Updated 29 June 2017

Doctors warn SA mental healthcare collapsing after Esidimeni

Some mental health hospitals have no psychiatrists, and no province currently has organised community-based psychiatric services.

While almost all the previous Life Esidimeni psychiatric patients have been transferred from the NGOs in Gauteng back into hospital, the psychiatric structure in South Africa is falling apart, a group of doctors are warning.

The South African Society for Psychiatrists (SASOP) says 150 days after the Health Ombudsman released his damning report in February, many hospitals are still understaffed with few resources.

“The SA healthcare system is totally fragmented and broken. Esidimeni was just the tip of the iceberg," Prof Bernard Janse van Rensburg, president of SASOP told Health24.

Earlier this year, Health ombudsman Prof Malegapuru Makgoba said the death toll of mentally ill patients who were transferred from Life Esidimeni to 27 NGOs will continue to rise, and is now above 100. 

“The Health Ombud’s report recommended some action to be completed within 45 days, yet 150 days later, it is glaringly apparent that the general poor access to both physical and mental health care at community level remains unaddressed, and no comprehensive remedial strategy has yet been tabled in Gauteng, or elsewhere. Our own report now serves as a second call for action to be taken.”

Critical findings

Some of the most concerning findings from their report include:

  • Only six public sector psychiatrists are serving the whole of Limpopo.
  • Hayani hospital in Limpopo, a 390-bed mental health specialist hospital, where in 2016 a psychiatric nurse was killed by an inpatient, currently has no psychiatrist.
  • In all provinces, psychiatrists have to admit children and adolescents unlawfully into adult psychiatry wards.
  • In Kwa-Zulu Natal, a massive specialist staffing crisis exists where only 20 of the 45 specialist posts are filled.
  • No province currently has organised community-based psychiatric services.

“The health system still does not cater adequately for the thousands of people who continue to live with mental illness within the community,” says Janse van Rensburg.

'Solution is simple'

According to Prof Janse van Rensburg, SASOP continually engages with government, but there is no will to see the seriousness of the situation.

“Their priorities are wrong and the sector is seriously underfunded. We will never have enough psychiatrists and psychologists, but we need better care at community level.

“We are not asking for high-tech equipment; all we need are well-trained multidisciplinary teams. The solution is quite simple."

Read more: 

Mental Health Watch reporting system is launched in SA

20% increase in global depression in a decade

Mental health goes mobile in Khayelitsha


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