Severe psychotropic medication shortages are creating dangerous conditions in public healthcare facilities across South Africa as hospitals struggle to source essential sedatives and antipsychotic drugs.
Psychiatric Wards Turn Into Danger Zones
Public health facilities in Gauteng and other provinces are facing an escalation of chronic medication shortages that have transformed psychiatric wards into hazardous environments. Supply chain disruptions have impacted mental health treatments.
National Department of Health spokesperson Foster Mohale said suppliers have pointed to manufacturing constraints, supplier delays, regulatory requirements, poor stock distribution, and congestion at the Port of Durban. The shortages affect medicines used to treat mental illnesses, including schizophrenia, bipolar disorder, and major depressive disorder.
Hospital staff describe safety breaches in overcrowded wards. According to one hospital administrator, nursing staff faced frequent physical attacks while operating in cramped care areas that were not built to house high volumes of psychiatric patients.
A hospital manager said the situation deteriorated dramatically. They previously had resources to calm psychotic patients down.
“We do not have the chemical sedatives. We don't have Ativan and other stabilising medication,” a hospital manager at a Tshwane hospital said.
“We don’t have enough staff. We don’t have security. We don’t have restraints,” the hospital manager said.
The manager recounted an incident where a patient gasped for air and struggled to breathe, and nurses only noticed after the fact. Staff work without sufficient personnel, security, or restraints in environments where they feel unsafe.
Nationwide Impact on Severe Mental Illnesses
The South African Society of Psychiatrists raised alarms about stockouts affecting schizophrenia, bipolar disorder, and major depressive disorder across Gauteng, KwaZulu-Natal, the Western Cape, and the Eastern Cape. Patients face a risk of relapsing, which places a strain on hospital beds.
Dr Mahlatse Thosago, speaking as a representative of the South African Society of Psychiatrists, said current deficits could reverse years of patient progress and stabilization. “Patients who have been stable for years can relapse, sometimes quite severely,” Thosago said, adding that schizophrenia can bring a return of psychotic symptoms while bipolar disorder can trigger manic or depressive episodes.
Dr Mvuyiso Talatala, Past-President of SASOP, said patients experiencing relapses often wait in hospital emergency departments for hours or days because psychiatric beds are unavailable.
“When patients relapse, there is increased utilisation of hospital beds that are already a scarce resource. Patients are then left waiting for beds in emergency departments of hospitals for hours to even days,” Talatala told IOL.
SASOP members reported that hospital management teams barred psychiatrists from issuing private prescriptions that would allow families to buy alternative medications at private pharmacies. Talatala said this restriction stems from concerns that families may alert the public to the shortage by posting prescriptions online.
Provinces and Officials Respond to Shortages
The Western Cape Department of Health and Wellness reported that between 120 and 160 different medication line items are affected nationally. Dr Saadiq Karriem, Chief of Operations at the Western Cape department, said facilities receive partial shipments or complete stockouts of chronic and mental health medicines.
Professor Renier Coetzee, who serves as both president of the Pharmaceutical Society of South Africa and professor at the University of the Western Cape’s School of Public Health, said the missing pharmaceutical supplies were of vital importance. Mohale said the Department engaged with suppliers to address shortfalls.
Civil society organization Stop Stockouts Project warned that shortages of chronic medication could expose patients to health complications. The National Health Department said medicine availability stands at 83.4%, with Mohale saying port congestion at Durban and regulatory delays compounded distribution problems.
SASOP urged Health Minister Aaron Motsoaledi to investigate nationwide drug shortages. Talatala said hospital management and provincial health departments provided several explanations for drug shortages, but “none seem to sufficiently explain why so many drugs made by different pharmaceutical companies for multiple disease areas would run out at once”.
According to Mohale, vendors gave assurances that all pending requisitions will be cleared by the end of November, and a minimum of two months’ worth of reserve stock will be sustained starting in December.