The NHI can soothe South Africa’s mental health crisis

Published Oct 7, 2024

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By Lerato Mthunzi

October is Mental Health Awareness Month. This provides an opportunity to drive conversations that will ultimately lead to improved outcomes for the healthcare sector as a whole with regard to mental health. 

The government has a pivotal role to play in shaping mental health policies and ensuring that mental health services is accessible to all. This can be achieved by increasing access to mental health facilities for all South Africans, including those living in rural and underserved areas. The proposed National Health Insurance (NHI) should prioritise the provision of quality free mental health services for all South Africans, as there is a dire need for these services. 

The World Health Organization Mental (WHO) states that “mental health is a state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well, and contribute to their community. It has intrinsic and instrumental value and is integral to our well-being”

According to a report by the Health Ombudsman Professor Malegapuru Makgopa, the Gauteng Department of Health was “most negligent and reckless” and “showed a total lack of respect for human dignity, care and human life”, in the manner in which they executed the ill-advised project of moving mental health patients from the Life Esidimeni facility to private care providers. The ensuing chaos in the badly planned and executed move resulted in the tragic death of 144 mental health patients. 

The devastating incident of Life Esidimeni is sadly part of the legacy of an under-resourced and over-burdened health care system which has been subjected to austerity and cost-cutting by the very same government that has been found wanting. 

The majority of South Africans are poor, who live in one of the world’s most unequal economy. They simultaneously have to navigate appallingly high levels of violent crimes. This, according to the South African Human Rights Council (SAHRC) puts a massive and growing segment of South Africans at a high risk for mental health conditions. And we have not even mentioned the collective trauma of black South Africans from the crime of Apartheid, which for many remains fresh, with the daily reminders reflected in the bare inequality that permeates all of our society. 

Not only should the government scrap austerity and the cutting of costs of public services, but it should hasten the implementation of the NHI as a critical measure to stem the mental health time bomb, which ticks faster and faster. The NHI is a necessary intervention which can ensure universal access to healthcare. Part of the crisis is that ordinary people are locked out of accessing mental healthcare services because they cannot afford it. The best doctors and specialists are in the private sector and this has created a serious crisis for the working class and the poor. 

Accessing healthcare services is a constitutional right. It is immoral that there are some who want to continue to justify unequal access to healthcare, in post-Apartheid South Africa, just so the parasitic private healthcare sector can continue to milk the public and increase their wealth, at the expense of the majority of people. Safeguarding the right to quality and holistic primary healthcare is even more important for the most vulnerable members of our society, which include children, the elderly and those who utilise mental healthcare services. 

In addition, the government should do more to integrate mental health services into primary care, and resource this at the scale that the crisis demands. This can help identify and treat mental health issues early because primary health care providers are often the first point of contact for individuals seeking care. By adequately resourcing primary health, both in terms of facilities and personnel, many of the conditions that affect people who use mental health care facilities can be identified and treated early.

Mental Health Awareness month is also a worthwhile intervention from the WHO and its member countries, South Africa included. It provides a platform to reach many members of the public, and to educate them about the importance of mental health. This helps reduce stigma and encourages people to seek help. 

In ensuring that this constitutional right is given tangible meaning, the government has a responsibility to ensure that mental health care is accessible, integrated, and effective. 

As we observe Mental Health Awareness Month this October, let us advocate for policies that support mental well-being and create a society where everyone can thrive, regardless of whether they are rich or not.

* Lerato Mthunzi is the General Secretary of Young Nurses Indaba Trade Union, also known as the Health and Allied Workers Indaba Trade Union - HAITU.

** The views expressed do not necessarily reflect the views of IOL or Independent Media.

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