World Mental Health Day: Care for people with schizophrenia
Dr Mvuyiso Talatala, South African Society of Psychiatrists’ past president, said people with schizophrenia need to be recognised as requiring prioritisation.
THE South African Society of Psychiatrists (SASOP) has called upon the government and medical schemes to enhance mental healthcare for individuals with schizophrenia this Mental Health Day.
World Mental Health Day is commemorated on October 10 and is aimed at creating public awareness to make issues related to mental health a global priority.
Dr Mvuyiso Talatala, past president of SASOP, said schizophrenia patients face a significantly higher risk of premature mortality, with their life expectancy reduced by 10 to 20 years, and the lack of access to mental healthcare is weakening their quality of life as well as of their families.
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“Schizophrenia is a debilitating mental illness characterised by episodes of psychosis, which encompass symptoms like hallucinations, delusions, disorganised behaviour and incoherent communication. Without timely intervention and proper management, schizophrenia can have severe consequences on social, occupational and interpersonal functioning,” he said.
While precise data on the prevalence of schizophrenia in South Africa is lacking, Talatala said the challenges faced by patients are evident in healthcare facilities.
“These challenges include limited knowledge about the illness, difficulties accessing care at the primary level, insufficient access to appropriate medications, inadequate support for both patients and their families, resource limitations within the healthcare system, and the persistent stigma surrounding mental-health issues.”
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He emphasised that stigma remains a significant obstacle to the proper treatment of individuals with schizophrenia.
According to Talatala – in the private sector, the regulations of the Medical Schemes Act stipulate 21 days of hospitalisation per year for individuals with schizophrenia, with limited guidance on outpatient care despite the existence of treatment algorithms for schizophrenia that advocate for comprehensive outpatient care.
“Medical schemes are often hesitant to fund outpatient care for people with schizophrenia. In the public healthcare system, the predominant approach revolves around providing care for individuals with schizophrenia only when they are severely ill and in need of hospitalisation.
“Despite the current reliance on hospitalisation as a cornerstone of schizophrenia treatment in South Africa, there is still a shortage of psychiatry beds, falling short of the recommended target of 28 mental-health care beds per 100 000 population.”
SASOP urged both the government and medical schemes to bolster community-based mental-healthcare services for individuals with schizophrenia, requiring increased funding and improved care models.
“This includes providing sufficient space for therapists in community-based clinics, implementing relapse-prevention strategies for schizophrenia in both the public and private sectors; early diagnosis and treatment, preferably with injectable antipsychotics; adequate treatment of schizophrenia and the management of substance use from the first episode, and better funding for community-based care to ensure treatment adherence and adequate psychosocial support,” said Talatala.
He added that overcoming the stigma associated with schizophrenia demands that it be recognised as a priority by both the government and medical schemes.
“Overall, South Africa must strengthen its community mental-healthcare services to reduce barriers to access for individuals in need,” he said.
For support, members of the public can reach out to the South African Depression and Anxiety Support Group (SADAG) and You Are Not Alone (YANA).
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