Question NW4053 to the Minister of Health
25 November 2022 - NW4053
Ismail, Ms H to ask the Minister of Health
(1)What (a) was the budget for mental health in the past five financial years, (b) is the breakdown of the total number of (i) psychiatrists, (ii) mental health facilities and (iii) mental health awareness campaigns that are needed in his department; (2) what amount does his department need to adequately provide for the mental health needs of the Republic?
Reply:
1. (a) In line with Mental Health Care Act, 2002 as well as the World Health Organization’s approach to mental health services delivery, mental health is integrated into the general health services environment from primary health care level upwards. This is because individuals with a mental health problem often have other comorbidities as well. The budget for mental health is therefore integrated into other health services budget and cannot be singled out. The only clear cut mental health budget is that of specialised psychiatric hospitals, subsidies to community based mental health services, contracted mental health services budget, Mental Health Review Boards budget and the recently allocated conditional grant for mental health. The table below depicts the budget for mental health per province in the past five financial years as provided by the provinces.
Province |
2017/18 |
2018/19 |
2019/20 |
2020/21 |
2021/2022 |
Eastern Cape |
R776 812 825 |
R814 343 561 |
R842 019 615 |
R677 232 329 |
R685 291 223 |
Free State |
R383 350 000 |
R373 432 000 |
R389 396 100 |
R374 545 000 |
R421 315 000 |
Gauteng |
R270 849 000 |
R391 061 000 |
R505 703 059 |
R610 018 600 |
R664 723 555 |
KZN |
R858 384 455 |
R922 424 520 |
R965 369 481 |
R1 002 502 520 |
R954 083 000 |
Limpopo |
R517 009 000 |
R547 850 000 |
R567 535 000 |
R584 614 000 |
R611 386 000 |
Mpumalanga |
R48 693 000 |
R53 692 707 |
R59 510 701 |
R65 118 946 |
R78 647 305 |
Northern Cape |
R54 871 000 |
R85 205 000 |
R108 547 000 |
R119 510 000 |
R127 371 000 |
North West |
R482 452 366 |
R506 307 086 |
R503 906 430 |
R542 408 696 |
R602 446 383 |
Western Cape |
Figure not provided |
R921 445 000 |
R984 102 000 |
R992 619 000 |
R1 042 290 000 |
Total |
- |
R4 625 760 874 |
R4 926 089 386 |
R4 968 569 091 |
R5 189 492 466 |
(b)(i) The Department of Health’s Norms for Severe Psychiatric Conditions require a minimum of:
- 1x psychiatrist for acute inpatient mental health services per 100 000 fifteen (15) years and older population.
- 0.1x psychiatrist for medium to long stay inpatient mental health care per 100 000 fifteen (15) years and older population.
- 0.25xpsychiatrists for ambulatory mental health services per 100 000 fifteen (15) years and older population.
In terms of the 2022 midterm population estimates the population of 15
years and older is 43 593 223.
In line with these norms that are based on the World Health Organisation model for mental health human resources, an estimated minimum number of psychiatrists required to service the 43 592 223 South Africa population of fifteen (15) years and older is 589.
There are no norms to estimate the number of psychiatrists needed for the below 15 years old population.
According to the Health Profession’s Council of South Africa registers, South Africa has 930 psychiatrists.
(ii) The Norms for Severe Psychiatric Conditions measure the mental health service needs through the number of beds required as opposed to number of mental health facilities. In terms of the norms, a population of 100 000 fifteen (15) years and older population require an estimated minimum of 28 beds for acute mental illness, 10 medium to long stay beds and 20 beds for community based residential mental health services. In this regard, the 43 592 223 fifteen (15) years and older South African population require an estimated minimum total of 25 283 mental health beds:
- 12 206 beds for acute mental illness
- 4359 medium to long stay mental health beds
- 8718 community based residential mental health beds
According to the latest available statistics obtained from provinces South Africa has 19752 mental health beds.
(iii) Campaigning for increased awareness with regard to prevention of mental illness (adopting a healthy lifestyle), early detection and how to access mental health services when needed is a continuous process. The National Department and provincial health departments are currently doing so through door-to-door campaigns, pop-up stalls at events and in malls, community events, group and one-on-one counselling at health facilities, community radio slots and print media. These campaigns also focus on combating stigma that is associated with mental illness.
(2) Budgeting for health and other government services depends on the available resources. The World Health Organization recommends that countries allocate a minimum of between 5% and 10% of the country’s total health budget to mental health. The current estimates indicate that South Africa is spending 5% of its total health budget on mental health.
END.