PORTFOLIO COMMITTEE HEARINGS : 7 MARCH 2000

CLUSTER: Corporate Services and external Relations

POLICY ISSUES: GENERAL

Mental Health & Substance Abuse

Budget

Expenditure

Deviation

%

Comment re over/ under expenditure

Budget

Spent

2000/01

Personnel expenditure

1,597

1,379

218

86.35

Final month R130,000

1,554

Administrative expenditure

395

183

212

46.33

Additional R10 000 anticipated

812

Stores and livestock

393

76

317

19.34

Goods valued at R117 000 ordered and awaiting delivery

205

Equipment- current

15

10

5

66.66

 

30

Equipment- capital

51

29

22

56.86

Goods received for R16 000 – still to be paid

34

Professional & Special services

2,289

1,014

1275

44.29

Accounts submitted or to be submitted this year R1192000

2,105

Transfer payments-current

722

490

232

67.86

Transfer of R232 000 to go through

1,152

Transfer payments-capital

   

0

   

-

Miscellaneous

26

19

7

73.07

23

Total

5,488

3,200

2288

58.30

Total year expenditure expected to be 89% of allocation

5,915

PERFOMANCE TARGETS (OPERATIONAL PLANS) AND ACHIEVEMENTS FOR 1999/00

PERFOMANCE TARGET

PRIORITY

ACHIEVED (WITH EXPLANATION)

NOT ACHIEVED (STATE REASONS WHY NOT)

Mental Health Care Act submitted to parliament

Very High

 

Bill gazetted for public comment

Additional public comment required to get greater consensus before submission to parliament

Policy documents

  • Child and Youth mental health
  • Psycho-social rehabilitation
  • Substance abuse prevention
  • National drug Master Plan (participant on intersectoral committee)
  • Norms and Standards for severe Psychiatric problems

High

Drug Master plan passed

Other policy documents in draft stage

 

Improve care and conditions for psychiatric patients

  • Management training
  • Norms manual
  • Forensic service plan
  • Ombudsbody
  • Deinstitutionalisation
  • Integrate mental health into primary and secondary general health care

 

High

 

  • Ongoing
  • Awaiting finalisation
  • Improvements made in services
  • Preparations finalized for discharge
  • Progress varied across provinces and districts

 

 

 

  • Difficulties experienced in payments from Justice Department
  • Delay due largely to negotiations with Human Rights Commission
  • Difficulties finding appropriate NGOs to take patients

Epidemiological prevalence of mental health problems

High

Project started with University and international partners

 

 

Implement Health lead projects of National Crime

Prevention Strategy

  • Violence surveillance
  • Primary health practitioner training (240 health workers)
  • Secondary level referral centers (3Centres)
  • Violence prevention in schools (18 pilot schools)
  • Parent/child bonding programme

 

High

 

 

 

Operating in 10 mortuaries

240 Health workers trained

Two centers started

Programme being implemented

Project tender awarded

 

 

 

  • Some problems experienced in mortuaries run by SAPS
  • Difficulties experienced in getting funds from Department of Welfare Victim Empowerment Programme
  • Delayed by detailed co-ordination needed with Department of Education
  • Some delays due to tender processes

Prevent substance Abuse amongst target groups

  • Youth:-

- Integrate substance abuse life-skills programme into HIV/AIDS Life-Skills

-Support innovative prevention programmes through the South African Alliance for the Prevention of Substance Abuse and WHO

- Participate in intersectoral campaign to highlight substance abuse issues (International Days)

  • Fetal Alcohol Syndrome

-Educational Video

-Epidemiology

  • Home brew concoctions

Assess harmful affects

 

 

High

 

 

Programme developed and currently being tested

Five programmes running

 

 

 

Reasonably successful campaign

 

 

 

Video made

Research supported

CSIR report received

 

 

 

 

 

SAAPSA is still a relatively weak organisation requiring more assistance

 

 

 

 

 

 

 

 

 

Campaign launch delayed until further research is conducted in other areas

 

2 PERFOMANCE TARGETS (OPERATIONAL PLANS) FOR THE 2000/01 FISCAL YEAR

TARGET

OBJECTIVE

PRIORITY

TIME FRAME

LEGISLATION

CONSTRAINTS

SOLUTIONS

Pass Mental Health Care Bill through parliament

 

Very high

Submit to cabinet in June.

Submit to parliament in second half of the year

Yes

None foreseen – though there is likely to be some opposition

As much consensus as possible to be achieved before submission to parliament

Draw up regulations for the Mental Health care Act

 

Very High

Second half of financial year

     

Finalise four policy documents

  • Child and Youth mental health
  • Psycho-social rehabilitation
  • Substance abuse prevention
  • Norms and Standards for severe Psychiatric problems
 

 

High

 

 

July

November

January

 

April

 

 

 

 

Once the policies are finalized, it may be difficult to implement them in all provinces due to resource constraints

Policies will need to be phased in over time.

Address mental health aspects of HIV/AIDS

  • Assist with plan and manual for pre-and post test counselling and all mental health aspects of people living with HIV
  • Introduce programmes for HIV prevention in psychiatric hospitals
  • Develop protocols for care/treatment of mentally ill people with HIV

Very high

December

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Initial programmes in May

 

 

July

 

Providing for all the counselling needs of HIV/AIDS is a massive undertaking

 

 

 

 

 

 

 

NGOs will have to be brought in as partners.

Nurses in clinics will have to be given time for counselling.

Improve care and conditions for psychiatric patients

  • Hospital Management training
  • Norms implementation
  • Forensic service plan
  • Ombudsbody
  • Deinstitutionalisation

Integrate mental health into primary and secondary general health care

High

May

June

Ongoing

March

Ongoing

Ongoing

   

A number of blockages which delayed delivery in the previous year have been worked on and smooth delivery is expected

However certain intersectoral issues such as funding for forensics and NGOs for community care will need special attention.

Mental Health Epidemiology

Research to continue

High

March

     

Continue with implementation of NCPS Health Lead projects

Conduct assessments

  • Violence surveillance
  • Primary health practitioner training 300 health workers)
  • Secondary level referral centers (3Centres)
  • Violence prevention in schools (18 pilot schools)
  • Parent/child bonding programme

High

Ongoing

March

 

Ongoing

 

August

 

December

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Plans will have to be drawn up for the expansion of these projects beyond the initial sites (if they are shown to be effective). Financial restraints may seriously inhibit this expansion

The Health and the cost benefits of these programmes will have to be demonstrated to show that these are indeed worthwhile programmes

Prevent substance Abuse amongst target groups

 

The Health objectives of the National Drug Master Plan will be implemented.

  • Make substance abuse services more accessible to users through integration
  • Improve availability of information and educational materials – especially to youth
  • Integrate substance abuse life skills in schools
  • Prevent fetal alcohol syndrome

 

Youth programmes will continue through the Department’s partnership with the WHO and the South African Alliance for the Prevention of Substance Abuse

Possibilities of putting restrictions on alcohol advertising/warning labels on bottles etc will be assessed

 

 

High

 

 

 

 

Ongoing

 

 

 

June

 

 

 

Programme finalized in June – then must be implemented in all schools

Ongoing

 

 

 

 

 

 

 

 

August

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Legislation will be required though probably only in 2001/2002

 

 

 

 

Resources within provinces are lacking