Dearth of men­tal health fa­cil­i­ties re­vealed

Pretoria News - - NEWS - JONISAYI MAROMO

PSY­CHI­ATRIC pa­tients in South Africa were still cared for in in­sti­tu­tions built be­fore the dawn of democ­racy in 1994, the ar­bi­tra­tion hear­ing into the death of 118 men­tal health pa­tients heard yes­ter­day.

In ad­di­tion, the govern­ment’s bid to con­struct new fa­cil­i­ties had failed dis­mally, said na­tional Depart­ment of Health’s di­rec­tor-gen­eral Pre­cious Mat­soso.

She was giv­ing ev­i­dence on the fourth day of the hear­ings chaired by for­mer deputy Chief Jus­tice Dik­gang Moseneke in Joburg.

“You see, I don’t think the pre­vi­ous wit­ness (Levy Mosenogi, di­rec­tor of plan­ning, pol­icy and re­search at Gauteng Health Depart­ment) was the ap­pro­pri­ate per­son to know and an­swer this ques­tion.

“When I look at the fa­cil­i­ties, th­ese fa­cil­i­ties were built be­fore 1994, am I right? Cul­li­nan, Sterk­fontein, or Weskop­pies – the names tell you they were built be­fore 1994. Have we built any af­ter 1994, for men­tal health in par­tic­u­lar?” Jus­tice Moseneke asked Mat­soso.

She re­sponded: “I can just an­swer in a brief way to say that an at­tempt to build one, I can say, was an ab­so­lute dis­as­ter. This is a fa­cil­ity that was built in North­ern Cape. It con­sumed huge re­sources, (but) was not ap­pro­pri­ate for men­tal health care. It was a les­son for us that it should not be done in that way.

“With the pro­vi­sion in the Men­tal Health Act, that we should not move to­wards keep­ing peo­ple in in­sti­tu­tions, rather move to­wards com­mu­nity-based men­tal health­care, we should rather make in­vest­ments in our pri­mary health­care fa­cil­i­ties, our ex­ist­ing health fa­cil­i­ties where out­pa­tients ser­vices are ap­pro­pri­ate. The in­vest­ment can­not be in build­ing more fa­cil­i­ties where peo­ple are go­ing to be in­sti­tu­tion­alised…”

She said the un­suc­cess­ful at­tempt to es­tab­lish a func­tional fa­cil­ity in the North­ern Cape was a ma­jor con­cern for the Depart­ment of Health.

Jus­tice Moseneke pointed out that in spite of the pol­icy, both govern­ment-owned and pri­vately-owned men­tal health fa­cil­i­ties were still be­ing used widely.

“But we are still us­ing clin­ics, we are us­ing Life Esidi­meni – I have seen it here in your re­port back. Once there are dif­fi­cul­ties with com­mu­nity-based health­care, the depart­ment ran right back to those in­sti­tu­tions. So the ques­tion that begs an an­swer is, don’t we need a mix of in­sti­tu­tions and the pub­lic health­care fa­cil­i­ties?” Jus­tice Moseneke asked Mat­soso.

The di­rec­tor-gen­eral con­ceded that South Africa did in fact need men­tal health in­sti­tu­tions.

“Pre­cisely, we do. A bal­ance between fa­cil­i­ties that we call fa­cil­i­ties for acute care, for men­tal health, and those that are for long term care. This is the dif­fer­ence between your Weskop­pies, Sterk­fontein ver­sus th­ese other fa­cil­i­ties that are for long term care,” said Mat­soso.

Un­con­vinced, Jus­tice Moseneke re­peated his ques­tion: “So the ques­tion still re­mains – do we need fa­cil­i­ties for acute and long term care? Do we need more of them, so that we won’t have the temp­ta­tion to move them (men­tally ill pa­tients) out of clin­ics, to move them out of Life Esidi­meni?”

Mat­soso said South Africa did need more long-term care fa­cil­i­ties.

The pa­tients died af­ter be­ing moved from the Life Esidi­meni group’s fa­cil­i­ties last year.

For­mer health MEC Qedani Mahlangu re­signed in the wake of the tragedy, while head of depart­ment Bar­ney Selebano was sus­pended for gross mis­con­duct and in­com­pe­tence.

The death toll fig­ure rose, bring­ing the num­ber of deaths to 118. – ANA

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