Mental health services in the Western Cape
Our Department of Health continuously aims to address the growing need for care of patients with mental impairments by improving access to treatment and counselling at primary healthcare level.
What is mental illness?
Mental illness or impairment is a treatable condition of the brain, mind and emotions that may affect the way a person thinks, feels or behaves. Mental impairments include a broad range of problems with different symptoms. However, these are generally characterised by some combination of abnormal thoughts, emotions, behaviour and relationships with others. Most mental health disorders can be successfully treated if the correct advice, help and treatment is found.
A number of district and secondary level facilities provide for admission of people with mental impairments in line with the Mental Healthcare Act 17 of 2002. The Western Cape Department of Health has also implemented a policy decision to build fit-for-purpose psychiatric wards at all large district hospitals as well as the regional hospitals.
There are 4 psychiatric hospitals in the Western Cape:
- Alexandra Hospital
- Lentegeur Hospital
- Stikland Hospital
- Valkenberg Hospital
The sub-acute facilities are:
- New Beginnings, supported by Stikland Hospital.
Additionally, the Mental Health Review Board located in the Cape Town Metro District, provides added support to these mental health facilities.
Together these facilities support the integration of mental health services into general care settings in line with the Mental Healthcare Act 17 of 2002, and provide access to the full package of psychiatric hospital services to the citizens of the Western Cape. The psychiatric hospitals continue to provide outreach and support services to acute regional and district hospitals.
As part of the Healthcare 2030 vision, mental health services in the province will be integrated into community-based, primary healthcare, and acute hospital platforms and service delivery. Only those services requiring a more specialised level of intervention will be treated within a specialist hospital.
The Healthcare 2030 vision will also allow for continued emphasis to be placed on district mental health teams managing the acute psychiatric burden of disease.
Treatment for mental health issues is handled professionally and in a caring environment. It’s important to treat mental health like any other health issue you or your loved one may have, by:
- Finding professional guidance and assistance, and
- Seeking advice and support from support groups, and receiving the correct treatment to manage your mental wellbeing.
Mental health community outreach in the Western Cape
There are various outreach initiatives that are routinely and consistently done by arrangement with the psychiatric hospitals in the Western Cape. This is when mental health professionals, psychiatrists, psychiatry registrars and psychologists provide care at clinics, Regional, District Hospitals and Community Health Centres. In addition, the Primary Healthcare (PHC) service, offers mental health services where they:
- Identify, diagnose and treat common mental health conditions, and
- Organise the referral of complicated mental health problems to more appropriate levels of mental health care.
If you or someone you know lives with a mental health condition, you can go to your local clinic where a health worker will assess you and offer initial treatment.
In the Metro, Southern Cape Karoo and West Coast Winelands regions, your community health worker may refer an individual for more specialised care offered by a mental health (psychiatric) nurse, when necessary.
Treatment may include medication as well as short-term individual or group counselling and support. The mental health nurse may consult with the psychologist or psychiatrist (or other members of the mental health team) when additional expertise is required. If necessary, the mental health nurse may set up an appointment with one of these specialists for further assessment at the PHC clinic.
Challenges facing people with mental illness
The main issues facing people with mental illness is discrimination and stigma due to the general lack of understanding regarding mental health issues. According to the Guardian, people with mental health problems face poverty, homelessness and unemployment due to discrimination in the workplace.
Apart from the difficulties arising directly from their mental illness, there’s a wide variety of other issues and difficulties that mentally impaired people are also faced with, including:
- Being accepted in society due to stigmas and stereotypes associated with mental illness,
- Finding employment due to the symptoms of the illness which may make it difficult to perform the function required, or due to the negative and unfounded perceptions of the employer,
- Finding accommodation,
- Relating to others who may not understand how the illness affects them, and
- Having these various issues addressed due to the disempowering nature of society's response to people living with a mental illness.
Despite all of this, most people who experience mental illness will, if given the right support, be able to recover sufficiently to be able to live, work, learn and participate fully in their communities.
Part of being mentally healthy, involves knowing when you need help or support - to know when you may be experiencing a serious problem. You can be diagnosed with a mental illness, but be a productive member of society and live a fulfilled life.
Mental Health and substance abuse:
Psychiatric services continue to remain under pressure, particularly as a result of the high rate of substance abuse, acuity of patients and other social factors. Substance use disorders are extremely high in the Western Cape; this includes fetal alcohol abuse, methamphetamine (tik) epidemic and a growing problem of heroin abuse. Individuals with these disorders often have very high levels of co-occurring mental and physical health problems.
Approximately 50% of mentally ill patients have a substance abuse problem, with the top 3 substances including cannabis (marijuana), tik or methamphetamine and alcohol. Substance abuse not only increases the burden of disease in the Province, but also compromises education outcomes, destroys families and fuels insecurity, all of which threaten economic growth and job creation.
It’s also important to highlight that when a mental health problem goes untreated, the substance abuse problem usually gets worse as well. And when alcohol or drug abuse increases, mental health problems usually increase too.
By far the most common issue connecting mental illness and substance abuse is the intention of patients to medicate the mental health symptoms that they find disruptive or uncomfortable by using alcohol and drugs. Therefore, in instances where there's a dual diagnosis of both a mental health disorder and a substance abuse issue, it’s important that the individual first receives psychiatric evaluation and assistance, before addressing their substance abuse problem. Once the individual’s mental condition is stable, they can be encouraged to join a rehabilitation programme or facility to address their substance abuse problem.
What help is there for people with mental health problems?
Help is available from a wide variety of professionals, including counsellors, nursing practitioners, social workers, occupational therapists, psychologists, general practitioners and psychiatrists.
Help can be obtained through your local clinic or general practitioner who will be able to recommend specialists. The Western Cape Government health facilities that offer services to people with mental health problems are:
- Community health centres,
- District hospitals
- Psychiatric hospitals
View information relating to the symptoms associated with mental illness.
Who to contact
Help is available at your nearest health facility. Find out how you can be assisted.
Contact these Provincial Mental Health Services:
Western Cape psychiatric hospitals
Tel: 021 826 5788
Valkenberg Hospital is a psychiatric hospital which operates in the Cape Town Central Health District of the Metro Region.
Forensic observations and mentally ill prisoners:
Valkenberg for the entire Western Cape then transferred to Lentegeur as appropriate.
Tel: 021 370 1111/1408
Lentegeur Hospital is a psychiatric hospital which operates in the Mitchells Plain health District of the Metro Region.
Child and adolescent mental health service:
In-patient service is provided at Lentegeur for the entire Western Cape.
Tel: 021 940 4400/ 4403
Stikland Hospital is a psychiatric hospital which operates in the Tygerberg Eastern Health District of the Metro Region.
Tel: 021 503 5000/5009
Alexandra Hospital is a specialist mental health facility, offering treatment and rehabilitation for adults, adolescents and children with complex mental health needs and intellectual disabilities.
Cape Mental Health
Tel: 021 447 9040
Cape Mental Health offers a range of 22 community-based programmes and landmark advocacy initiatives for the development and rights of people with mental disabilities (both intellectual and psychiatric) and for the promotion of mental health.
Cape Mental Health catchment area:
Intellectual and psychiatric disability as well as mental health:
|New Beginnings||Tel: 021 940 4400/ 4403|
You can also contact these support groups for mental illnesses or problems:
Support groups for mental illnesses
The South African Depression and Anxiety Group (SADAG)
|Tel: 011 234 4837|
Terminology used in mental health services
Acute psychiatry - Acute psychiatry refers mainly to a psychiatric intervention that usually occurs on an emergency basis. Patients who seek care from an acute psychiatry unit usually suffer from sudden and severe psychiatric symptoms.
Child and adolescent mental health service - Child and adolescent mental health services is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children and adolescents. Specialists normally focus on treating mental, emotional, or behaviour disorders.
Forensic observations of mentally ill prisoners - A forensic observation is a psychiatric assessment of an individual’s fitness to stand trial, and of his or her capacity to appreciate wrong doing. The assessment takes place in a psychiatric ward, in a psychiatric hospital, and is carried out by a team which includes psychiatrists, psychologists, nursing staff, social workers and occupational therapists.
Intellectual disability - Intellectual disability is a disability characterised when an individual has significant limitations both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behaviour (collection of conceptual, social, and practical skills).