A psychiatry expert has warned that an acute lack of community-based resources and specialised beds is leaving South Africa’s public sector overstretched, reports IOL.
This follows a parliamentary inquiry by the DA’s Dr Karl Willem du Pré le Roux to Health Minister Dr Aaron Motsoaledi regarding psychiatric hospital units, available mental health beds, and patient treatment statistics from 2023 onward.
Experts said the issue, and a vital lack of resources, could have a cascading effect, not just on the patients themselves but on staff, and also families and communities.
Saturday marked World Mental Health Day, held under the theme “Lived experiences heard: real voices, real change”, supported by the national slogan: “Let’s Talk”.
Motsoaledi said South African hospitals provide mental health services on an inpatient and outpatient basis, depending on the capacity of the hospital, the complexity of the presenting condition, and the ability of the patient to give consent to mental healthcare and treatment.
Those needing further involuntary mental healthcare, treatment and rehabilitation after the 72-hour assessment procedure or requiring a higher level of expertise or to be managed in a more secure and contained environment, are referred to designated psychiatric units, he added.
He said 63 720 patients were treated for mental health-related illness in psychiatric hospitals in 2023, rising to 65 218 in 2024: in 2025 the numbers dropped to 60 332 but shot up again to 31 458 in 2026.
However, he highlighted that the health information system does not separate the outpatient and emergency data for patients treated for mental health-related illness.
These next data combine outpatient and emergency departments: provincial (tertiary) hospitals treated 69 773 patients in 2023, 69 543 in 2024, 68 000 in 2025, and 36 060 in 2026 for mental health-related illnesses in their emergency and outpatient departments.
Regional hospitals treated 175 642 patients in 2023, 194 126 in 2024, 196 307 in 2025, and 97 869 in 2026 for mental health-related illnesses in their emergency and outpatient departments.
Stellenbosch University Department of Psychiatry senior lecturer Dr Kerry Louw said the 72-hour assessment process was to exclude medical illnesses that could cause mental health symptoms, stabilise acute presentations, and determine whether patients needed ongoing involuntary care before being transferred to psychiatric hospitals for specialist treatment.
“Lack of mental health beds means that patients are assessed and treated in general medical beds or emergency rooms where they have no access to adequate mental health assessment and management. This can lead to delays in appropriate treatment, missed diagnoses and adverse incidents involving staff and patient safety.”
She said that the emergency and outpatient components of mental health services comprise a significant part of care and must be understood to plan service delivery and research systemic burdens and intervention outcomes.
As many patients are seen and discharged in emergency settings, those data are critical for understanding healthcare utilisation and throughput, and without adequate research, it is difficult to motivate necessary services.
Looking at the factors behind the volume of mental health patients being treated at the regional hospital level compared with provincial tertiary and specialised psychiatric hospitals, Louw said regional hospitals are the primary entry points for mental healthcare users, and they face the massive frontline burden of disease.
“There are revolving-door patients who relapse and have recurrent presentations due to non-adherence to treatment, medication stock-outs, inadequately treated illness, medical co-morbidities, substance misuse, or social stressors. There are also bottlenecks with delays in access to specialised psychiatric hospitals. And these often struggle to discharge patients and have long lengths of patient stays,” she added.
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