on Mental Illness Awareness Month at Weskoppies Hospital
13 July 2006
Programme Director,
Distinguished guests,
Ladies and gentlemen:
I would like to thank all of you for making time to join us this morning
during this visit to Weskoppies Hospital.
We have a critical task during this month of July to increase awareness
about mental illnesses. We have a duty to transform mental health services to
ensure that they comply with the culture of human rights that has been ushered
in through the introduction of the Mental Health Care Act.
The Department of Health has made significant progress in complying with the
Act and improving the mental health services.
We were able to meet the deadline to designate health establishments to
function as mental health facilities that provide care, treat and rehabilitate
for state patients and mentally ill prisoners.
All provinces have established Mental Health Review Boards and I am glad
that I have this opportunity to meet all of you as board members this morning.
These boards are independent bodies charged in terms of the Mental Health Care
Act to oversee care, treatment and rehabilitation of those who were admitted
without consent.
We have trained health professionals on various new procedures and processes
that were introduced by the Act. There is a need to continue with this training
to ensure our staff understand and adhere to the new procedures for admission,
referral, reviews, etc.
An easy to use procedure manual for all health professionals is being
developed and a manual to assist the heads of provincial health departments and
mental health facilities have been printed. We are also printing procedure
manual relating to management of state patients to assist staff in handling
these cases in line with the Act.
We have worked with South African Police Service (SAPS) to develop an order
that will direct the conduct of police in dealing with mental health
patients.
Programme Director, I can say with much confidence that we have been
decisive in dealing with challenges of non-compliance to national norms and
standards.
At Fort Napier Hospital in KwaZulu-Natal we appointed a committee to
investigate the allegations of abuse. Disciplinary measures were taken and
matters relating to criminal justice system were referred to the SAPS.
We closed down the Libode Mental Health facility which is attached to St
Barnabas Hospital in the Eastern Cape because of poor conditions and lack of
compliance. Patients from that facility were transferred to Umtata Mental
Health facility.
You will recall that last year we shut down some sections of the mental
health unit at George Mukari Hospital in Garankuwa and transferred patients to
this hospital. While there have been much improvements in the infrastructure at
George Mukari, there is need to put up proper toilet facilities for the
seclusion rooms. We hope that the hospital will comply with all the
requirements soon.
In each case of lack of compliance, provinces have been requested to
urgently mobilise resources to improve compliance including revitalisation of
the facility. A good example was at Town Hill Hospital in KwaZulu-Natal where
major revitalisation work was done to improve compliance with norms and
standards within a few months.
While we continue to make progress in improving the environment for mental
health patients, there are challenges of human resources that we have to tackle
particularly relating to the availability of forensic psychiatrists. Forensic
psychiatric observation is an intensive work requiring specialist skills.
As part of the implementation of the Human Resources Plan for Health, we are
engaging with institutions of higher learning to find measures to attract
people into specialising in forensic psychiatry. We need to find measures to
make this field of study and practice attractive to young psychiatrists and
increase capacity of universities to produce more of these specialists.
While we seek long term solutions to this challenge, we are working on
establishing more efficient means of observation to enable forensic
psychiatrists to form an opinion much quicker on whether a person referred by
courts is fit to stand trial.
Weskoppies Hospital is one of the facilities that are at the forefront in
complying with the new era introduced by the Mental Healthcare Act. The
hospital has complied with most of the minimum requirements for mental health
services as we have seen during our visit here. They also have complaints
mechanism which enables patients and interested parties to raise issues
relating to service delivery. These are issues that now and again get reported
in the media mainly because there is an opportunity to report and complaints
are being dealt with.
It is for these reasons that we thought it was important to bring you here
as members of Mental Health Review Boards to view this facility before you
convene for your two-day workshop at Kopanong Conference Centre later
today.
The theme for this yearâs July Mental Illness Awareness Month is
âPartnership in Human Rights for Mental Health.â This theme is relevant for the
dialogue that will be taking place at the workshop. Our Constitution and Mental
Health Care Act gives our people including vulnerable groups such as those
people with mental disorders and their families, hope for a better life.
Mental disorders are inextricably linked to human rights issues. Mental
health care users and their families are affected by stigma, discrimination and
human rights violations. They are by and large still facing limitations to
social equity, equal opportunity and care.
Many of these limitations are a direct result of the neglect and inhuman
laws of the past. Mental health care services lacked a human rights culture,
were fragmented, under-resourced and were inequitably distributed. There was
reliance on chronic custodial treatment in large centralised institutions.
In keeping with the spirit of our Constitution, we all are under an
obligation to correct the transgressions and prevent further abuses. Mental
health care users deserve to be treated with dignity and respect. They are
particularly vulnerable to abuse and violation of rights. In this regard, the
Mental Health Care Act is aimed at promoting the rights of persons with mental
disorders. We want to provide an appropriate environment within which care,
rehabilitation and aftercare can take place. We believe in full integration of
people with mental disorders into community life and we should promote mental
health in different sectors of society.
Involuntary or compulsory admissions to mental health facilities and
involuntary treatment for those incapable of making informed decisions are
controversial as they impinge on personal liberty and the right to choose and
they carry the risk of abuse.
On the other hand, assisted or involuntary admission and treatment can
prevent harm to oneself and others and assist some people in attaining their
rights to health care which due to their mental disorder they may be unable to
manage voluntarily. Involuntary care will remain necessary for a minority of
patients who suffer from mental disorders.
To ensure that the system is not abused, the Act has set out stringent
requirements for admission of assisted or involuntary patients. The boards are
there to monitor and ensure that regular and time bound reviews of assisted or
involuntary patients are done. It is crucial that as soon as a patient does not
meet the criteria for assisted or involuntary admissions, that patient be
treated as voluntary.
We must work tirelessly to change the practice from the past that mental
health care users could be locked in hospitals and unilateral decisions taken
on their care, treatment and rehabilitation. Mental health care users should be
allowed to challenge these decisions.
Mental health care users can be rehabilitated and integrated into community
life. We are fully cognisant of the fact that this approach requires a
collaboration of different stakeholders and sectors.
That is why during this Mental Illness Awareness Month, we are making a call
to different role players to play their role and contribute towards full
compliance with the Mental Health Care Act.
Our message today is; âIn partnership with all stakeholders and role
players, we can work together to ensure a better life for millions of people
suffering from mental disorders.â
I therefore urge all of us to unite and advocate for the rights of our
people.
I thank you!
Issued by: Department of Health
13 July 2006
