Abstract
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.
Highlights
From the World Health Organization’s (WHO) definition of mental health, as “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”, it is clear that mental health is not merely the absence of illness or disease, with an impact on the individual as well as the population.[1]
S Afr Fam Pract 2019;61(5):[25,26,27,28,29] prevalence of post-traumatic stress disorder (PTSD) in patients attending primary health care (PHC) clinics in South Africa was as high as 19.9% in the period 2003–2004.16 During the same period, females were 1.75 times more likely to be diagnosed with major depressive disorder than males,[17] while males were at an increased risk of developing substance-use disorders.[17]
Mental health disorders remain neglected within the healthcare system, yet they share common features of other chronic conditions and should be integrated into the chronic disease model
Summary
From the World Health Organization’s (WHO) definition of mental health, as “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”, it is clear that mental health is not merely the absence of illness or disease, with an impact on the individual as well as the population.[1]. Over the last two decades, South Africa has taken a public health approach towards better mental health care, firstly with the reform of the Mental Health Care Act (17 of 2002), emphasising the human rights of patients.[4,5] Secondly, in line with WHO recommendations and to reduce the burden of untreated mental health conditions, South Africa developed a National Mental Health Policy Framework and Strategic Plan 2013–2020,6 aimed at the integration of mental health care into a comprehensive primary health care (PHC) approach.[4,5] Currently, evidence of successful implementation of this policy with integration of mental health is still limited.[7] In 2017, nearly 150 patients with mental health illness died at unlicensed facilities after being moved from the Life Esidimeni Hospital.[8]
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