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

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

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

DOI 10.1016/j.ssmmh.2023.100247

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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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Self-citation

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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.
ORCID: Sorsdahl, K.
Petersen, I.
Myers, B.
Zingela, Z.
Lund, C.
Venue: SSM - Mental Health
Publisher: Elsevier BV
Published: 2023-12
Volume: 4
Pages: 100247
ISSN: 2666-5603 (ISSN-L)
DOI: 10.1016/j.ssmmh.2023.100247
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: gold
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
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: Health Sciences › Medicine › Psychiatry and Mental health › 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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A reflection of the current status of the mental healthcare system in South Africa

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