant differences in this ratio among specific staff categories. There is an inequitable distribution of resources between the eastern and western regions of the province. When compared with the western regions, the eastern regions have poorer access to mental health facilities, human resources and non-governmental organisations. </p><p><strong>Conclusion. </strong>Owing to the inequitable distribution of resources, the provincial authorities urgently need to develop an equitable model of service delivery. The province has to address the absence of a reliable mental health information system.</p>

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Pillay, Anthony L., Harshalini Y. Bundhoo, and Uma Bhowon. "Depression-Related Distress in Mauritian and South African Adolescent Girls: An Exploratory Investigation." Psychological Reports 107, no. 1 (August 2010): 87–94. http://dx.doi.org/10.2466/02.10.12.13.pr0.107.4.87-94.

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Self-reports of depression-related distress were obtained from girls of 14 to 17 years of age living in communities of low socioeconomic status in Mauritius ( n = 198) and South Africa ( n = 275). Of the girls in the two samples, 26.3 and 21.5%, respectively, had thought about self-harm during the past 5 yr., while between 14.6 and 16.7% had made self-harm attempts. Also, 39.9% of the Mauritian girls and 31.0% of the South Africans reported being sad and tearful every day for more than 2 wk. over the past year. Of the girls, Mauritians (54.0%) and South Africans (32.1%) felt their problems were too much to cope with, while 20.4% of the South African girls and 44.4% of the Mauritians knew of no place to go for help when feeling sad or depressed. The findings highlight the extent of depression-related symptoms and issues related to access to mental health services. Increasing mental health services and awareness programmes are indicated.

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Pillay, Anthony L. "Is deinstitutionalisation a cheap alternative to chronic mental health care?" South African Journal of Psychology 47, no. 2 (May 10, 2017): 141–47. http://dx.doi.org/10.1177/0081246317709959.

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Worldwide, there has been a dominant belief that the deinstitutionalisation of the mentally ill is a cost-saving approach, leading health authorities to embark on such initiatives without adequate community-based health and social service resources and supports. These have resulted in disaster, even in high-income countries, when insufficient planning and preparation have been effected. The recent experience in South Africa that saw the deaths of approximately 100 people with chronic mental illness within 1 year of being moved from a mental health facility is further evidence of the need for more concerted and deliberate planning and resourcing of mental health care services. The article examines various issues relating to deinstitutionalisation and urges authorities to re-examine their approach to mental health care and especially the priority accorded to this marginalised group.

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Dommisse, John. "Apartheid as a Public Mental Health Issue." International Journal of Health Services 15, no. 3 (July 1985): 501–10. http://dx.doi.org/10.2190/xrwq-r9ma-06wr-09a5.

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The most serious hazard to the physical and mental health of the majority rural poor black population in South Africa is caused by the ruling wealthy white minority's policy of apartheid. Forced removals and dumping of millions of people into small, disconnected, barren, poor reserve areas, bereft of adequate medical, psychiatric and public health services (the ‘final solution’ of the ‘native problem’) causes widespread malnutrition, infectious and other diseases, and high mortality and mental-illness rates. Blacks and progressive whites are banned, terrorized, detained without trial, tortured, and murdered by the state; the Africans are not only disfranchised but are now also being denationalized and deprived of their ancient birthright to this richly-endowed part of Africa. Acceptance of this modern version of Naziism by the World Psychiatric Association and the World Medical Association, in the face of adequate information provided by the United Nations, its agency the World Health Organization, the American Psychiatric Association, and numerous other agencies and reports, needs urgent examination and decisive action.

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De Wet, Anneliese, John Parker, and Chrisma Pretorius. "The Spring Foundation: a recovery approach to institutional public mental health services in South Africa." Perspectives in Public Health 139, no. 3 (May 2019): 123–24. http://dx.doi.org/10.1177/1757913919838767.

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Swartz, Leslie, and Gerard Drennan. "Beyond Words: Notes on the ‘Irrelevance’ of Language to Mental Health Services in South Africa." Transcultural Psychiatry 37, no. 2 (June 2000): 185–201. http://dx.doi.org/10.1177/136346150003700202.

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Mwanri, Lillian, and William Mude. "Alcohol, Other Drugs Use and Mental Health among African Migrant Youths in South Australia." International Journal of Environmental Research and Public Health 18, no. 4 (February 5, 2021): 1534. http://dx.doi.org/10.3390/ijerph18041534.

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This paper was part of a large study that explored suicide among African youths in South Australia. The paper reports perspectives about alcohol and other drugs (AOD) use and mental health among African migrant and refugee youths in South Australia. The study employed a qualitative inquiry, conducting 23 individual interviews and one focus group discussion with eight participants. An acculturative stress model informed data analysis, interpretation and the discussion of the findings that form the current paper. African migrant and refugee youths revealed challenging stressors, including related to cultural, socioeconomic, living conditions, and pre- and post-migration factors that contributed to mental health problems and the use of AOD in their new country. The traumatic loss of family members and social disruption experienced in their countries of origin were expressed as part of factors leading to migration to Australia. While in Australia, African migrant and refugee youths experienced substantial stressors related to inadequate socioeconomic and cultural support, discrimination, poverty, and unemployment. Participants believed that differences in cultural perspectives about AOD use that existed in Africa and Australia also shaped the experiences of social stressors. Additionally, participants believed that these cultural differences and the identified stressors determined AOD use and mental health problems. The findings highlight the need to understand these social and cultural contexts to improve mental health services and help reduce the use of AOD, which, when problematic, can influence the health and integration experiences of these populations.

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Mpanza, D. M., and P. Govender. "Rural realities in service provision for substance abuse: a qualitative study in uMkhanyakude district, KwaZulu-Natal, South Africa." South African Family Practice 59, no. 3 (July 10, 2017): 55. http://dx.doi.org/10.4102/safp.v59i3.4715.

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Background: Substance abuse is recognised as a worldwide concern, contributing significantly to morbidity and mortality in South Africa. There is minimal research that has considered influences in mental health care service delivery in rural and disadvantaged communities in South Africa. Methods: A qualitative study with substance abuse service providers in uMkhanyakude rural district of KwaZulu-Natal was undertaken to gain insight into the experiences and challenges in service delivery. Focus groups and semi-structured interviews were conducted with various stakeholders (n = 29) in the rural district. Results: The findings of the study suggest that service providers experience challenges in service delivery in this rural area. The effects of culture (amarula festival and ancestral worship) exacerbate the use of substances; the high rate of unemployment and poverty lead to the produce of home-brewed substances for sustainable living; a lack of resources poses threats to service delivery; the poor prioritisation of mental health care services and a lack of monitoring and evaluation of services in the district were highlighted. Conclusions: Despite this being a single district study, findings reflect the need for a district, provincial and national standard for substance abuse rehabilitation services in addition to the improvement of monitoring and evaluation for quality improvement. There is also a need to respond to the gaps that exist in after-care and community-based or decentralised substance abuse services that are essential in such areas, which are under-resourced despite the high prevalence of substance users. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272232

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Sukeri, Kiran, Orlando A. Betancourt, Robin Emsley, Mohammed Nagdee, and Helmut Erlacher. "Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape." South African Journal of Psychiatry 22, no. 1 (May 6, 2016): 5. http://dx.doi.org/10.4102/sajpsychiatry.v22i1.787.

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<strong>Objectives:</strong> No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. <strong></strong><p><strong>Methodology:</strong> This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. <strong></strong></p><p><strong>Results:</strong> During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. <strong></strong></p><p><strong>Conclusions:</strong> Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic psychiatric service. This should be driven by the provincial Department of Health.</p>

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Lund, Crick, Alan J. Flisher, Kim Porteus, and Tennyson Lee. "Bed/population ratios in South African public sector mental health services." Social Psychiatry and Psychiatric Epidemiology 37, no. 7 (July 2002): 346–49. http://dx.doi.org/10.1007/s00127-002-0552-9.

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Eaton, Julian, Djibo Douma Maiga, and Soumana Pate. "Mental health services in the Republic of Niger." International Psychiatry 6, no. 3 (July 2009): 63–64. http://dx.doi.org/10.1192/s1749367600000606.

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The Republic of Niger is a large, landlocked west African country. Around 80% of its vast land mass (1 300 000 km2) is in the Sahara Desert. Its neighbours are Mali, Algeria, Libya and Chad to the north, and Nigeria, Benin and Burkina Faso to the south. The country came under French rule in the 1890s and gained its independence in 1960, but development has been slowed by political instability, lack of natural resources and drought. In 1999, voters overwhelmingly approved a new constitution, allowing for multi-party elections, which were held later that year. An ongoing rebellion in the north makes access to much of the country difficult.

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Davis, Glen P., Andrew Tomita, Joy Noel Baumgartner, Sisanda Mtshemla, Siphumelele Nene, Howard King, Ezra Susser, and Jonathan K. Burns. "Substance use and duration of untreated psychosis in KwaZulu-Natal, South Africa." South African Journal of Psychiatry 22, no. 1 (May 20, 2016): 7. http://dx.doi.org/10.4102/sajpsychiatry.v22i1.852.

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<p><strong>Background:</strong> Substance use and psychiatric disorders cause significant burden of disease in low- and middle-income countries. Co-morbid psychopathology and longer duration of untreated psychosis (DUP) can negatively affect treatment outcomes.</p><p><strong>Objectives:</strong> The study assessed substance use amongst adults with severe mental illness receiving services at a regional psychiatric hospital in KwaZulu-Natal (South Africa). We describe the prevalence and correlates of lifetime substance use and examine the association between substance use and DUP.</p><p><strong>Methods:</strong> A cross-sectional survey recruited adults diagnosed with severe mental illness and assessed lifetime and past 3-month substance use using the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test. Regression analyses were conducted to determine associations between lifetime substance use (other than alcohol and tobacco) and DUP as measured by the World Health Organization Encounter Form.</p><p><strong>Results:</strong> Amongst 87 participants, alcohol (81.6%), tobacco (75.6%) and cannabis (49.4%) were the most common substances reported for lifetime use. Risk of health-related problems (health, social, financial, legal and relationship) of cannabis use was associated with younger age, single marital status and lower education. Adjusted regression analyses indicated that use of amphetamines and methaqualone is associated with longer DUP.</p><p><strong>Conclusions:</strong> Substance use is prevalent amongst psychiatric patients in KwaZulu-Natal and may contribute to longer DUP. Mental health services in this region should address co-morbid substance use and psychiatric disorders.</p><p><strong>Keywords: </strong>Substance Use; Psychosis; KwaZulu-Natal</p>

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Abrahams, Naeemah, Soraya Seedat, Carl Lombard, Andre P. Kengne, Bronwyn Myers, Alesha Sewnath, Shibe Mhlongo, et al. "Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa." BMJ Open 7, no. 9 (September 2017): e017296. http://dx.doi.org/10.1136/bmjopen-2017-017296.

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IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

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Swartz, Leslie, and Hayley MacGregor. "Integrating Services, Marginalizing Patients: Psychiatric Patients and Primary Health Care in South Africa." Transcultural Psychiatry 39, no. 2 (June 2002): 155–72. http://dx.doi.org/10.1177/136346150203900202.

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Ægisdóttir, Stefanía, Mark M. Leach, John L. Romano, Saundra Tomlinson-Clarke, and Deniz Canel-Çınarbaş. "Sociopolitical, Cultural, and Historical Contexts That Influence Counseling Practice in Four Countries." Counseling Psychologist 47, no. 4 (May 2019): 578–607. http://dx.doi.org/10.1177/0011000019883321.

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In this article, we provide examples of how historical and sociopolitical events have shaped the development of psychology and psychological services in Iceland, South Africa, Thailand, and Turkey. These examples are offered to (a) enhance international competencies related to the countries’ cultures, ecological system, and subsystems, and (b) inspire counseling psychologists to collaborate with colleagues around the world on efforts to indigenize psychology paradigms and promote accessible service delivery systems. Common themes across these countries indicated that (a) provision of psychological services is highly influenced by the biomedical model of mental health, (b) access to mental health care is influenced by cost and stigma, and (c) a limited connection exists between traditional healing practices and Western-based diagnostic and mental health services. In all countries there was a struggle for greater recognition of psychological services; in Iceland, Thailand, and Turkey, counseling psychology is not recognized as a legally sanctioned profession. Suggestions are offered for internationally competent counseling psychologists who intend to promote the provision of culturally responsive psychological services worldwide.

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Stones, Christopher R. "Attitudes toward Psychology, Psychiatry and Mental Illness in the Central Eastern Cape of South Africa." South African Journal of Psychology 26, no. 4 (December 1996): 221–25. http://dx.doi.org/10.1177/008124639602600403.

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A survey of attitudes held by a large sample of university students as well as by smaller samples of psychologists, general medical practitioners, members of the public, psychiatric hospital staff and patients in the central eastern Cape toward mental illness and mental health-care service providers was conducted during the early part of 1994. It was found that marked differences existed between the different samples and that the extent of a person's knowledge about mental illness, as well as the degree of contact with mental-health professionals and their services, were important influences on the attitudes of respondents. In particular, third-year psychology students tended to be more negatively disposed to psychiatric treatment than those students in their first year of study. Conversely, the attitudes of final-year students toward the discipline of psychology were more positive than those held by students in their first year of studying psychology. Within both the student and the patient samples, only a small minority indicated that they would first seek help from general medical practitioners if they were ever to contemplate taking their own lives or if they were seriously mentally ill. Psychiatric patients and service providers indicated their confidence in psychiatric treatment and the psychiatrist was considered to be the most appropriate professional to deal with mental illness. Members of the general public were found to be more optimistic than psychologists about the efficacy of psychological and psychiatric treatment, but less so than general medical practitioners. Although mental health-care professionals were viewed in a favourable light, most respondents indicated that they would nevertheless prefer to approach a friend in times of psychological distress.

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Kaliski, Sean. "Psychiatry in the ‘New South Africa’." Psychiatric Bulletin 16, no. 6 (June 1992): 343–45. http://dx.doi.org/10.1192/pb.16.6.343.

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Academic medicine in South Africa was created largely by talented graduates who, having travelled overseas (especially to Britain) for postgraduate training, returned to teach in the newly established medical schools and teaching hospitals. However, over the past three decades fewer have decided to return. Consequently academic medicine generally is in decline. Hospital specialists are demoralised, and about 80% of those recently surveyed indicated that they intended leaving the public health service if the present imbalance between service commitments, research opportunities, and poor pay persists (Curtin, 1991). About 40% of graduating medical students emigrate, usually to avoid conscription. The continuing violence and political uncertainty within the country probably ensure that few will ever return.

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Lund, Crick, Gerard Boyce, Alan J. Flisher, Zuhayr Kafaar, and Andrew Dawes. "Scaling up child and adolescent mental health services in South Africa: Human resource requirements and costs." Journal of Child Psychology and Psychiatry 50, no. 9 (September 2009): 1121–30. http://dx.doi.org/10.1111/j.1469-7610.2009.02078.x.

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Journal articles on the topic 'Mental health services – South Africa'

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