Context of Mental Health in SA Flashcards
What is the Treatment Gap?
The Treatment Gap refers to the discrepancy between those who receive mental health disorder diagnosis but received no treatment.
What percent of adults in SA received a mental health diagnosis and no treatment?
75%
What is the difference between structural and non-structural barriers to mental health? Give two examples of each.
Structural barriers refer to restrictions in resources and finances e.g., costly treatment, absence of referral pathways, inadequate training.
Non-structural refers to individual and community attitudes e.g., distrust of Western practices and stigma.
Name 5 of 10 barriers to mental health treatment
Lack of proximity to clinics
Lack of community services after discharge
Absence of referral pathways
Inadequate training of primary health care workers in detection
Long wait lists/ waiting times
Costly
Lack of integration between Western and traditional medicine
Distrust of Western practices and lack of access e.g., due to language
Stigma
Low mental health literacy
What does lifetime prevalence refer to?
What percentage of people have met the criteria for diagnosis in their lives.
What does current prevalence refer to?
What percentage of people who are currently living with the disorder (in the past 12 months)
How does the National Prevalence Study collect data?
Takes a representative sample through random sampling and conducts interviews concerning psychological processes.
Discuss the National Stress and Health Study (SASH).
What was it’s purpose/apart of?
What were some of its limitations?
What were its findings?
SASH was part of a WHO study to look at prevalence of common mental health disorders across 27 countries.
It was the first study of its kind to be conducted in Sub-Saharan Africa.
Diagnoses were based on the DSM-5 and only tested for CMI.
Sampled 4351 participants.
Substance disorders had a LT prevalence of 13.3% and current of 5.8%.
Anxiety disorders had a LT prevalence of 15.8% and current of 8.1%.
30% of pop. experience at least on disorder in their lifetime.
Discuss the National Mental Health Policy Framework.
What are its aims?
Give examples of how finances are being spent in the different provinces.
Framework aimed to scale up task-sharing of primary health care nurses, and common mental health workers.
Emphasis is placed on mental health promotion and prevention with full implementation aimed for 2020.
Increase MH budget to meet needs of the population.
National spending on MH in 2005 4% and increased to 5% in 2016 (9.8b)
2016 Gauteng had 6.7% and Limpopo 2.6% –> treatment is based on where you live.
Why is MH prevention important?
The indirect cost of MH is x6 greater than the cost of treatment upon diagnosis.
Do the current amounts of MH workers adequately accommodate the population?
No. There are 1.8 social workers, 0.9 psychologists and 0.3 psychiatrists to every 100,000 people.
What is a hospi-centric approach to MH?
Most of the mental health budget goes to psychiatric hospitals.
Little focus on out-patient intervention and intervention/treatment of less severe cases.
Most of the budget also goes to readmissions and not new patients.
Patients stay for a long time and are ‘out’ for a short time. This is ineffective and unsustainable.
What did mental health look like under the apartheid regime? (3 marks)
Emphasis on pharmotherapy and institutional care.
Little concern for human rights and more concerned for ‘protection’ of society.
Resources focused on a white population.
How have approaches to mental health changed post apartheid?
1997 saw new guidelines stating that treatment should be more community based (people need their community to heal). Additionally importance of MH being a part of general health care.
2002 the MHC act was introduced to protect patients of MH from abuse and discrimination.
The national mental health policy framework was implemented in 2013 to increase MH funding.
How many levels of intervention are there?
3 - Primary, secondary, and tertiary.
