Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; EB Consulting, Pty Ltd, Cape Town, South Africa.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; SAMRC Unit on Risk & Resilience in Mental Disorders, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Compr Psychiatry. 2024 Apr;130:152458. doi: 10.1016/j.comppsych.2024.152458. Epub 2024 Feb 1.
The publication of South Africa's National Mental Health Policy Framework and Strategic Plan 2023-2030 and the proposed National Health Insurance (NHI) make it timely to review that state of mental health services in the country, and to emphasize the importance of prioritising mental health as a pivotal component of holistic healthcare.
We searched the published literature on mental health using Google Scholar, Pubmed, and Bing Chat, focusing on these words: epidemiology of mental health disorders, depression and anxiety disorders, mental health services, mental health facilities, human resources, financing and impact of COVID-19 on mental health in South Africa and beyond. We also searched the grey literature on mental health policy that is publicly available on Google.
We provided information on the epidemiology and economic impact of mental health disorders, the availability of mental health services, enabling policies, human resources, financing, and the infrastructure for mental health service delivery in South Africa. We detail the high lifetime prevalence rates of common mental disorders, as well as the profound impact of socioeconomic determinants such as poverty, unemployment, and trauma on mental health disorders. We note the exacerbating effect of the COVID-19 pandemic, and emphasize the pressing need for a robust mental health care system.
In addition to outlining the challenges, such as limited mental health service availability, a shortage of mental health professionals, and financial constraints, the review proposes potential solutions, including task-sharing, telehealth, and increasing the production of mental health professionals. The paper underscores the necessity of crafting a comprehensive NHI package of mental health services tailored to the local context. This envisioned package would focus on evidence-based interventions, early identification, and community-based care. By prioritising mental health and addressing its multifaceted challenges, South Africa can aspire to render accessible and equitable mental health services for all its citizens within the framework of the National Health Insurance.
南非发布了《国家精神卫生政策框架和战略计划 2023-2030》以及拟议的国家健康保险（NHI），这使得我们有必要对该国的精神卫生服务状况进行审查，并强调将精神卫生作为整体医疗保健重要组成部分的重要性。
我们使用 Google Scholar、Pubmed 和 Bing Chat 搜索了精神卫生领域的已发表文献，重点关注以下词汇：精神健康障碍的流行病学、抑郁和焦虑障碍、精神卫生服务、精神卫生设施、人力资源、精神卫生筹资以及 COVID-19 对南非及其他地区精神健康的影响。我们还在 Google 上搜索了可公开获取的精神卫生政策灰色文献。
我们提供了南非精神卫生服务提供的流行病学和经济影响、精神卫生服务的可及性、有利政策、人力资源、筹资以及精神卫生服务交付基础设施方面的信息。我们详细介绍了常见精神障碍的终身高患病率，以及贫困、失业和创伤等社会经济决定因素对精神健康障碍的深远影响。我们注意到 COVID-19 大流行的加剧作用，并强调需要建立强大的精神卫生保健系统。
除了概述挑战，如精神卫生服务的可用性有限、精神卫生专业人员短缺和资金限制外，该综述还提出了潜在的解决方案，包括任务分担、远程医疗和增加精神卫生专业人员的数量。该论文强调了制定适合当地情况的综合 NHI 精神卫生服务套餐的必要性。这个设想的套餐将侧重于基于证据的干预措施、早期识别和社区护理。通过优先考虑精神卫生问题并解决其多方面的挑战，南非可以在国家健康保险框架内为其所有公民提供可及和公平的精神卫生服务。
