The rise and fall of mental disorders : an analysis of epidemiological trends
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Authors
Van der Walt, Merrill Victoria
Issue Date
2021-04
Type
Dissertation
Language
en
Keywords
Diagnoses , Disorder correlations , Disorder frequency , Epidemiological trends , Longitudinal trends , Mental disorder , Mental disorder database , Medical aid scheme policy , South Africa
Alternative Title
Abstract
Epidemiological trends in mental disorders are shown against a background governed by
medical aid health policy. The study quantitatively analyzed a dataset of mental disorders for
South Africa’s leading medical aid scheme.
South Africa’s leading medical aid scheme has been in operation for almost three decades.
This degree of longevity allows for a reliable longitudinal analysis of diagnostic trends.
Through consent of the Scheme, a database was provided, which lists mental disorder
diagnoses over seven years from 2008 to mid-way through 2015. Data from this source were
analyzed and interpreted.
Data fields provided and made use of from the raw medical scheme database are: Date of
admission (Year, Month); Patient gender; Database population per year; Patient diagnosis
(DEG Description); Total per DEG Description.
Each diagnosis (mental disorder) is presented in the following ways:
1. Bar charts showing the volume of specific mental illnesses each year.
2. Bar charts showing fluctuations of occurrence of a specific mental illness over
time.
3. Frequency of specific mental illnesses over time, relative to the entire database
population.
4. Male:Female ratio per mental disorder.
5. Female Outpatient vs. Inpatient volumes across each mental disorder and across
all years (2008 – 2015).v
6. Male Outpatient vs. Inpatient volumes across each mental disorder and across all
years (2008 – 2015).
7. Total number of patients per mental disorder across time (2008 – 2015).
8. Frequency polygons showing the fluctuation of a selected mental disorder over
time as compared to other selected mental disorders.
It is found that there are changes in prevalence rates of mental disorders over time and that
these fluctuations are attributed to an economic factor within medical aid scheme cost-driven
policy.
The effect of cost-driven policy is that members diagnosed with a mental disorder may not be
granted provision of adequate treatment because diagnosis is in part, determined by economic
structures.
Costs for mental illness treatment programmes are curtailed by keeping patient numbers
significantly low, by radically over-diagnosing certain mental illnesses treated with
comparably cheaper pharmaceuticals or by drastically curbing time spent in a mental health
facility.
Some members of the medical aid scheme have been deliberately misdiagnosed.
Alternatively, those, correctly diagnosed, do not receive the treatment required of such an
illness. The scenario then is of thousands of mentally ill people, who are not treated
effectively.
Members continue to pay fees, paying under the illusion that medical cover ensures effective
treatment