Staff/population ratios in South African public sector mental health services
Objective. To document existing staff/population ratios per 100 000 population in South African public sector mental health services.
Design. Cross-sectional survey.
Method. A questionnaire was distributed to provincial mental health co-ordinators requesting them to provide the number of full-time equivalent (FTE) staff responsible for mental health care at all service levels. These data were supplemented by consultations with mental health coordinators in each of the nine provinces. Population data were obtained from preliminary findings of the 1996 census.
Results. The overall staff/population ratio per 100 000 population was 19.5, with an interprovincial range of 5.7 - 31.5. The staff/population ratios per 100 000 population for selected personnel categories (with the interprovincial ranges in brackets) were as follows: total nursing staff 15.6 (4.4 - 28.4), occupational therapists 0.4 (0.1 - 0,8), occupational therapy assistants 0.5 (O.O - 1.3), social workers 0.5 (0.1 - 0.9), community health workers 0.3 (0,0 - 1,0), psychologists 0.3 (0.0 - 0.7), intern psychologists 0.3 (0.0-- 0.7), psychiatrists 0.4 (0.1 - 0.8), psychiatric registrars 0.4 (0.0 - 1.2), medical officers 0.4 (0.2 - 1.3), pharmacists 0.2 (Q.1 - 1.1), and pharmacy assistants 0.2 (0.0 - 0.6).
Conclusions. Relative to international settings, there are low levels of mental health staff provision in South Africa, and there is a large amount of variability between provinces. There are considerable challenges in monitoring mental health staff resources within an integrated health service.