A situation analysis of clinical psychology services in South Africa’s public rural primary care settings

The goal of our study was to provide a situation analysis of clinical psychology services in South Africa’s public rural primary healthcare sector. In this setting, the treatment gap between human resources for and the burden of disease for mental illness is as high as 85%. The majority of South Africa’s mental health specialists – clinical psychologists and psychiatrists – practice in the country’s urban and peri-urban private sector. At the advent of South Africa’s democracy, public clinical psychological services were negligible, and the country is still facing challenges in providing human resources. The study was based on the analysis of both primary and secondary data. Primary data were collected by interviewing the heads of 160 public hospitals classified as rural by the Department of Health, while secondary data comprised a literature review. The number of clinical psychologists working in the public sector indicated a substantial growth over the last 20 years, while the number employed and/or doing out-reach to public rural primary healthcare areas shows a shortfall. Clinical psychology’s numbers, however, compare favourably to that of other mental health specialists in public rural primary healthcare settings. Since the National Mental Health Summit of 2012, strategies have been implemented to improve access to mental health care. In clinical psychology’s case relating to human resources, these strategies have showed encouraging results with a substantial amount of participating institutions reporting that clinical psychologists form a part of their proposed future staff establishment.