Profile of the current psychiatrist workforce in South Africa: establishing a baseline for human resource planning and strategy.

The World Health Organization Global Health Observatory Data Repository reports South Africa with 1.52 psychiatrists per 100 000 of the population among other countries in Africa with 0.01 psychiatrists per 100 000 (Chad, Burundi and Niger) to more than 30 per 100 000 for some countries in Europe. The overall situation, while being cognizant that mental health care is not only provided by specialist psychiatrists and that the current treatment gap may have to be addressed by strategies such as appropriate task sharing, suggests that there are actually too few psychiatrists to meet the country's mental health care needs. To address the need to develop a strategy to increase the local specialist training and examination capacity, a situational review of currently practicing psychiatrists was undertaken by the [BLINDED] and the [BLINDED] using the South African Society of Psychiatrists membership database. The number, distribution and attributes of practicing psychiatrists were compared with international figures on the ratio of psychiatrists per 100 000 population. In April 2019, there were 850 qualified psychiatrists actively practicing in the country and based on the national population figure of 55.6 million people (2016 Census), the psychiatrists per 100 000 ratio was 1.53. This indicates no improvement between 2016 to 2019. From the South African Society of Psychiatrists database, we determined that about 80% of psychiatrists are working in the private sector-a much higher proportion than is usually quoted. As the vast majority of psychiatrists are practicing in urban areas in two provinces, Gauteng (n = 350) and Western Cape (n = 292), the ratio of psychiatrists per 100 000 in these areas is relatively higher at 2.6 and 5.0, respectively, whereas rural areas in South Africa are largely without specialist mental health expertise at a rate of 0.03 per 100 000 population. This investigation provides a discipline-specific situational review of the attributes and distribution of the current workforce of specialists in the country.

A model for the role of defined spirituality in South African specialist psychiatric practice and training.

The current bio-psycho-social approach in South African psychiatry refers to Engel's extended model of health care. It forms the basis of the existing collaboration between medicine, nursing, psychology, occupational therapy and social work. Psychiatry also has to bridge the multi-cultural, multi-religious and spiritual diverse reality of everyday practice. It has become important to establish how, within accepted boundaries, spirituality should be incorporated into the model for practice. Referring to methods described for nursing theory development, a defined core concept was used to construct a model. It may contribute to the discourse on spirituality in local psychiatry, health and mental health.

Community placement and reintegration of service users from long-term mental health care facilities

Objective: To ascertain community placement and reintegration of service users from long-term mental health care facilities. Method: This study reviewed the progress during 2003 with the alternative placement of a selected candidate group of 27 service users in some of Lifecare's long-term mental health care facilities in Gauteng. Results: Despite a significant amount of time and effort to find alternative options with family; old age homes or other non-governmental organizations; only 9 (33) were placed a year later. A longer follow-up period however is necessary to ascertain the actual successful outcome of these placements. Conclusions: Concerns exist about sufficient development of community-based services in accordance with the new Mental Health Care Act (Act No. 17 of 2002); parallel to hospital-based care