Mental Health Awareness Month - October 2013

The growth in the burden of mental illness has put strain on the whole care pathway, from primary care facilities to psychiatric hospitals and necessitated the need for Western Cape Government Health to apply ambulatory care strategies, improve patient referral mechanisms and apply systems-strengthening strategies.

"The Western Cape Government is well aware of the service pressures with regard to mental health. However, in developing an appropriate mental health service we see the strengthening of district mental health services being the key to ensuring that people are identified earlier and receive appropriate mental health care services.

"Most mental illnesses can be treated without hospitalisation. What we experience is a perceived lack of beds with a small percentage of people with very serious mental illnesses who are re-admitted to hospital due to the lack of sufficient community-based, alternative, supervised residential placements. Furthermore, the abuse of alcohol and substances by people with mental illnesses or people vulnerable to developing mental illnesses places enormous pressure on hospital beds. That is why we emphasise the importance of personal responsibility for your health," says Theuns Botha, Western Cape Minister of Health.

During the 2012/13 financial year the four psychiatric hospitals and two sub-acute facilities collectively attended to 6 079 inpatients and 28 611 outpatients. Lentegeur Hospital launched the Green Hospital Project and opened a Green Resource Centre in December 2012. This project presents an opportunity to change the management of psychiatric patients at a specialised facility, with the input of the family and community towards better recovery outcomes.

In addition, the project allowed a reshaping of the immediate environment and infrastructure to a friendlier, sustainable and cost-efficient place of healing for patients and improved workplace for employees and estate partners.

The department also provides the following psychiatric services:

• Acute and chronic intellectual disability services for patients with intellectual disability and mental illness or severe challenging behaviour at Lentegeur and Alexandra hospitals.
• Acute psychiatric services at Lentegeur, Stikland and Valkenberg hospitals, including a range of specialised therapeutic programmes in accordance with the Mental Health Care Act, 17 of 2002.
• Forensic psychiatric services, including observation services for awaiting trial prisoners at Valkenberg Hospital only, and state patient services for people who have been found unfit to stand trial at Valkenberg and Lentegeur hospitals.
• Support and outreach programmes to all Metro district and regional hospitals have been established.
• Integrated assertive community team (ACT) services forms part of the acute services continuum of care and resorts under the senior psychiatrists in these services. The ACT services improve quality of care and treatment adherence.
• Ambulatory services were strengthened by incrementally improving the implementation of the full package of specialist ambulatory services, which support district and regional hospitals.
• The focus on the psycho-social rehabilitation aspects of the service and involvement of the full multidisciplinary team largely provided in-, day- and out-patient services with the residential programme delivered at the William Slater and New Beginnings sub-acute facilities.

As part of the Healthcare 2030 vision, mental health services in the province will be integrated into community-based, primary health care- and acute hospital platforms and service delivery. Only those services requiring a more specialised level of intervention will be treated within the specialist hospital platform.