South African Society Of Psychiatrists Research Articles

The South African Society of Psychiatrists (SASOP) and SASOP State Employed Special Interest Group (SESIG) position statements on psychiatric care in the public sector

Executive summary. National mental health policy: SASOP extends its support for the process of formalising a national mental health policy as well as for the principles and content of the current draft policy. Psychiatry and mental health: psychiatrists should play a central role, along with the other mental health disciplines, in the strategic and operational planning of mental health services at local, provincial and national level. Infrastructure and human resources: it is essential that the state takes up its responsibility to provide adequate structures, systems and funds for the specified services and facilities on national, provincial and facility level, as a matter of urgency. Standard treatment guidelines (STGs) and essential drug lists (EDLs) : close collaboration and co-ordination should occur between the processes of establishing SASOP and national treatment guidelines, as well as the related decisions on EDLs for different levels. HIV/AIDS in children: national HIV programmes have to promote awareness of the neurocognitive problems and psychiatric morbidity associated with HIV in children. HIV/AIDS in adults: the need for routine screening of all HIV-positive individuals for mental health and cognitive impairments should also be emphasised as many adult patients have a mental illness, either before or as a consequence of HIV infection, constituting a ‘special needs’ group. Substance abuse and addiction: the adequate diagnosis and management of related substance abuse and addiction problems should fall within the domain of the health sector and, in particular, that of mental health and psychiatry. Community psychiatry and referral levels: the rendering of ambulatory specialist psychiatric services on a community-centred basis should be regarded as a key strategy to make these services more accessible to users closer to where they live. Recovery and re-integration: a recovery framework such that personal recovery outcomes, among others, become the universal goals by which we measure service provision, should be adopted as soon as possible. Culture, mental health and psychiatry: culture, religion and spirituality should be considered in the current approach to the local practice and training of specialist psychiatry, within the professional and ethical scope of the discipline. Forensic psychiatry: an important and significant field within the scope of state-employed psychiatrists, with 3 recognised groups of patients (persons referred for forensic psychiatric observation, state patients, and mentally ill prisoners), each with specific needs, problems and possible solutions. Security in psychiatric hospitals and units: it is necessary to protect public sector mental healthcare practitioners from assault and injury as a result of performing their clinical duties by, among others, ensuring that adequate security procedures are implemented, appropriate for the level of care required, and that appointed security staff members are appropriately trained and equipped.

An overview of the State Employed Special Interest Group (SESIG) of the South African Society of Psychiatrists (SASOP) from 2000 - 2012

Introduction. The State Employed Special Interest Group (SESIG) of SASOP was established in Durban during the national congress in September 2000. Issues of concern at the time included: suboptimal physical conditions in state hospitals and clinics; stalling of the essential drug list (EDL) review process; and understaffing and difficulties to recruit and retain mental health medical personnel in the state sector. During the past 2 years, attention was given to liaising with the South African Medical Association (SAMA) as a medical labour organisation; standards for psychiatric inpatient structures, services and care; and scheduling a national SESIG strategic workshop. Methods. Ethics clearance was obtained for a retrospective quantitative review of the demographic and occupational profile of SESIG’s members, as captured by the SASOP database of current and potential members. The investigation included a review of the policies and process by which strategic activities, priorities and measures for progress were identified within the different areas of SESIG’s mandate. Results. In 2007, 38% (n=144) of the potential total number of stateemployed psychiatrists (380) were paid-up SESIG members; and 53% (n=202) of the potential total number (378) in 2011. The Eastern Cape, Free State and Northern Gauteng subgroups had the biggest percentage of members per region in 2007, which changed in 2011 to Northern Gauteng, Western Cape and Eastern Cape. In 2011, 40% of the total membership were psychiatric registrars. Presentations and discussion during the first national strategic meeting of state employed psychiatrists in 2012 covered: the scope of state sector practice; pertinent policies for state practice; planning per region; teaching and research; accepted principles for care; and strategic mobilisation (details in the supplement of this issue of the SAJP). Conclusion. Eleven position statements were formulated to guide SASOP/SESIG activities during 2012 - 2014, including statements on: national mental health policy; psychiatry and mental health; infrastructure and human resources; standard treatment guidelines and EDL; HIV in children and adults; substance abuse and addiction; community psychiatry and referral levels; recovery and re-integration; culture, mental health and psychiatry; the specialty status of South African psychiatry; and forensic psychiatry.

Building our identity of psychiatry in the past, present and future South Africa

This issue of the South African Journal of Psychiatry celebrates the 60th anniversary of the South African Society of Psychiatrists (SASOP) and its 17th national congress. It reflects on the past of psychiatry, ponders on what psychiatry has become, and looks ahead, particularly in South Africa. Doing so says something of the identity of psychiatry in South Africa, which is crucially about people--our people. Our people have built the identity of psychiatry in South Africa by doing things, and doing things in certain ways--actions that say much more about the identity of the profession than honorary tributes to individuals. Individuals contributed remarkably, of course, and we can identify them gratefully; our professional identity has certainly been built in adding-up these contributions, that is, collectively--but that is not all. Our professional identity has especially been built communally by what we have been doing in SASOP and in our relations with fellow psychiatrists, colleagues from other professions, patients, patients' families, and other societies in South Africa and internationally. Building the identity of psychiatry in South Africa, individually, collectively and communally by our actions, commenced even before the word 'psychiatry' was coined in 1808 by Professor Johann Christian Reil, (1) as reflected upon in this issue by one of our veteran psychiatrists, Professor Lynn Gillis. (2) A reflection on the building of our identity in our history is important for our professional identity in the present and for the future building thereof--as many cultures in the world have recognised: know your historical roots, and cherish them, as they tell who you are, at least in part. I urge you, thus, for the sake of our present and future professional identity! Our identity-building actions of the past decade are considered in this issue by the current president of SASOP, Dr Ian Westmore. (3) Under his leadership and that of Dr Bernard Janse van Rensburg, an impressive milestone in the building of our current professional identity has been achieved: that is, the nationally collaborative work by which well-articulated goals for psychiatric care in the public services have been set, as reported in this issue on the activities of the SASOP State Employed Special Interest Group (SESIG) and in the special supplement to this issue. (4,5) Our identity-building actions in the present have to address contemporary challenges in South Africa and internationally, as reflected upon in this issue by Drs David Swingler (6) and Franco Colin. (7) No less so, I wish to plead for us to think about the identity that we want for our future, as this is shaped and made possible by the ways in which we think about ourselves, at least in part. In particular, for the sake of building our identity, I urge us to (re)consider carefully how we think about (and practise) psychiatry in relation to other medical specialities. Do we really want to maintain and even propagate a'last-born'attitude, trapped in continuous aspirations to live up to an (presumed) agenda of'big brother'; for example, by continuing to aspire to the discovery of biomarkers, as if only that would mark our becoming mature? Now, the discovery of biomarkers is very worthy to aspire towards; and our speciality is perhaps one of the younger ones neither is denied, nor is the point here. The point is that we should recognise and materialise our maturity in other ways than merely in terms of the biological underpinnings of psychiatry. …

17th Biennial National Congress of the South African Society of Psychiatrists: 'Pride, prejudice and promise – from origins to outcomes', 7 - 11 September 2012, Misty Hills Country Hotel, Muldersdrift, Johannesburg

17th Biennial National Congress of the South African Society of Psychiatrists: 'Pride, prejudice and promise – from origins to outcomes', 7 - 11 September 2012, Misty Hills Country Hotel, Muldersdrift, Johannesburg

The South African Society of Psychiatrists (SASOP) and SASOP State Employed Special Interest Group (SESIG) position statements on psychiatric care in the public sector

<p><strong>Executive summary.</strong> National mental health policy: SASOP extends its support for the process of formalising a national mental health policy as well as for the principles and content of the current draft policy.</p><p><strong> Psychiatry and mental health:</strong> psychiatrists should play a central role, along with the other mental health disciplines, in the strategic and operational planning of mental health services at local, provincial and national level.</p><p><strong>Infrastructure and human resources:</strong> it is essential that the state takes up its responsibility to provide adequate structures, systems and funds for the specified services and facilities on national, provincial and facility level, as a matter of urgency.</p><p><strong>Standard treatment guidelines (STGs) and essential drug lists (EDLs)</strong>: close collaboration and co-ordination should occur between the processes of establishing SASOP and national treatment guidelines, as well as the related decisions on EDLs for different levels.</p><p><strong>HIV/AIDS in children:</strong> national HIV programmes have to promote awareness of the neurocognitive problems and psychiatric morbidity associated with HIV in children.</p><p><strong>HIV/AIDS in adults:</strong> the need for routine screening of all HIV-positive individuals for mental health and cognitive impairments should also be emphasised as many adult patients have a mental illness, either before or as a consequence of HIV infection, constituting a ‘special needs’ group.</p><p><strong> Substance abuse and addiction:</strong> the adequate diagnosis and management of related substance abuse and addiction problems should fall within the domain of the health sector and, in particular, that of mental health and psychiatry.</p><p><strong>Community psychiatry and referral levels:</strong> the rendering of ambulatory specialist psychiatric services on a community-centred basis should be regarded as a key strategy to make these services more accessible to users closer to where they live.</p><p><strong>Recovery and re-integration:</strong> a recovery framework such that personal recovery outcomes, among others, become the universal goals by which we measure service provision, should be adopted as soon as possible.</p><p><strong> Culture, mental health and psychiatry:</strong> culture, religion and spirituality should be considered in the current approach to the local practice and training of specialist psychiatry, within the professional and ethical scope of the discipline.</p><p><strong> Forensic psychiatry:</strong> an important and significant field within the scope of state-employed psychiatrists, with 3 recognised groups of patients (persons referred for forensic psychiatric observation, state patients, and mentally ill prisoners), each with specific needs, problems and possible solutions.</p><p><strong> Security in psychiatric hospitals and units:</strong> it is necessary to protect public sector mental healthcare practitioners from assault and injury as a result of performing their clinical duties by, among others, ensuring that adequate security procedures are implemented, appropriate for the level of care required, and that appointed security staff members are appropriately trained and equipped.</p>

A presidential and personal reflection on SASOP during the past decade

No abstract available.

An overview of the State Employed Special Interest Group (SESIG) of the South African Society of Psychiatrists (SASOP) from 2000 - 2012

<p><strong>Introduction.</strong> The State Employed Special Interest Group (SESIG) of SASOP was established in Durban during the national congress in September 2000. Issues of concern at the time included: suboptimal physical conditions in state hospitals and clinics; stalling of the essential drug list (EDL) review process; and understaffing and difficulties to recruit and retain mental health medical personnel in the state sector. During the past 2 years, attention was given to liaising with the South African Medical Association (SAMA) as a medical labour organisation; standards for psychiatric inpatient structures, services and care; and scheduling a national SESIG strategic workshop. <strong></strong></p><p><strong>Methods.</strong> Ethics clearance was obtained for a retrospective quantitative review of the demographic and occupational profile of SESIG’s members, as captured by the SASOP database of current and potential members. The investigation included a review of the policies and process by which strategic activities, priorities and measures for progress were identified within the different areas of SESIG’s mandate. <strong></strong></p><p><strong>Results.</strong> In 2007, 38% (n=144) of the potential total number of stateemployed psychiatrists (380) were paid-up SESIG members; and 53% (n=202) of the potential total number (378) in 2011. The Eastern Cape, Free State and Northern Gauteng subgroups had the biggest percentage of members per region in 2007, which changed in 2011 to Northern Gauteng, Western Cape and Eastern Cape. In 2011, 40% of the total membership were psychiatric registrars. Presentations and discussion during the first national strategic meeting of state employed psychiatrists in 2012 covered: the scope of state sector practice; pertinent policies for state practice; planning per region; teaching and research; accepted principles for care; and strategic mobilisation (details in the supplement of this issue of the SAJP). <strong></strong></p><p><strong>Conclusion.</strong> Eleven position statements were formulated to guide SASOP/SESIG activities during 2012 - 2014, including statements on: national mental health policy; psychiatry and mental health; infrastructure and human resources; standard treatment guidelines and EDL; HIV in children and adults; substance abuse and addiction; community psychiatry and referral levels; recovery and re-integration; culture, mental health and psychiatry; the specialty status of South African psychiatry; and forensic psychiatry.</p>

South African Psychiatry - charting a way forward

South African Psychiatry witnessed a recent event, that by all accounts is unprecedented in low and middle income countries: a national mental health summit, this according to one of the speakers at the summit- Shaker Saxena, of the World Health Organization. South Africa is divided into 9 provinces and prior to the national summit, provincial summits were held in order to identify issues and develop position statements for the national summit i.e. the process was systematic. Between these various summits, the South African Society of Psychiatrists (SASOP) convened a special meeting of state employed psychiatrists to consider a range of matters relevant to psychiatric practise in the state sector ‐ this in order to not only inform the national summit but to provide input into the National Mental Health Policy which is currently work in progress, and represents the development of a policy for mental health that will be officially endorsed. In essence, a series of events which speak to a collaborative approach to charting a way forward for South African

16th National Congress of the South African Society of Psychiatrists (SASOP)

16th National Congress of the South African Society of Psychiatrists (SASOP)

Community rehabilitation for schizophrenia patients: Is it feasible in South Africa?

No abstract available.

The psyche and the soma - redefining the role of the psychiatrist in medical care

n/a

A framework for current public mental health care practice in South Africa

One of the main aims of the new Mental Health Care Act, Act No. 17 of 2002 (MHCA) is to promote the human rights of people with mental disabilities in South Africa. However, the upholding of these rights seems to be subject to the availability of resources. Chapter 2 of the MHCA clarifies the responsibility of the State to provide infrastructure and systems. Chapters 5, 6 and 7 of the Act define and regulate the different categories of mental health care users, clarify the procedures around these categories and spell out mental health practitioners' roles and responsibilities in this regard. Also according to the National Health Act No. 61 of 2003, the State remains the key role player in mental health care provision, being responsible for adequate mental health infrastructure and resource allocation. Due to "limited resources" practitioners however often work in environments where staff ratios may be fractional of what should be expected and in units of which the physical structure and security is totally inadequate. The interface between professional responsibility of clinical workers versus the inadequacy of clinical interventions resulting from infrastructure and staffing constraints needs to be defined. This paper considered recent legislation currently relevant to mental health care practice in order to delineate the legal, ethical and labour framework in which public sector mental health practitioners operate as state employees. These included the Mental Health Care Act, No.17 of 2002; the National Health Act, No. 61 of 2003 and the proposed Traditional Health Practitioners Act, No. 35 of 2004. Formal legal review of and advice on this legislation as it pertains to public sector mental health practitioners as state employees, is necessary and should form the basis of the principles and standards for care endorsed by organized mental health care practitioner groups such as the South African Society of Psychiatrists (SASOP).

Hypotheses, neuroscience and real persons: The theme of the 10th International Conference on Philosophy, Psychiatry and Psychology

NO ABSTRACT AVAILIBLE

Facts and Values in Psychiatric Practice: the theme of the 2006 national psychiatry congress

NO ABSTRACT AVAILIBLE

Psychiatry in the medico-legal setting

NO ABSTRACT AVAILIBLE

13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004

13th National Congress of the South African Society of Psychiatrists, 20-23 September 2004

Psychiatric impairment and disability assessment — proposals to improve current inadequacies

Impairment and disability assessment on psychiatric grounds has always been subjective, controversial and at best, a difficult task. The South African Society of Psychiatrists (SASOP) needs to be congratulated, firstly on being instrumental in the publication of the first ‘Guidelines to the Management of Disability Claims on Psychiatric Grounds’ 1 in 1996, and secondly on following this up with an improved and revised version in May 2002.