The National Council of Provinces recently held a debate on the prevalence of mental illness in South Africa, as well as access to adequate care, treatment and rehabilitation of mentally ill patients. The debate on “Mental Health for all: Giving priority and greater access to mental health care for all” was led by the Deputy Minister of Health Dr Sibongiseni Dhlomo.

He told the NCOP virtual sitting that although efforts have been made to pay special attention to mental health, the conditions that contribute to the problem remain highly prevalent worldwide. In South Africa, the Deputy Minister said, the latest estimates of the global burden diseases, mental, neurological and substance use conditions make up to 18.2% of the total years lived with a disability. It is estimated that about one in three people will suffer from a mental illness in their lifetime, whilst about 16, 5% suffer from a mental illness in a 12-month period.

However, “The mental health treatment gap has been documented internationally and in our local context too. About 75-95% of people with mental disorders in low-middle income countries are unable to access mental health services,” said Dr Dhlomo.

The gap has widened due to Covid-19, which has denied many people with mental illness the treatment they need, while also increasing the pressure on many people as a result of isolation and loss of income. The pandemic has illuminated the urgency of a global and population-wide approach to mental health care, treatment and rehabilitation.

“The impact of Covid-19 on mental health services came through the inability of the health system to prioritise mental health services during the pandemic. It has further been associated with increased anxiety, loss, social isolation increased food insecurity, poverty and domestic violence and femicide, which are serious predisposing factors for mental illness.

“We therefore need to improve mental health systems and improve them with speed. We have made major strides in implementing recommendations by the Human Rights Commission from their investigative hearings held after the Gauteng Marathon Project. We have put a variety of interventions to address this area, some of which include improved collaboration with stakeholders within the criminal justice system.

“It is apparent that neither the state departments nor mental health civil society organisations are able to provide comprehensive mental health services as independent entities. We need multi-sectoral mental health approaches and stakeholders including mental health care users to coordinate and effectively address the service demand,” the Deputy Minister said.

NCOP Permanent Delegate and Chairperson of the Select Committee on Health and Social Services, Ms Maurencia Gillion, called for end to stigmatisation of mental illness through public awareness and collaboration between government and civil society. “Dismantling the stigma around mental illness is crucial and this requires collaboration between government departments, parents, teachers, learners and NPOs. It is also noted that issues of mental health can be related to the triple challenges of poverty, unemployment and inequality, and whilst trying to come with strategies to curb these challenges mental illness becomes the priority.”

She also commended the Department of Health for taking critical steps to strengthen the mental health system, including reforming the Mental Healthcare Act of 2002 and the development of the South African National Mental Health Policy Framework and Strategic Plan (2013 – 2020). These policies identify key factors that are considered catalytic to further transforming mental health services in South Africa and ensuring quality health services are accessible, equitable, comprehensive and integrated at all levels of the health system, in line with WHO recommendation.

Another NCOP Permanent Delegate Mr Mbulelo Bara said his biggest concern was that mental health is underfunded and under-resourced. More needs to be done to address mental health, especially among young people. He suggested that the departments of Health, Social Development and Basic Education embark on joint awareness campaigns about mental health in young people.

“There is a great need for mental health awareness and for accessible and affordable care service. We need to take away the stigma on people who come forward needing mental healthcare service,” Mr Bara said.

Other members of the NCOP also called for an end to discrimination and bullying of people suffering from mental illness. Mr Michael de Bruyne said: “Mental illness is not a death sentence. If given necessary support and healthcare, people suffering from mental illness can live normal life and contribute positively to society.”

Ms S’lindile Luthuli said: “Mental patients are neglected, discriminated and at times even disowned by their own families. exposed to gross human rights violations, called names and accused of witchcraft.”

Sakhile Mokoena
25 February 2022