Daily Dispatch- Eddie Botha
LACK of proper mental health care in the public sector for the over 700000 people living in Buffalo City rates among the worst in South Africa with only two full-time psychiatrists working in Cecilia Makiwane Hospital.
An investigation by the Daily Dispatch has revealed that the medical and nursing staff complement at Cecilia Makiwane Hospital’s (CMH) Mental Health Unit vastly trails the targets set by the national Department of Health for mental health care in its psychiatric and general hospitals.
The Mental Health Unit is the only public sector institution that renders mental health care in the city.
There are 14 State-employed psychiatrists in the Eastern Cape, which has a population of 6527747 (Statistics SA 2008).
A senior psychiatrist at the CMH unit, Dr Kiran Sukeri, is presently researching the mental health care figures in the province. Sukeri and Dr Heloise Uys, the head of the unit, are the only two full-time specialist psychiatrists working in the unit, while Dr Tony Pentz, the retired former head, conducts sessions at CMH.
There are four permanent medical officers and two psychologists at the unit. There are no registrars (doctors specialising in psychiatry).
The unit at CMH currently has only 50 beds and 49 nurses to care for patients.
In terms of the national target norm, and based on Buffalo City’s population, the unit needs 244 beds, seven psychiatrists, 14 registrars, nine psychologists, 10 medical officers, and 185 nurses to render proper mental health care for the city.
The unit is also far behind the national baseline norm, which is a national average indicator of existing services.
According to the department’s norms manual, the findings “show clearly that South African mental health services are grossly under- resourced in comparison to other countries with similar levels of economic development”.
The CMH unit also provides an out- patient and outreach and community service.
In 2008 the unit’s medical staff consulted with 12455 outpatients. One medical officer also visits Frere Hospital daily to see parasuicidal patients at that hospital.
Uys, a medical officer and nursing staff also travel to Transkei once a month to visit patients at a clinic.
The provincial Health Department says that patients from Buffalo City are also admitted to other psychiatric institutions in the province, such as Fort England in Grahamstown.
However, those patients are not admitted directly to Fort England and are first seen by CMH’s doctors and then transferred to Fort England.
A recent Mental Health and Poverty Project at the Department of Psychiatry and Mental Health at the University of Cape Town has evaluated the link between poverty and mental ill health.
Its aim is to ensure that the poorest communities have access to mental health care.
The project found that living in poverty, a low socio-economic status, exposure to stressful life events like crime and violence, inadequate housing, unemployment and social conflict were all linked to mental ill health.
It said that to date the link between poverty and mental ill health had not been sufficiently addressed in mental health policies and programmes in South Africa.
The researchers said that the project yielded shocking statistics and facts about mental health care in South Africa.
It found that mental health was not at the forefront of policy development and implementation in the health, education, employment, social development or other key sectors in South Africa, and that there was little co-ordination of mental health across these sectors.
“We knew that mental health services were under-resourced in South Africa, and that mental health has always been low on the priority list. But what surprised us was the level of inequality between provinces,” said Dr Crick Lund, chief research officer of the project. - By EDDIE BOTHA
Stop ignoring the mind
MENTAL health in South Africa carries an unfortunate stigma best summed up by the expression “Out of sight, out of mind”.
There appears to be a mindset that questions why we should worry if the ailment is not physical or immediately apparent through its symptoms.
Disease of the body, it would seem, is more precious than disease of the mind.
This is a curious status quo considering our minds and consciences are what separate us from the rest of the animal world.
It’s like having an expensive computer with an array of advanced functions rendered obsolete because the brains of the machine are infected with a virus.
Eradicate the virus and functionality returns.
In the human world life is not so trivial and simple but it doesn’t make sense to ignore the one for the other. Still, mental health seems, at best, to be an afterthought in government healthcare planning.
It’s even worse if you or a family member suffers from mental illness, live in Buffalo City and rely on the State for treatment.
A Daily Dispatch investigation has shown just how poorly mental health care ranks in this part of the country in terms of the norms set by the State for public facilities.
The numbers are alarming: there are only two full-time specialist psychiatrists working at the Mental Health Unit in Cecilia Makiwane Hospital, the only public sector institution which provides mental health care in the municipal area.
In addition, there are four permanent medical officers and two psychologists at the unit, but no registrars (doctors specialising in psychiatry). The unit only has 50 beds and 49 nurses to care for patients.
By national Department of Health standards, and based on Buffalo City’s population of about 700000, the unit actually requires seven psychiatrists, 14 registrars, nine psychologists, 10 medical officers and 185 nurses.
That equates to a desired average of a five-fold increase in personnel. Simply put, existing staff are working way beyond their capacities.
Last year, 12455 outpatients visited the unit. If you “do the math”, as they say, it becomes clear that the system is failing both doctors and patients.
Resource constraints are nothing new to the province or the Health Department. On the pecking order, mental health suffers even further.
But that paradigm will have to change soon. Dr Crick Lund, a chief researcher in Cape Town, tells us the cost to the economy is more if mental health is ignored.
Government needs a new model. And it can start by accepting that mind, body and soul is a concept that works only in equilibrium.