Robertson Lesley J, Szabo Christopher P
Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, South Africa.
Sedibeng District Health Services, South Africa.
S Afr J Psychiatr. 2017 Jul 5;23:1055. doi: 10.4102/sajpsychiatry.v23i0.1055. eCollection 2017.
Community mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an intervention pyramid. Staffing norms provide for a minimum mental health service coverage of 2.7% of the population for adults and 1.5% for children and adolescents.
The aim of this study was to describe the existing CMHS in Southern Gauteng in terms of the National Mental Health Policy.
The CMHS of the City of Johannesburg, Ekurhuleni, Sedibeng and West Rand districts were studied. Information regarding service organisation and staffing was obtained via the Gauteng Directorate of Mental Health. Routinely collected District Health Information Systems data for the 2014/2015 year were analysed.
The organisation of services was not consistent with that recommended by the Mental Health Policy, and specialist CMHS were inappropriately situated within primary care. Only 2.23% of clinic visits were for mental health, and 80% of these were at specialist CMHS. Overall mental health coverage was approximately 0.3% of the population for adults and 0.02% for children and adolescents. Staffing, residential facilities and day care were far below the cited norms for minimal cover.
Our audit revealed that the CMHS in Southern Gauteng did not meet any of the norms cited by the Mental Health Policy. Barriers to implementation of this aspect of the Mental Health Policy need to be explored.
社区精神卫生服务是《国家精神卫生政策框架和战略计划》的核心目标。该服务包含三个核心组成部分：住院设施、日间护理和门诊服务。根据干预金字塔模型，需要有专科支持的初级精神卫生保健服务。人员配备标准规定，成人精神卫生服务的最低覆盖率为人口的2.7%，儿童和青少年为1.5%。
本研究旨在根据《国家精神卫生政策》描述豪登省南部现有的社区精神卫生服务情况。
对约翰内斯堡市、埃库鲁莱尼市、塞迪本和西兰德地区的社区精神卫生服务进行了研究。通过豪登省精神卫生管理局获取了有关服务组织和人员配备的信息。对2014/2015年度常规收集的地区卫生信息系统数据进行了分析。
服务组织与《精神卫生政策》的建议不一致，专科社区精神卫生服务在初级保健机构中的设置不合理。只有2.23%的门诊是精神卫生相关的，其中80%在专科社区精神卫生服务机构。成人的总体精神卫生覆盖率约为人口的0.3%，儿童和青少年为0.02%。人员配备、住院设施和日间护理远低于所引用的最低覆盖标准。
我们的审计显示，豪登省南部的社区精神卫生服务未达到《精神卫生政策》引用的任何标准。需要探讨实施该精神卫生政策这一方面的障碍。
