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EC MENTAL HEALTH SERVICES

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Presentation on theme: "EC MENTAL HEALTH SERVICES"— Presentation transcript:

1 EC MENTAL HEALTH SERVICES
PRESENTATION TO HEALTH PORTFOLIO COMMITTEE Dr. PP DYANTYI MEC HEALTH ECDOH

2 Statistics and Applied Norms
Population Stats (Eastern Cape) Population size: (StatsSA: Mid-year population estimates, 2015) 13.5 %share of the total population. Mental Health Service Norms Acute psychiatry: 28 beds/ (Units and EDH) = 1 930 Medium to long stay psychiatric care: 10 beds / (FEH, TH &KH) = 690 Community care: 20 beds / (Nil) = 1 380 Total beds required = 4 000

3 Population Distribution
District Municipality Population Size % of total Alfred Nzo 12% Amathole 13% Buffalo City Metro 11% Chris Hani Joe Gqabi 5% Nelson Mandela 18% OR Tambo 21% Sarah Baartman 7% Total 100%

4 Platform of Care Primary Health Care with Community Based Services
District Hospital Services with 72hr Services and Hospital Management Services with Acute and Chronic In-patient management

5 Primary Health Care Platform
Services still mainly managed in Specialised facilities Currently beds with two NGO Aftercare Haven (60 beds) and Capricon Halfway House (10beds) – Registered, Licensed NGOs, reviewed yearly, and this to be used as a model for development of service Also have services with Algoa Frail Care for Mentally Challenged patients (145 beds) Also 700 Chronic Beds at Kirkwood with Life Esidimeni The plan is to slowly introduce the service through the platform of Community Health Workers and Nurses District Specialist Teams and School Health

6 District Health Care Platform
This platform renders 72hr assessment in listed facilities, that first rule out medical and surgical conditions The list is attached The main challenge is infrastructure that is not suitable Currently two District Hospitals also offers Designated Acute services in the Eastern part of the province at Libode (currently 30 beds under Revitalisation – to open September 2017)

7 Regional & Tertiary Platform
This platform currently offers Acute beds in the following facilities Nelson Mandela Academic Hospital – 60 beds Cecilia Makiwane Regional Hospital – 50 beds & Dora Nginza Regional Hospital beds

8 Specialised Hospitals
Institution (*Privately Contracted) Beds Acute Med SPP Observations Chronic Substance Abuse Elizabeth Donkin 169 - Fort England 313 90 174 29 20 Komani 440 140 5 185 Tower 400 154 30 216 *Kirkwod (Chronic) 700 *Algoa (Mentally Challenged Children) 145 Ernst Malgas Adoloscence Substance Abuse Centre

9 Bed Deficiencies & Plans to Mitigate
Currently there is a 1600 bed shortage in the Province Mostly the beds are concentrated in the western area of the province, also due to re-dermacation of 320 Mzimkhulu Hospital to KZN in the East 30 Beds are to open at Libode (St Barnabas District Hospital) The plan is to increase Acute Beds and to prioritise the eastern part of the province with the target district hospitals being: St Barnabas Madzikane ka Zulu Holy Cross St Patricks & Zitulele Also critical to note is that the Burden of Disease shows a radical increase in Substance abuse that requires a social service of Rehabilitation. Only two facilities in the public in the province: Fort England with 20 beds and Ernst Malgas (Social Development Department Centre with 20 beds for Adolescents

10 Hospital Statistics – Designated Facilities
Data Element Norm E Donkin Fort England Komani Tower Grand Total No. of Functional Beds 163 313 440 400 1316 Average length of stay – total 60-90days Acute 90-180days Chronic 36 125 193 612 (Long Stay pts) 120 Inpatient bed utilisation rate – usable beds 85% 96 99 100 92 97

11 Forensic Patients ITEM TOTAL Waiting list : Observations State Patients 261 94 Waiting times: Observations 9 months 20 months There are 94 State Patients awaiting admission and 261 awaiting observation This is being mitigated through increase of 30beds at Komani and the use of Komani for observation. This will also improve waiting Times

12 Human Resources Category Number of posts Filled Vacant Psychiatrists
22 16 6 Clinical psychologists 63 37 26 Occupational Therapists 32 7 25 Social Workers 34 24 10 Pharmacists 8 2 Speciality Psychiatric Nurses 153 132 21 General Psychiatry Nurses 292 271 Enrolled Nurses 57 52 5 ENA 340 302 38 Total Nurses 842 757 85 Grand Total 1845 1606 239

13 Budget Allocation Per Facility
2016/17 R’000 2015/16 2014/15 2013/14 Elizabeth Donkin Pyschiatric Hospital 83 833 88 482 93 625 98 256 Komani Pyschiatric Hospital Tower Pyschiatric Hospital 87 589 90 514 95 981 Fort England Pyschiatric Tertiary Hospital Other (Contracted & MHU) 77 015 66 463 Total

14 Budget Allocation Per Economic Classification
Prog 4.3 2016/17 R’000 2015/16 2014/15 2013/14 COE G&S H/H 1 150 - 2 138 1 591 CAP 2 780 3 024 6 502 4 372 Total 4.3

15 Analysis Due to shortage of beds and Substance Abuse Rehab centres as well as HR there is pressure in the available beds with Short stay (less than 60 at EDH) Full beds average way above the 85% norm (at 97%) Reflects in overflow in Casualties and adverse events, with three patients dying Livingstone in the past six months

16 Corrective Actions Standardised protocol has been established (p7)
40 bedded unit being opened at PE Provincial Hospital 60 beds to open in central part of the province (30 Tower, 30 Komani) 30 beds to open in September at Libode increasing to 90 beds in the East with an additional 120 planned in the facilities listed above in the MTEF period

17 Mental Health Review Boards
There are three Review Boards, located in: Western – Port Elizabeth Central – Queenstown & Eastern – Mthatha All have three members each: Health Care Professional Legal Expert and Community member Function as protection of patients on their journey from a listed facility to involuntary admission through the courts. Ensure rights are not infringed They are a structure where the patients and relatives complain about the correctness of the admission process

18 THANK YOU


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