Providing Psychiatric Services in General Medical Settings in South Africa: Mental Health-Friendly Services in Mental Health-Friendly Hospitals Editorial

van Heerden, Margaretha S., Hering, Linda, Dean, Carol, Stein, Dan J., South African Journal of Psychiatry

Neuropsychiatric disorders rank high on the list of the most disabling medical disorders in both the developed and developing worlds. (1) Significant comorbidity also exists between neuropsychiatric disorders and general medical disorders; (2) this is key in the South African context where HIV/AIDS and substance use disorders are highly prevalent. (3,4) It has therefore become essential to provide mental health services in a range of settings, including those that focus on the delivery of general medical services. Furthermore, the Mental Health Care Act 17 of 2002 underlines the importance of providing integrated, accessible mental health care in the local community.

Despite growing recognition of the burden of disability due to common mental disorders, mental health services remain under-resourced in relation to their burden, both in developed and in developing countries. (5) In South Africa, the historical focus has been on providing mental health care in psychiatric hospitals rather than in general medical or community settings. (6) De-institutionalisation has occurred in recent decades, but development of adequate community-based services has lagged in catering for the immense need of community outpatients.

In the Western Cape, considerable effort and energy has been devoted to preparing a strategic plan for providing more effective community- and district-based mental health services in line with the new Mental Health Care Act. This plan is part of the Provincial Government of the Western Cape Department of Health's Comprehensive Service Plan for the Implementation of Health Care 2010 (HC2010). In this plan, a series of models of mental health care services is outlined to determine the number of posts for mental health clinicians, including community-based psychiatric nurses, in coming years (the 2010 Comprehensive Service Plan (CSP)). Additional work, however, is needed to implement the CSP, adjusting it to the realities 'on the ground'.

Challenges

As part of the province's HC2010 strategy, a clinician was appointed in each of the major specialties as co-ordinating clinician to assist the Department in guiding the discipline towards HC2010. Co-ordinating clinicians have worked with university departments, management, …

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Publication information: Article title: Providing Psychiatric Services in General Medical Settings in South Africa: Mental Health-Friendly Services in Mental Health-Friendly Hospitals Editorial. Contributors: van Heerden, Margaretha S. - Author, Hering, Linda - Author, Dean, Carol - Author, Stein, Dan J. - Author. Journal title: South African Journal of Psychiatry. Volume: 14. Issue: 1 Publication date: March 2008. Page number: 4+. © 2007 South African Medical Association. COPYRIGHT 2008 Gale Group.

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