Staff/population ratios in South African public sector mental health services

To document existing staff/population ratios per 100,000 population in South African public sector mental health services.

Cross-sectional survey.

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 co-ordinators in each of the nine provinces. Population data were obtained from preliminary findings of the 1996 census.

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 (0.0-1.3), 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 (0.1-1.1), and pharmacy assistants 0.2 (0.0-0.6).

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.