Integrating mental health into South Africa's health system: current status and way forward.

As implied by the World Health Organization’s statement, “There is no health without mental health”, it is essential to think of mental health as an integral part of health. As such, it should be integrated into health policy and practice in order to improve global health and address the significant treatment gap for mental, neurological and substance use (MNS) disorders.

Efforts to address this in South Africa have included policy responses as well as research and service innovations integrating mental health into general health care.This chapter provides an overview of the current policies and services in place for mental health care in South Africa; it also describes current research on effective strategies for providing such services, and identifies key barriers and facilitators in implementing these policies and scaling up mental health services.

The examples of research projects and service initiatives described reflect strategies of integration into Primary Health Care, such as using task-sharing together with a strong support structure for supervision and referral. Once effectiveness is established, the challenge of how to scale up these interventions remains. Further research will be required to evaluate both the outcomes of scaled-up mental health care and the best practices to achieve this.

Integration of mental health requires a vision, high-level commitment, allocation of resources, as well as oversight and support of the provinces in the implementation of mental health services. The vision is apparent in the South African Mental Health Policy and Strategy Plan – the implementation of this policy is the challenge that now lies ahead.