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 Psychiatrists22 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