Mental health service use among South Africans for mood, anxiety and substance use disorders

Soraya Seedat, David R Williams, Kathleen McGaffigan, Allen Herman, Hashim Moomal, Stacey L Williams, Pamela B Jackson, Landon Meyer, Dan J Stein


Background: Europe and North America have low rates of mental health service use despite high rates of mental disorder. Little is known about mental health service use among South Africans.
Design: A nationally representative survey of 4351 adults. Twelve-month DSM-IV diagnoses, severity, and service utilisation were determined using the WHO Composite International Diagnostic Interview (CIDI). 12-Month treatment was categorized by sector and province. South Africans in households and hostel quarters were interviewed between 2002-2004 in all 9 provinces.
Outcome measures: 4317 respondents 18 years and older were analysed. Bivariate logistic regression models predicted (i) 12-month treatment use of service sectors by gender, and (ii) 12-month treatment use by race by gender.
Results: 25.2% of respondents with a mental disorder had sought treatment within the previous 12 months; 5.7% had used any formal mental health service. Mental health service use was highest for adults with mood and anxiety disorders and among those with a mental disorder varied by province, from 11.4% (Western Cape) to 2.2% (Mpumalanga). More women received treatment largely attributable to higher rates of treatment in women with mood disorders. Age, income, education and marital status were not significantly associated with mental health service use. Race was associated with the treatment sector accessed in those with a mental disorder.
Conclusions: There is a substantial burden of untreated mental disorders in the South African population, across all provinces and even in those with substantial impairment. Greater allocation of resources to mental health services and more community awareness initiatives are needed to address the unmet need.

Authors' affiliations

Soraya Seedat, University of Stellenbosch

David R Williams, Harvard University

Kathleen McGaffigan, Harvard University

Allen Herman, MEDUNSA

Hashim Moomal, University of Witwatersrand

Stacey L Williams, University of Michigan

Pamela B Jackson, Indiana University

Landon Meyer, University of Cape Town

Dan J Stein, University of Cape Town

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services treatment; mental disorders; 12-month

Cite this article

South African Medical Journal 2009;99(5):346.

Article History

Date submitted: 2008-11-05
Date published: 2009-05-11

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