Masiviwe - logo

Accessing Public Mental Health Care

The South African public mental healthcare system can be difficult to access, so it helps to understand how the system works. This tip sheet explains it briefly. (make one line)

  • Mental Health Nurse – Trained to deal with mental health issues. They can refer you to the relevant mental health professionals and assist you with managing your mental health treatment.

 

Mental health struggles are real—and you’re not alone. Seeking help is a sign of strength!

It will take time and effort to find the right support, so be as patient and persistent as you can. Reach out to friends, family or a support group to be there for you as you navigate this journey, it can make a huge difference!

 For extra support, reach out to mental health NGOs & Helplines.

Know who Mental Healthcare Providers are

  • Mental Health Nurse – Trained to deal with mental health issues, who can refer you to the relevant mental health professionals and assist you with managing your mental health treatment.
  • Social Worker – Provides support and guidance to individuals and families dealing with emotional and psychological issues related to their health or social circumstances.
  • Psychologist – A mental health professional who can diagnose mental health conditions and provide talk therapy/counseling to help people deal with their mental health, emotional, psychological and social issues.
  • Psychiatrist: A specialised doctor who can diagnose mental health conditions and prescribe medication.
  • Mental health struggles are real—and you’re not alone.
  • Seeking help is a sign of strength!

Stand up for yourself and your right to mental healthcare

  • Mental health is a human right.
  • You have the right to be treated with respect and dignity in any healthcare setting.
  • If you’re not being taken seriously, politely ask to speak to the facility manager or a patient rights officer.
  • It will take time and effort to find the right support, so be as patient and persistent as you can.
  • Have support – Reach out to friends, family or a support group to be there for you as you navigate this journey, it can make a huge difference!

How to access mental healthcare services

1. Start at your local clinic

  • Start at your local clinic – You must first visit your nearest public clinic, unless it’s an emergency (e.g., a suicide attempt), where you should go straight to a hospital’s emergency department.
  • Who to speak to: Ask to speak to the mental health nurse about a mental health issue.  If there is no mental health nurse, explain to the nurse what you are experiencing and ask them to give you a referral to a clinic or community health centre (CHC) where there is access to mental health services.
  • What will happen: If there are mental healthcare providers at your clinic, they will likely put you on a waiting list. These lists can be long, so you may have to be very patient. You can ask how long they think the waiting period will be.

    A lot of clinics don’t have mental healthcare providers, in which case they should refer you to another clinic or community health centre (CHC) where you can access mental health services.

    If you are experiencing a mental health crisis, meaning you are at risk to yourself (e.g., suicide) or others, they should refer you to a hospital for a 72-hour observation period.

    They won’t do this unless they believe it’s urgent, so you need to be direct about how you are feeling and try advocate for yourself.

2. If it’s an emergency, go to your nearest hospital’s emergency room

Hospitals are meant to assist with psychiatric emergencies, such as someone who is suicidal and a risk to themselves, or someone who is hearing things that others don’t hear (hallucinating), is very aggressive or disoriented.

  • Hospitals must deal with psychiatric emergencies and are obliged to assist you according to The Mental Healthcare Act 2002, but there may be a long wait.
  • As mental health issues are often not obvious and beds for mental health issues are very limited, they may not want to admit you. So, you need to be direct about your situation and explain why you need urgent help.

3. Once admitted to a hospital

If you do get admitted into a hospital, they are meant to keep you for a 72-hour period, where your condition should be assessed by two mental health practitioners (e.g., a doctor, psychologist, psychiatrist or nurse) to determine whether you require an admission into a psychiatric hospital for further inpatient treatment, or if you can be treated as an outpatient.

If they decide you need further inpatient treatment, they may refer you to a psychiatric hospital. This is often an involuntary admission, which they can do if they believe you are at risk to yourself or others.

4. What if the person refuses to go to the clinic or hospital?

If someone has a mental illness or suspected mental illness and are a risk to themselves or others, but they refuse to go to the hospital – you can call the South African Police Services (SAPS).

The Mental Healthcare Act 2002 (Section 40) obliges SAPS to assist in bringing the person to a nearby hospital or clinic that offers emergency services. The police don’t do this often, so they may refuse to do so, or will take the person to the police station instead of a clinic or hospital, because they aren’t properly aware of their responsibility to assist in this way.

If this is the case, call and ask to speak to the station commander and politely remind them of their responsibility, according to the Mental Healthcare Act.

5. Psychiatric hospitals

If you are admitted to a psychiatric hospital, you will receive specialised treatment by a range of mental health practitioners, including a psychiatrist (medication and diagnosis), psychologist (therapy), social worker (support), mental health nurse (treatment monitoring), occupational therapist (recovery activities).

 
Once they determine that you are no longer a risk of harm to yourself or others and that you are able to receive treatment on an outpatient basis, they will discharge you and refer you back to your local clinic or CHC.


Some psychiatric hospitals have voluntary programmes, however you will need to be referred by a mental health practitioner.

6. Following up at your local clinic

If you don’t get help right away, go back. Keep asking. Keep showing up. The system can be slow, but persistence helps!

If you’ve been prescribed medication, you can get it free at your local clinic or hospital pharmacy. Stick to your check-ups and collect your medication on time. This helps keep your treatment consistent.

7. For Extra Support, reach out to mental health NGOs & Helplines

Here are some very useful resources to access for mental health crisis support, counselling and help finding local clinics or support groups, free of charge. Here is a link to a list of options – https://masiviwe.org.za/getting-help/