Psychiatrists call for urgent overhaul of mental health

PSYCHIATRISTS have called for an overhaul of state mental health hospitals, at which they say conditions are “appalling”.

Following the report on the deaths of more than 100 mental health patients in Gauteng‚ the SA Society for Psychiatrists (Sasop) travelled throughout the country to look at state mental health hospitals.

Results from all regions were discussed on June 10 and a report was compiled and released on Tuesday.

In it‚ Sasop calls for a comprehensive overhaul of the mental health care system in all provinces.

The report shows that Limpopo and the Eastern Cape suffer the most severe lack of resources‚ said Professor Bernard Janse van Rensburg‚ president of Sasop.

“Only six public sector psychiatrists serve the whole of Limpopo‚ mainly from general hospitals. Hayani hospital‚ a 390-bed mental health specialist hospital‚ where in 2016 a psychiatric nurse was killed by an inpatient‚ has currently no psychiatrist.

“Child and adolescent psychiatric care is non-existent in the Eastern Cape and Limpopo provinces‚ and in all provinces‚ psychiatrists have to admit children and adolescents unlawfully into adult wards.

“No province currently has an organised community-based psychiatric service‚” he said.

The report shows that Mpumulanga and the Northern Cape have no public-sector psychiatry representation while KwaZulu-Natal faces a massive specialist staffing crisis, with only 20 of the 45 specialist posts filled.

“With physical beds missing‚ others not in use due to flooding of wards caused by the non-repair of damaged roofs post a storm in 2015‚ and no water or food at some hospitals such as Umzimkhulu in KwaZulu-Natal … the most fundamental basic human rights of patients are under threat‚” Janse van Rensburg said.

He said the Eastern Cape was struggling, with a dearth of general hospital beds, to accommodate acute psychiatric admissions.

In most regions the inability to deal with aggressive behaviour by severely mentally ill people resulted in long waiting lists for forensic psychiatric services‚ he said.

Other problems reflected in the report were an absence of mental health directorates in five of the nine provinces and dysfunctional Mental Health Review Boards in all provinces.

“Mental Health Review Boards are key structures provided for by the Mental Health Care Act of 2002‚ to protect the human rights of those patients whose disability or acute illness renders them unable to stand up for themselves.”

Janse van Rensburg said severely mentally ill patients need to access physical and psychiatric care at district health services‚ with timeous hospital admissions when required.

The report further revealed a significant lack of communication and planning regarding the provision of psychiatric care at all levels of the mental health care system‚ particularly at district services and in general hospitals.

In February the health ombud‚ Malegapuru Makgoba‚ released a report into the death of over 100 psychiatric patients who where moved from Life Esidimeni into unaccredited facilities by the Gauteng department of health.

Janse van Renseburg said one of the recommendations in the Esidimeni report had not yet been adhered to.

“Notably recommendation 16‚ referring to the whole mental health system which should include resourced‚ developed communitybased primary and specialist multidisciplinary teams. The reality‚ however‚ is that the health system still does not cater adequately for the thousands of people who continue to live with mental illness within the community.” — TMG