Mental health care in South Africa
Many factors including violence, communicable disease, and urbanisation have increased the prevalence of mental disorders in the country.
Even though it often functions in an inhibitory manner, a comprehensive health plan with a focus on collaboration between traditional practices and Western medicine could prove very beneficial.
Prior to 1997, mental health care in South Africa was mainly institutionalised, and little emphasis was placed on the development of curative therapies.
[7] Primary health care facilities are so severely understaffed that a physician often does not have time to do anything other than refer a mental case to the district hospital.
Not only does this break the continuity of care, but it also obstructs physicians from learning about these mental disorders and the appropriate treatments necessitated for different sets of symptoms.
Although protocols regarding data collection and reporting exist, the sheer lack of personnel among PHC facilities makes such requirements impractical.
However, faced with limited resources, the South African government must prioritise its problems, and mental illness does not often take precedence.
This is largely due to the lack of oversight from mental health specialists as many nurses stationed at the primary care facilities have little to no interaction with them.
As a result, the nurses caring for the psych patients have varying degrees of experience and many possess minimal familiarity with mental illness.
Once treatment at a mental health facility is completed, the patient is handed back into the care of his fellow villagers and they are informed of the discharge instructions.
[9] Many factors including work-related stress, disease, poverty, abuse, sexual violence, as well as the decay of the traditional value system are contributing to the high occurrence of mental health issues in South Africa.
As a result, many individuals for fear of social ostracism, keep their mental illness secret instead of seeking the much needed medical attention.
The alluring financial and social prospects of an urban environment draw many young individuals splitting up families and villages.
[17] In an interview, Dr. Mustafa Elmasri, a Gaza psychologist with over twenty years of experience describes how he has often collaborated with African Traditional Medicine.
Instead of labelling traditional healers as primitive and demonic, he worked with them and even trained some of them in scientific methods for identifying certain mental illnesses such as epilepsy and psychosis.
Dr. Elmasri found that "traditional healers were the key partner beyond the patients and their families in gaining an understanding of the psychological experience and access to social support structures".
Dr. Elmasri also recounts how he occasionally refers mild stress cases to the healers as these patients require a holistic approach from individuals that they know and trust.
Much of this trend is attributed to socio-cultural conditions such as "increased family involvement, informal economies, less segregation of the mentally ill and community cohesion".
Therefore, conducting therapy in South Africa with an emphasis on "valued citizenship" does nothing more than create an intangible goal which will simply cause added stress to the individual.
[21] Effective treatment must be uniquely targeted to each culture with careful consideration to the socio-cultural conditions and "contextually relevant coping mechanisms".
