Academic journal article South African Journal of Psychiatry

The South African Society of Psychiatrists Is Speaking Up for Good Reasons

Academic journal article South African Journal of Psychiatry

The South African Society of Psychiatrists Is Speaking Up for Good Reasons

Article excerpt

The South African Society of Psychiatrists (SASOP) is gearing up to shape mental health services in the country like never before. In this issue of the SAJP, Professor Bernard Janse van Rensburg explains SASOP's contributions to the National Mental Health Action Plan, [1] following various recent strategic initiatives driven by the dictum, 'There can be no health without mental health, there can be no complete mental health without psychiatry'.

SASOP should play a pivotal role in shaping mental health services as part of the anticipated major changes in South Africa's health sectors, which include the planned implementation of national health insurance (NHI).

SASOP's growing capacity puts it in a progressively better position to shape South African mental health services in both the public and private sectors. SASOP celebrated its 60th anniversary during 2012: since its formation as the Society of Psychiatrists of South Africa (SPSA) in 1962, it has aimed to establish branches in all provinces of the country and, to quote Professor Gillis, 'has made an important contribution to the needs of psychiatric patients and the profession, acting as a pressure group for the mentally ill and holding regular conferences and meetings on academic topics and important issues of the day'. [2] Psychiatry only developed a distinguished 'voice' as an organisation after SPSA/SASOP had separated from a specialist group of psychiatrists, neurologists and neurosurgeons in the then Medical Association of South Africa--a group that had been only 9 years old at the time. Since then, psychiatry has developed into a major discipline of medicine. SASOP has grown from a group of 70 psychiatrists in 1965 to today's 592, from a potential 730, members. We need to doff our caps to the early pioneers and veterans of our society, and build on their work.

SASOP is redefining its role and strategic vision in ways that are responsive to current changes in mental health services in both public and private sectors. The NHI plan will draw the public and private healthcare sectors closer, and is expected to revolutionise the healthcare industry by 'introducing an innovative system of healthcare financing with far-reaching consequences on the health of South Africans.' [3] The NHI 'is intended to bring about reform that will improve service delivery. It will promote equity and efficiency so as to ensure that all South Africans have access to affordable, quality healthcare services regardless of their socio-economic status'. [3]

Given the well-documented connections between mental illness and poverty (as shown in work including that of our Western Cape colleagues, led by the late Professor Alan Flisher), the NHI has specific implications, including risks, for the discipline of psychiatry, and SASOP would be wise to have a critical influence on these effects. For example, psychiatrists have a role to play in preventative medicine, and I would argue that psychiatrists have a definite role to play in combating the so-called quadruple burden of disease in South Africa. We deal with non-communicable diseases, attend to persons emotionally scarred by interpersonal violence and accidents, and form part of the multidisciplinary treatment team for people living with HIV/AIDS and TB. Women's health and child welfare are increasingly recognised as important issues in mental healthcare.

SASOP should aim its influence at all four key interventions proposed to successfully implement the NHI, viz:

* a complete transformation of healthcare service provision and delivery

* the total overhaul of the entire healthcare system

* radical changes in administration and management

* the provision of a comprehensive package of care, underpinned by a re-engineered primary healthcare system.

The paradigm shift will be from a hospi-centric, curative and central approach to a district and municipal ward, community-based, ambulant and preventative model of care. …

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