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July is commemorated as Psychosocial Disability Awareness month, and this year the South African Federation for Mental Health is focused on raising awareness around the issue of stock outs of psychiatric medication, and the negative effect this has on mental health care users.

For many people living with mental disorders or disabilities, access to psychiatric medication is essential for their recovery and enables them to live fully productive lives and function as active members of their community. Mental health care service users not being treatment compliant in terms of medication could potentially lead to relapses. When service users want to access medication and remain treatment compliant, but are unable to do so due to medication stock outs at clinics, it becomes a human rights issue that cannot be ignored.

A study released earlier this year by the World Health Organisation and the World Bank found that depression and anxiety disorders alone cost the global economy US$1 trillion each year. The study also found that mental disorders account for 30% of the global non-fatal disease burden. Statistics like these highlight the need to prioritise mental health and to ensure that service users have access to the required services and treatment. Ensuring access to correct psychiatric medication is one aspect of this.

For many service users, having the required access to psychiatric medication is essential to their recovery and to the ongoing management of their conditions. The availability of psychiatric medication is therefore crucial. Being unable to receive the correct, prescribed medication at clinics leaves patients in a situation which can result in a deterioration in mental health functioning and, worst case scenario, relapse. This can have a number of negative and long lasting consequences, such as re-admission to inpatient facilities, loss of employment, a breakdown in family or other relationships, poorer quality of life and social isolation. The stress caused by not receiving medication and fearing relapse can have very negative effects on the mental wellbeing of service users, and could in itself be enough to trigger a relapse. It may have taken months or even years to reach a point where the individual is stable and able to have full and functional life, and a relapse negates all the hard work that went into their recovery a process. Additionally, increased relapse rates amongst mental health care users also places unnecessary strain on a mental health system that is already in many cases overburdened and under-resourced.    

Due to medication stock outs at clinics, service users are sometimes placed in a position where they are given a different type of medication than what was originally prescribed to them. This can be very harmful, as the substitute medication may not be effective, may bring about unforeseen and unmanageable side-effects and may in itself lead to relapses. In many cases however service users are forced to leave the clinic without any medication, putting them in a position where they would have to go to private pharmacies to buy their medication themselves. For many people this is not financially possible. Being unable to receive the correctly prescribed medication leads to service users having to make additional trips to the clinic, which places them under even more financial pressure as they now have to spend more money on transport.

Robynn Patmore is a mental health service user living with Bipolar Disorder. She has been unable to receive the correct medication due to stock outs, and this has led to relapse and hospitalisation:

“The clinic I always received my medication from ran out of Convalex, and the Convalex is a very good mood stabiliser for me, the other types of medication doctors tried on me in the past didn’t work. Convalex was making me very stable, very calm, cool and collected. I was doing very well on it. And then suddenly the clinic ran out of the Convalex, and the nurses just said they don’t know when it will come back in stock. The psychiatrist put me on Lamaxil instead, and the Lamaxil made me so sick that I actually relapsed and spent four months in hospital.

The hospital put me back on Convalex and I stabilised. But now for the last two months the hospital hasn’t been able to give me the Convalex either, and they don’t know when it will be back in stock. The hospital said they could give me a script for Convalex, but they estimated that it would cost me a thousand rand to buy the medication myself from a pharmacy. I am on a disability pension of R1500, I can’t afford that. So now I have to be on Lithium Carbonate, which I don’t respond well to. So I am expecting another relapse. It is stressing me out terribly, because I have a very high pressure job, and I am so stressed all the time, because I am not on the right medication. And my psychiatrist wants to see me every two weeks, because she is really scared that I am going to relapse.

I just relapsed and was away for four months, so if I relapse again I could lose my job. And every time you relapse, it is that much more difficult to get back on your feet. And four months out of action is a long time. Something needs to be done. Why should we have to be hospitalised because of the clinics errors? Why must I get sick because they can’t provide me with the right medication?”

The lack of access to correct medication at clinics is not just a logistical or policy issue; it is a human rights issue as it violates a person’s right to health and dignity. The National Mental Health Policy Framework stipulates that all psychiatric medication must be available at all levels of care. This however does not reflect the reality as stock outs of psychiatric medication is a problem that many mental health service users face on a regular basis.

SAFMH would like to encourage both the National and Provincial Departments of Health to place greater emphasis on ensuring that service users’ right to health and dignity are protected by ensuring the availability and accessibility of all psychiatric medications at all levels of health care, as well as ensuring the full implementation of the Mental Health Policy Framework. Members of the public are also encouraged to report any medication stock outs to The Stop Stock Outs Campaign, as well as The Mental Health Watch Reporting System. 

The Stop Stock Outs Campaign:

Report stock outs to:

084 855 7867 - SMS, Please Call Me, Phone, WhatsApp

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Mental Health Watch Reporting System:

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011 781 1852

Sms/Whatsapp – 076 0788 722


Marthé Viljoen

Programme Manager: Information & Awareness 

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