Question NW4053 to the Minister of Health

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.