The road to recovery for psychiatric patients is hampered by a lack of access to medication at public healthcare facilities. Nearly 60% of patients reported experiencing stock-outs of at least one psychiatric medicine, stifling their recovery, a survey by the South African Mental Health Federation (SAMHF) said.Nursing staff were even found to have been reducing dosages or substituting with alternative medicines because of stock-outs. They sometimes had to borrow from other clinics. Other findings were: • 30% of those surveyed experienced a complete relapse leading to hospitalisation;• 30% experienced resurfacing symptoms; • 23% experienced increased anxiety when they did not have access to medicine; and• Eight percent were forced to purchase medication privately, leading to personal financial strains. A recent article in international medical journal the Lancet, authored by members of SAMFH, said a lack of medication has several long-term consequences like “readmission to inpatient facilities, loss of employment, a breakdown in family relationships, poorer quality of life and social isolation”. SAMFH’s Marthé Kotze told The Witness that the root cause of the problem was unknown. “We do ask the question and we get different answers. “Some say the medication is not ordered at the right time, there is a mismanagement on the part of the clinic, there’s a problem with funds, other times we hear getting medication from overseas is a problem.”The Pietermaritzburg Mental Health Society, which has about 1 500 beneficiaries with varying needs, said stock-outs were a problem in the area. Executive director Philippa Manning said: “Our clients in rural areas are cash-strapped, so they don’t have many clinics to go to, so we encourage them to press clinics to get the medication. “Their worry is that they will go ‘oh well’ and not go back.”She said the organisation tries to source medication privately for those in cities who are without medication. But chief director of non-communicable diseases at the Department of Health, Professor Melvyn Freeman, said: “We tried to verify this [SAMHF’s findings] with our procurement section which wasn’t aware of any such stock-outs.”He said SAMHF’s report lacked precise details of cases where stock-outs were reported. He added: “There is a system in place for clinics to notify the national department when stock is nearly out — nobody did that.”Operations director at the South African Depression and Anxiety Group, Cassey Chambers, advised psychiatric patients to develop coping strategies in case of stock-outs.“Coping strategies such as controlled breathing, relaxation techniques and so on. Keep a mood diary to help identify any changes in mood.”The public can report stock-outs by contacting 084 855 7867 or firstname.lastname@example.org.Sadag can be reached at 0800 70 80 90.