Cited by 106Mental Health Treatment and AccessPsychiatric care and mental health servicesHistorical Psychiatry and Medical Practices

A reflection of the current status of the mental healthcare system in South Africa

Open access
Sorsdahl, K., Petersen, I., Myers, B., Zingela, Z., Lund, C., van der Westhuizen, C.·2023·SSM - Mental Health

Abstract

In this paper we begin by highlighting the large treatment gap in South Africa for mental health conditions. We then describe the mental health services available, including the provision of evidence-based treatments in South Africa at each level of care, using the WHO's optimal mix of mental healthcare services as a framework. The optimal mix of services pyramid includes the following domains: informal services, which comprise self-care and informal community mental health care (including religious and traditional healers), primary care mental health services, psychiatric services provided at general hospitals, community mental health services, specialist services and long-stay facilities. In South Africa, mental healthcare services are concentrated at the apex of the pyramid within secondary hospital and specialist services, with fewer resources available at other levels of care, particularly at the community level. Barriers to access and delivery of evidence-based treatments at each level of care are discussed, including the current mental healthcare system resourcing and structure which drives the focus on the provision of medications and specialized services for patients with serious mental health conditions. The results of research conducted locally in collaboration with the Department of Health to address this gap, particularly regarding care for common mental health conditions in community settings, are described. Finally, we provide recommendations for the way forward to ensure that high-quality mental health services at all levels of care are delivered in an equitable, acceptable and effective manner.

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Crossref · 10.1016/j.ssmmh.2023.100247

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Authors
Sorsdahl, K., Petersen, I., Myers, B., Zingela, Z., Lund, C., & van der Westhuizen, C.
Affiliations
  • University of Cape Town (ZA)
  • University of KwaZulu-Natal (ZA)
  • South African Medical Research Council (ZA)
  • Nelson Mandela University (ZA)
Corresponding author
Sorsdahl, K.
Venue
SSM - Mental Health
Publisher
Elsevier BV
Published
2023-12
Volume
4
Pages
100247
ISSN
2666-5603 (ISSN-L)
OpenAlex
W4385478352
Cited by
98
References
77
Citations by year
2026: 29 · 2025: 40 · 2024: 25 · 2023: 4
FWCI
29.07
Type
journal article
Language
en
Open access
Locations
  • SSM - Mental Health (publishedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Nelson Mandela University Research Repository (submittedVersion)
Funders
  • National Department of Health
  • Providence Health Care
  • World Health Organization
  • Association for Progressive Communications
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
Keywords
mental health services, treatment gap, South Africa, community mental health services, primary care mental health, access barriers, evidence-based treatment, mental health equity

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