REPORT: Health System Costs of Mental Health Services and Programmes in South Africa

An Evaluation of the Health System Costs of Mental Health Services and Programmes in South Africa
The Alan J Flisher Centre for Public Mental Health (CPMH), together with the South African Medical Research Council (SAMRC), announce the release of the full technical report of the Evaluation of the Health System Costs of Mental Health Services and Programmes in South Africa (2016/17 FY); and the accompanying open-access publication: Mental health system costs, resources and constraints in South Africa: a national survey.

Responding to some of South Africa’s biggest information gaps related to our mental health system, for the first time, this study offers a nationally representative reflection of the state of mental health spending and elucidates inefficiencies and constraints emanating from existing mental health investments in South Africa; achieving one of the highest sample sizes of any costing study conducted for mental health in LMICs. 

This research endeavor was a joint effort of the National Department of Health (NDOH), the Provincial Departments of Health, the SAMRC and the Alan J Flisher Center for Public Mental Health, University of Cape Town, South Africa. The research was conducted by Sumaiyah Docrat1, Donela Besada and Prof Crick Lund.

Information presented in this report is based on best available data derived from primary and secondary sources. Discrepancies between different sources reflect the current quality of mental health systems data.
All data should therefore be interpreted carefully and with recognition of potential inaccuracy.

Following the completion of this first phase of work, technical support from the authors has been requested to develop a mental health investment case. We are now in a position to explore the mechanisms by which our country and Provinces can accelerate our progress towards the achievement of the National Mental Health Policy Framework and Strategic Plan (2013-2020) and take forward the prescribed recommendations of the South African Human Rights Commission Report on the State of Mental Health Care in South Africa in the context of the recent passing of the NHI Bill.  This investment case will involve intensive and ongoing dialogue with Provincial and National structures, the recently enacted Mental Health Think Tank, the Ministerial Task Team for Mental Health and a range of stakeholders involved in the provision of mental health services and research across the country.   The goal is to provide empirical evidence on the costs and benefits of investing in mental health based on the existing constraints identified in our mental health system, the most cost-effective mix of interventions to address these constraints, and the broader health-sector transformations that are ongoing in the country, over the next 20 years. Completion of the Investment Case is anticipated by October 2020.

The information contained in this publication may be freely distributed and reproduced, provided that the source is acknowledged.

Suggested citation for this report
Docrat, S., Besada, D., Lund, C. 2019. An Evaluation of the Health System Costs of Mental Health Services and Programmes in South Africa. Alan J Flisher Centre for Public Mental Health, University of Cape Town. https://doi.org/10.25375/uct.9929141

Suggested citation for the accompanying open-access publication
Docrat, S., Besada, D., Cleary, S., Daviaud, E., Lund, C. 2019. Mental health system costs, resources and constraints in South Africa: a national survey. Health Policy and Planning. Advance article. Available at: https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czz085/5572608

1S.D. is a staff member of the University of Cape Town and is supported by the South African Medical Research Council through its Division of Research Capacity Development under the SAMRC National Health Scholars Programme from funding received from the South African National Treasury. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the University of Cape Town, the South African Medical Research Council or the funders. 

Maggie Marx