Disturbing research shows the link between poverty and mental health is a strong one and access to care is severely limited when finances are tight.
The Mental Health and Poverty Project (MHaPP) at the Department of Psychiatry and Mental Health at the University of Cape Town conducted the research 1 August 2006 and 31 March 2007 using data requested from services for the 2005 calendar year.
Evidence is emerging from low- and middle-income countries to indicate that mental ill health is strongly associated with poverty and social deprivation. Living in poverty, low socio-economic status, exposure to stressful life events like crime and violence, inadequate housing, unemployment and social conflict, are all linked to mental ill health.
Poverty is also associated with exclusion, isolation, feelings of disempowerment, helplessness and hopelessness, which can lead to chronic insecurity and social mistrust, affecting people's mental well being.
Not addressed in mental health policies
In spite of the political freedoms and human rights advances, there has been a growing trend of economic inequality, poverty and unemployment, which has marked the social, economic and political landscape in South Africa. To date, the link between poverty and mental ill health has not been sufficiently addressed in mental health policies and programmes in South Africa.
Some shocking statistics have emerged:
- A huge discrepancy between the provinces has emerged: in the public sector there is a 45-fold difference in the number of psychiatrists between the North West (1 psychiatrist per 5 000 000) and the Western Cape (1 psychiatrist per 110 000).
- The number of beds in community residential facilities varies from 0 in the North West and Northern Cape to 6.5 beds per 100 000 population in Gauteng.
- Mental health services and human resources are limited across South Africa with 0.28 psychiatrists, 0.45 other medical doctors, 10.08 nurses, 0.32 psychologists, 0.4 social workers, and 0.13 occupational therapists per 100 000 people in the country.
- There are 41 psychiatric inpatient units in general hospitals in the country with a total of 2.8 beds per 100 000 people.
- For South Africa's over 40 million population, there are only 23 public mental hospitals, providing 18 beds per 100 000 people.
- Only 1% of these beds are reserved for children and adolescents.
- The number of mental hospital beds has decreased by 7.7% in the last five years.
Source: SAPA, May 2009.