South Africa faces psychiatric treatment crisis due to medication shortages

A severe shortage of psychiatric drugs in Gauteng public health facilities has escalated into a treatment crisis, with wards turning into danger zones. Nurses, a hospital manager, and a psychiatrist have warned that the lack of essential sedatives and antipsychotic medication is putting patients and healthcare workers at risk. The shortages stem from supply chain disruptions affecting key psychiatric medicines, including olanzapine and quetiapine.

Health department spokesperson Foster Mohale attributed the crisis to manufacturing delays and global supply disruptions due to the blockage of the Strait of Hormuz bordering Iran. This has resulted in supply interruptions of vital medication, including chronic and psychiatric drugs, in the country, and Gauteng is feeling the pinch. Suppliers have cited manufacturing delays linked to difficulties in sourcing active pharmaceutical ingredients, while global freight and logistics challenges have further affected the supply of these medicines.

A hospital manager at a Tshwane hospital described the situation as "the most horrendous experience" of her professional career. She said the shortages were creating dangerous conditions for patients and staff, as newly admitted, undiagnosed, and relapsed patients became increasingly difficult to manage. The manager recounted an incident where a psych patient went to a critically ill patient, removed their oxygen, and started breathing from it, putting the patient's life at risk.

The shortage of medication has led to an increase in assaults on staff, with nurses regularly being attacked while working in overcrowded wards. The manager said a week rarely passed without a nurse being assaulted, and the situation had deteriorated dramatically. Previously, healthcare workers could rely on medication to stabilise patients and manage their symptoms, but now they feel emotionally and physically unsafe.

A nurse at Weskoppies Psychiatric Hospital said the shortages were making it increasingly difficult for doctors to stabilise patients. When doctors prescribe medication, there is a reason for it based on the patient's condition, and the medication helps contain aggression and manage symptoms. The nurse said patients were often switched to alternative medication when their prescribed treatment became unavailable, but substitutes did not always produce the same results.

The crisis extends beyond hospitals, with healthcare workers at a clinic in Ekurhuleni bearing the brunt of frustrated patients who arrive to collect medication only to find it unavailable. The nurse said patients were accusing them of stealing medication, and some patients were abandoning their treatment due to shortages of medication used to manage psychiatric treatment side effects.

Psychiatrist Dr Kali Tricoridis warned that interruptions could undo months of treatment progress, and restarting treatment was equally challenging. The shortages have also created a significant financial burden on organisations caring for people with intellectual and physical disabilities, with Little Eden spending almost R150,000 in three months on privately buying medication that should have been supplied by the state.

Key points

• Medication shortages in Gauteng public health facilities have led to a psychiatric treatment crisis.
• The crisis has resulted in dangerous conditions for patients and staff, with an increase in assaults on nurses.
• Suppliers have committed to fulfilling outstanding orders by the end of November and maintaining at least two months' buffer stock from December.