Mental health services funding and development in KwaZulu-Natal: A tale of inequity and neglect
Methodology. Budget allocations over a 5-year period to 6 psychiatric and 7 general hospitals in KwaZulu-Natal (KZN) are compared and current numbers of psychiatric beds and psychiatric personnel in that province are contrasted with the numbers required to comply with national norms.
Results. The mean increase in budget allocations to public psychiatric hospitals was 3.8% per annum, while that to general hospitals over the same period was 10.2% per annum. The median cumulative budget increase for psychiatric hospitals was significantly lower than that of general hospitals (Mann-Whitney U-test, p=0.001). No psychiatric hospitals received specific funding for tertiary services development. KZN has 25% of the acute psychiatric beds and 25% of the psychiatrists required to comply with national norms, with the most serious shortages experienced in northern KZN. There are 0.38 psychiatrists per 100 000 population in KZN.
Conclusion. Inequitable funding, inadequate facilities and significant shortages of mental health professionals pervade the mental health and psychiatric services in KZN. There is little evidence of government abiding by its public commitments to redress the inequities that characterise mental health services.
Jonathan K Burns, Nelson R Mandela School of Medicine
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Date published: 2010-10-01
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