INTRODUCTION:
Mental health disorders contribute substantially to the global burden of disease, yet they remain inadequately integrated into national health surveillance and routine health information systems. In many low- and middle-income countries, mental health data are fragmented across surveys, routine systems, longitudinal cohorts and civil society platforms, limiting their utility for policy, planning and equitable resource allocation. South Africa provides a relevant case study, given its high burden of mental illness, intersecting epidemics, and expanding health data architecture.

METHODS:
This review synthesised recent nationally representative surveys, routine health information system data, longitudinal cohort platforms, administrative financing and workforce datasets, and policy indicator frameworks to assess the current state of mental health surveillance in South Africa. Indicators were appraised for coverage, disaggregation, governance, and alignment with broader health system monitoring, including HIV, TB, maternal and child health, and socio-environmental risk factors.

RESULTS:
Mental health data availability has improved, with expanded routine indicators and growing inclusion in longitudinal cohorts. However, major gaps persist. These include limited community-level data capture, weak age-, gender- and geography-disaggregation, inconsistent indicator definitions, and insufficient integration of private sector and civil society data. Governance challenges further constrain interoperability across platforms. Service performance data reveal marked provincial inequities, workforce shortages, and under-investment relative to burden. These limitations impede the routine use of mental health data for monitoring system performance, informing integrated care models, and tracking progress towards universal health coverage.

CONCLUSIONS:
Strengthening mental health surveillance requires deliberate integration into national health information systems rather than parallel reporting structures. Key priorities include standardising indicators, improving data governance, linking routine and longitudinal data, and embedding mental health metrics within existing HIV, TB and primary health care platforms. South Africa’s experience highlights transferable lessons for countries seeking to elevate mental health within public health monitoring, policy and accountability frameworks.