Sanofi partnership strengthens mental health service delivery in South Africa

Sanofi South Africa has partnered with the National Department of Health, the Foundation for Professional Development and the World Association of Social Psychiatry to upskill health workers to diagnose and manage mental health disorders at primary and secondary levels of care.

This is in response to South Africa’s rising burden of mental health disorders, with approximately 1 out of 3 South Africans suffering from a mental illness during their lifetime,1 but only an estimated 25% of those with mental disorders receiving treatment.2 This is mainly due to a shortage of health workers specialising in mental health, over-burdened specialist tertiary facilities, a high rate of readmission, and slow integration of mental health into primary health services.3

 

As highlighted in the Human Rights Commission Report on the state of mental health care in South Africa following the Life Esidimeni tragedy: “although the Mental Health Policy Framework and Strategic Plan (2013–2020) emphasizes the value of a primary healthcare approach in reducing the treatment gap, the provision of men­tal health services seems to focus on care in psychiatric hospitals.”4 Many barriers to providing mental health services were pointed out in this report. The lack of knowledgeable and skilled human resources to provide efficient and empathetic stigma-free services, especially in under-resourced rural areas, was highlighted.

The Sanofi South Africa partnership resulted in the South African National Mental Health Education Programme, and positive results from the first phase have just been published in the African Journal of Primary Health Care & Family Medicine.3

In this phase, 1 120 healthcare professionals (Medical Officers and Professional Nurses) were trained across all nine provinces within public health facilities, correctional services and university PHC clinics. The original one-year programme used a blended mental health care training approach, combining a 3-day face-to-face workshop with 4 months of e-learning.3

Results showed significant increases in their confidence in dealing with mental health issues:3

  • Overall average confidence rating for performing mental health care activities increased from 5.8 before the course to 8.2 immediately after it, and was still 8.2 when followed up 3 months later (p < 0.001).
  • Overall average confidence rating for managing mental health conditions increased from 5.8 before the course to 7.6 immediately after it, rising further to 7.9 when followed up 3 months later (p < 0.001).

Says Dr Beki Magazi, Medical Head: Sanofi General Medicines, South Africa: “Furthermore, at the 3-month follow-up after the training, participants reported approximately an overall 48% decrease in the mental health patients they had to refer to higher levels of care. This means they were able to assist these patients effectively themselves.”

 

A second phase of this programme, with the aim of upskilling another 500 healthcare professionals across the country, was recently concluded.

Says Dr Magazi: “Ensuring that South Africans with mental disorders receive adequate care and treatment is essential – and becomes even more vital given the additional burden of HIV and AIDS in the country. Persons living with HIV/AIDS are at higher risk of some mental health conditions. For example, people living with HIV are twice as likely to have depression as people who do not have HIV.5

“The results of the first phase of the South African National Mental Health Education Programme are greatly heartening, and indicate that we will be able to make a significant impact in improving the numbers of South Africans with mental disorders who receive appropriate treatment at the level of care nearest to them.”

 

To find out more about the South African National Mental Health Education Programme watch  the BBC StoryWorks video here:  https://ncdalliance.org/turning-the-tide/films/meeting-minds.

To find out more about Sanofi’s commitment to people with mental disorders in low and middle income countries, watch the video here: Mental Health & Epilepsy: Tackling The Challenge of Access to Care.

 

References

1 Herman A, Stein DJ, Seedat S, et al. The South African Stress and Health (SASH) study: 12- month and lifetime prevalence of common mental disorders. S Afr Med J. 2009;99(5 Pt 2):339-44.

2 Seedat S, Stein DJ, Herman A, et al. Twelve-month treatment of psychiatric disorders in the South African Stress and Health Study (World Mental Health Survey Initiative). Soc Psychiatry Psychiatr Epidemiol. 2008;43(11):889-97. https://doi.org/10.1007/s00127-008-0399-9.

3 Slaven FB, Erasmus Y, Uys M, et al. Can a brief training intervention help improve mental health service delivery in South Africa? Afr J Prm Health Care Fam Med. 2021;13(1):e1-6. https://doi.org/10.4102/phcfm.v13i1.2909.

4 South African Human Rights Commission Report – National Investigative Hearing into the Status of Mental Health Care in South Africa – 2019.

5 National Institutes of Health. 13 August 2021. HIV and mental health. Available from: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-mental-health. Accessed 29 Nov 2021.