Mental health News South Africa

#MentalHealthAwarenessDay: Changing the way care is accessed

Along with economic uncertainty and political instability comes anxiety and depression, which is when healthcare costs and claims tend to increase. Recent studies show that over 17-million people in South Africa are dealing with anxiety disorders such as panic attacks, post-traumatic stress disorder and mood disorders.
#MentalHealthAwarenessDay: Changing the way care is accessed
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The WHO and the increase in mental disorders

In addition, statistics from a global study presented at a recent mental health summit in Johannesburg, revealed that mental disorders have increased by 22.7%. In South Africa, around 30% of people report life-long psychiatric disorders, while one in three will be affected by a mental illness in their lifetime.
According to WHO, mental healthcare requires a holistic integrated care model, without which outcomes are poor, and there is an increased risk of co-morbid chronic illnesses such as diabetes and HIV.

The way it is

The bulk of mental health care delivery in South Africa has historically been separated from general healthcare, relying heavily on psychiatric hospitals with little attention to mental health care in the primary setting. There are inadequate numbers of specialised healthcare workers to serve the population, which leads to poor access to quality mental health care of good quality and ultimately, complications and costly hospitalisations.

The costs

“Mental health admissions are the third highest admission category in terms of hospital costs,” says Gerhard van Emmenis, principal officer of Bonitas Medical Fund. “This cost continues to climb and is up 7% from the previous year. In 2016, there were a total of 5,791 admissions for mental health at a cost of R132m (3% of total scheme costs). The average cost for a mental health admission is R23,000 and the length of stay is 11 days.”

The relationship between mental and physical health

‘Mental and other health cannot be separated,’ says Van Emmenis. ‘The presence of mental illness increases the risk of disability and premature mortality from other diseases. This is due to a number of factors including side effects of medication, unhealthy behaviours such as diminished physical activity and substance abuse as well as neglect of the patient’s physical health – by patients themselves, their families and their healthcare providers.

Conversely, chronic illness like diabetes is increasingly recognised as a risk factor for the development of mental illness.

‘With such a strong link between health and mental health we have introduced a new treatment optimisation model of care for mental health that aims to improve clinical outcomes and access to cost-effective care. This model is over and above the support and programmes that are already in place for mental health patients.’

So what’s new?

The new Mental Health Programme aims to change the way mental healthcare is accessed. The model is informed by local and international clinical research, spearheaded by the WHO. Parallel to healthcare provider upskilling it uses specialised mental health managed care interventions to promote effective self-care by members suffering from moderate to severe mental illness.

By integrating mental healthcare into a person-centred (as opposed to disease-centred) primary care model, early screening and comprehensive management for those at risk for mental illness can occur, and vice versa for those with mental illness who are at risk of developing other chronic illnesses and complications. For many sufferers of mental illness who do present for care, the family practitioner is the first port of call, ideally placed at the coalface of primary care delivery to promote integration of care.

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