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Black Africans made up the majority of the population (88%), and females constituted 52% of the total population. The high proportion of women is a reflection of the migrant labour system prevalent in this province. A total of 33% of the population was <15 years old, and those ≥65 years constituted 6%. (1) A Statistics SA report, based on a household survey measuring income and expenditure, ranked the EC as the second poorest province in the country, with a poverty rate of 58%. (3) As early as 2004, it was noted that seven of SA's ten poorest municipalities were located in the EC. The poorest municipality was Ntabankulu, with 85% of its population living below the poverty line. (4) The upper limit of the Background. The Eastern Cape Province of South Africa is a resource-limited province with a fragmented mental health service. Objective. To determine the current context of public sector mental health services in terms of staff and bed distribution, and how this corresponds to the population distribution in the province. Method. In this descriptive cross-sectional study, an audit questionnaire was submitted to all public sector mental health facilities. Norms and indicators were calculated at provincial and district level. This article investigates staff and bed distribution only. Results. Results demonstrated that within the province, only three of its seven districts have acute beds above the national baseline norm requirement of 13/100 000. The private mental health sector provides approximately double the number of medium- to long-stay beds available in the public sector. Only two regions have staff/population ratios above the baseline norm of 20/100 000. However, there are significant differences in this ratio among specific staff categories. There is an inequitable distribution of resources between the eastern and western regions of the province. When compared with the western regions, the eastern regions have poorer access to mental health facilities, human resources and non-governmental organisations. Conclusion. Owing to the inequitable distribution of resources, the provincial authorities urgently need to develop an equitable model of service delivery. The province has to address the absence of a reliable mental health information system.

Staff and bed distribution in public sector mental health services in the Eastern Cape Province, South Africa