Over the past year, a mental health screening tool has been successfully implemented at 13 community clinics in Cape Town, with plans underway to expand it to all City clinics.
As result of this, there has been a 145% increase in the number of patients seen for suicide attempts in the past year, as mental health services expanded from three City Health sub-districts to all eight.
During the previous year 68 such patients were seen compared to this year’s 167, while in total 30 230 mental health screenings were done, whereas last year 8 616 were done, indicating a 251% increase.
“City Health is placing mental health firmly at the heart of its strategic priorities, ensuring that preventative care, early detection, and community support are central to its services,” said City of Cape Town Mayco member for community services and health, Francine Higham.
Aligned with the 2025 World Mental Health Day theme, “Mental health in humanitarian emergencies”, City Health emphasised its commitment to building resilient communities by addressing mental well-being before crises occur.
Higham encourages residents to look after their mental health, seek support when needed, and engage in conversations that break discrimination and stigma.
“City Health psychologists are leading innovative awareness initiatives at community level, making mental health information accessible, culturally sensitive, and easy to understand in all three official languages. Preventing mental health challenges before they escalate is just as important as treating physical illnesses,” she added.
Stronger support needed
In South Africa, up to nine out of ten patients with mental health disorders do not receive treatment or have access to mental healthcare programmes. Primary healthcare (PHC) practitioners are working to fill this gap, but they are not getting the support they need.
This according to researchers from the department of family and emergency medicine at Stellenbosch University.
They explored the perceptions and experiences of PHC practitioners in managing common mental health disorders at clinics and district hospitals’ out-patient departments in the Garden Route District in the Western Cape — the province with the highest rate of mental health conditions in South Africa.
They focused on nurse practitioners, lay and registered counsellors, medical doctors — sessional and permanent medical officers (MOs), community service MOs, medical intern doctors and registrars in family medicine — and social workers.
Their findings were published recently in the African Journal of Primary Health Care and Family Medicine.
The researchers say that even though PHC practitioners play an important role in identifying, diagnosing and managing patients with common mental health disorders, they often lack the required resources and available support structures remain underutilised.
“Part of the problem is that less than 3% of the national health budget goes to mental health services and only 7,9% of the mental healthcare budget is allocated to primary healthcare,” says Prof Louis Jenkins from the department.
The researchers add that because specialist practitioners were scarce, PHC practitioners had heavy workloads, which made referrals difficult. They point out that there are just 0,31 public service psychiatrists for every 100 000 people — far below the recommended 1,03 psychiatrists and 10,36 nurses needed per 100 000 people to provide adequate mental health services.
“This workload shift to PHC is not supported by sufficient resources, particularly in the public health sector and especially in rural areas, resulting in overworked and insufficiently trained staff to manage both the high burden of disease and patients requiring specialist care. Just under half of participants (46,9%) said the workload was too heavy to allow effective mental health screening.”
They also highlight the importance of strengthening undergraduate programmes to better prepare practitioners to identify and manage mental health disorders effectively.
“Staff require additional training in mental health disorders, and managers need to emphasise and monitor the use of guidelines provided to assist in managing mental health disorders. There is a need to increase the number of mental health nursing practitioners, especially to support PHC clinics.
“It is crucial that we see primary health care as a priority, measure and improve quality, and make specialist support accessible and available. If primary mental health care is part of the model of PHC, then it needs to be supported by appropriate infrastructure, medication, workforce and information.”
Good mental health is a journey
Good mental health and emotional well-being can be easy to take for granted, but keeping this balance through life’s ups and downs can be a struggle for anyone.
World Mental Health Day, commemorated on Friday 10 October, reminds us that mental health is a constant work in progress, not something that can ever be finally achieved. This according to Megan Gonsalves, Netcare Akeso 24-hour Crisis Line Manager.
“It is helpful to think of it as a journey, not a destination; mental health requires us to invest in self-care on an ongoing basis — not only in times of crisis. Our mental well-being should be nurtured as part of our ordinary routine to set ourselves up for coping successfully in the ever-changing situations life throws our way.
“To maintain our mental health and well-being, we need to keep building our coping skills, maintain healthy habits, and nurture the social connections and activities that bring us fulfilment in different spheres of life,” she says.
