MHM Magazine

With less than 5% of South Africa's healthcare budget directed towards mental health care, encompassing contributions from the private sector, the South African Society of Psychiatrists (SASOP) aimed to discuss interventions that delegate healthcare services to less specialised health workers at the community level, at their congress held from 19-23 November in Cape Town. With the theme “Shifting the Paradigm towards Community Health and the Unheard Voices in Mental Health,” the congress spoke to the urgent need to expand perspectives and inclusively integrate diverse voices in enhancing mental health care in South Africa and addressing the resource shortage. SASOP's incoming president, Dr Anusha Lachman, says mental healthcare continues to be underfunded while mental health conditions such as anxiety and depression are on the rise. “One in three South Africans suffer from mental illness, with 75% unable to access treatment. This is largely due to medical facilities being under- resourced, but also to the stigma, which is a persistent deterrent to seeking help,” she said. “The focus of the mental healthcare system is skewed towards more severe mental health conditions that affect less than 1% of the population. The underfunding of mental healthcare hampers prevention and diagnosis of mental illness, and limits access to treatment. We need to incorporate more lived experiences, patient perspectives and evidence- based options for mental health interventions at the community level as a way for us to deal with the huge mental health burden of disease. Part of this approach in Southern Africa is task shifting - the upskilling and shifting to lay people and communities to help co-manage mental health and also decrease stigma.” Dr Lachman says it’s vital to address the persistent stigma surrounding mental health and to support family members for whom caring for loved-ones with mental health disorders is an immense challenge. “We need to shift the focus to the unseen supporters and voices of advocacy. Families and community members often bear the burden of mental illness on behalf of the person diagnosed. This conference aimed to voice their struggles but also offer messages of hope, encouragement and advocacy.” The congress which took place at the Century City Conference Centre, Cape Town saw psychiatrists, mental health activists, and community members, both locally and internationally, in attendance. More than 15 keynote addresses, 6 workshops, and more than 25 panel sessions were presented showcasing the unique and diverse strengths of Sub- Saharan Africa, unified in improving treatment, early diagnosis and intervention, and access to care. One of the keynote speakers, Charlene Sunkel, who lives with schizophrenia, discussed her extensive work on the principles that can be applied to transforming current mental health practices, empowering front-line medical personal and how our entire society can work together in preventing mental illness and providing care. The range of international speakers focused on the paradigm shift – moving away from a doctor- patient focus to a doctor-community focus, bringing lessons from other settings to collaborate on how better to support communities in the challenge of early recognition support and treatment of mental illness. level. References available on request. Interview with Dr Anusha Lachman Psychiatrist President of the South African Society of Psychiatrists (SASOP) SHIFTING FROM A DOCTOR-PATIENT TO A DOCTOR-COMMUNITY FOCUS IN MENTAL HEALTH 30 | MENTAL HEALTH MATTERS | 2023 | Issue 6 MHM