Cape Town - The World Health Organisation (WHO) has painted a bleak picture of the state of mental health across the world with its latest report showing one in 10 people have a mental disorder.
And the extent of South African care for the mentally ill - with only a quarter receiving treatment - lags behind that of many comparable countries, said local experts.
At least half of the world’s population live in countries where there was less than one psychiatrist for every 100 000 people, according to the world organisation’s latest mental health report released this week.
WHO said despite the growing incidence of mental illnesses, relatively few resources were directed at this disease burden, resulting in major inequalities with many people lacking access to psychiatric services.
The organisation’s Mental Health Atlas 2014 says only one percent of the global workforce worked in mental health - with low and middle income countries such as South Africa spending less than $2 (R25) per capita per year in this area. This compared with the $50 (R620) per person per year spent by high income countries.
In South Africa, where nearly a quarter of South Africans suffer a mental health disorder at some point in their lives, experts painted a mixed picture.
Last year, the country had 0.39 psychiatrists per 100 000 people - up on 2011, when the figure stood at 0.27.
Cassey Chambers, operations director at the South African Depression and Anxiety Group (Sadag), said that too few health professionals were trained to manage mental illness due to underinvestment by the government and despite the high incidence of mental illness, which affects one in three people in the country.
Professor Soraya Seedat, head of the psychiatry department at Stellenbosch University, said even though South Africa was classified as an upper middle-income country, the ratio of mental health professionals was “grossly inadequate and does not mirror the situation in the upper middle-income countries”.
“So many patients living with a mental illness do not have access to treatment facilities, especially in disadvantaged rural areas,” said Chambers.
“If a patient does get to a hospital or clinic, it doesn’t mean that there is a psychiatric ward, or a psychiatrist or trained psychiatric nurse, psychologist or psychiatric medication available to treat the patient. There aren’t enough psychiatrists or psychologists available in government hospitals or clinics, which makes it difficult for patients to access treatment and get well,” she said.
Chambers said despite the meagre numbers of skilled professionals trained, the few that graduated generally entered the private sector due to better working conditions and better pay.
Seedat said only 25 percent of South Africans with mental illness received treatment, indicating a huge imbalance between the availability of trained personnel and national mental health needs. Of those who received treatment, not all received adequate and appropriate treatment, she said.
“In fact, it has been estimated that inadequate and inappropriate spending on treatment of mental illness such as patients not receiving continuous, co-ordinated and evidence-based multisectoral care, is costing South Africa 2.2 percent of its GDP,” she said.
The government also spends too little of its health budget on mental health - only 4.5 percent of the total. In the Western Cape, only 10 psychiatrists a year graduate, from Stellenbosch University and UCT.
However, Prof Dan Stein, head of psychiatry at UCT, said: “South Africa has made the important step of developing a national mental health policy framework and strategic plan 2013-2020, which emphasises the treatment gap and outlines steps to address this.”
Cape Argus