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Improving Mental Health Services in Eastern Cape: Presentation to Health Portfolio Committee

Dr. P.P. Dyantyi from ECDOH presents statistics, platform of care, bed deficiencies, and plans to enhance mental health services in Eastern Cape.

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Improving Mental Health Services in Eastern Cape: Presentation to Health Portfolio Committee

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  1. EC MENTAL HEALTH SERVICES PRESENTATION TO HEALTH PORTFOLIO COMMITTEE Dr. PP DYANTYI MEC HEALTH ECDOH

  2. Statistics and Applied Norms • Population Stats (Eastern Cape) • Population size: 6 880 966 • (StatsSA: Mid-year population estimates, 2015) • 13.5 %share of the total population. • Mental Health Service Norms • Acute psychiatry: 28 beds/100 000 (Units and EDH) = 1 930 • Medium to long stay psychiatric care: 10 beds /100 000 • (FEH, TH &KH) = 690 • Community care: 20 beds /100 000 (Nil) = 1 380 • Total beds required = 4 000

  3. Population Distribution

  4. Platform of Care • Primary Health Care with Community Based Services • District Hospital Services with 72hr Services and • Hospital Management Services with Acute and Chronic In-patient management

  5. Primary Health Care Platform • Services still mainly managed in Specialised facilities • Currently beds with two NGO Aftercare Haven (60 beds) and Capricon Halfway House (10beds) – Registered, Licensed NGOs, reviewed yearly, and this to be used as a model for development of service • Also have services with Algoa Frail Care for Mentally Challenged patients (145 beds) • Also 700 Chronic Beds at Kirkwood with Life Esidimeni • The plan is to slowly introduce the service through the platform of • Community Health Workers and Nurses • District Specialist Teams and • School Health

  6. District Health Care Platform • This platform renders 72hr assessment in listed facilities, that first rule out medical and surgical conditions • The list is attached • The main challenge is infrastructure that is not suitable • Currently two District Hospitals also offers Designated Acute services in the Eastern part of the province at Libode (currently 30 beds under Revitalisation – to open September 2017)

  7. Regional & Tertiary Platform • This platform currently offers Acute beds in the following facilities • Nelson Mandela Academic Hospital – 60 beds • Cecilia Makiwane Regional Hospital – 50 beds & • Dora Nginza Regional Hospital - 40 beds

  8. Specialised Hospitals

  9. Bed Deficiencies & Plans to Mitigate • Currently there is a 1600 bed shortage in the Province • Mostly the beds are concentrated in the western area of the province, also due to re-dermacation of 320 Mzimkhulu Hospital to KZN in the East • 30 Beds are to open at Libode (St Barnabas District Hospital) • The plan is to increase Acute Beds and to prioritise the eastern part of the province with the target district hospitals being: • St Barnabas • Madzikane ka Zulu • Holy Cross • St Patricks & • Zitulele • Also critical to note is that the Burden of Disease shows a radical increase in Substance abuse that requires a social service of Rehabilitation. • Only two facilities in the public in the province: • Fort England with 20 beds and • Ernst Malgas (Social Development Department Centre with 20 beds for Adolescents

  10. Hospital Statistics – Designated Facilities

  11. Forensic Patients • There are 94 State Patients awaiting admission and 261 awaiting observation • This is being mitigated through increase of 30beds at Komani and the use of Komani for observation. This will also improve waiting Times

  12. Human Resources

  13. Budget Allocation Per Facility

  14. Budget Allocation Per Economic Classification

  15. Analysis • Due to shortage of beds and Substance Abuse Rehab centres as well as HR there is pressure in the available beds with • Short stay (less than 60 at EDH) • Full beds average way above the 85% norm (at 97%) • Reflects in overflow in Casualties and adverse events, with three patients dying Livingstone in the past six months

  16. Corrective Actions • Standardised protocol has been established (p7) • 40 bedded unit being opened at PE Provincial Hospital • 60 beds to open in central part of the province (30 Tower, 30 Komani) • 30 beds to open in September at Libode increasing to 90 beds in the East with an additional 120 planned in the facilities listed above in the MTEF period

  17. Mental Health Review Boards • There are three Review Boards, located in: • Western – Port Elizabeth • Central – Queenstown & • Eastern – Mthatha • All have three members each: • Health Care Professional • Legal Expert and • Community member • Function as protection of patients on their journey from a listed facility to involuntary admission through the courts. Ensure rights are not infringed • They are a structure where the patients and relatives complain about the correctness of the admission process

  18. THANK YOU

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