Shortage of beds at mental hospitals
There might be one for Shrien Dewani
ALTHOUGH honeymoon murder accused Shrien Dewani is likely to tie up his return to Cape Town for trial in lengthy appeals, the provincial health department says Valkenberg Hospital will be “more than prepared” to accommodate him should he be sent here.
Spokeswoman Faiza Steyn was responding to questions after the Cape Mental Health Society said bed shortages were a problem not only at Valkenberg, but also at “every mental health facility” throughout the country.
Dewani had been diagnosed in the UK with post- traumatic stress disorder and depression
The society’s comments followed news from earlier this month when the Cape Town Magistrate’s Court heard that a man accused of strangling his girlfriend to death had not yet undergone mental evaluation because he was waiting for a bed to become available before the process could begin.
Steyn said it was, however, “simplistic” to say that there were not enough beds in the province’s mental health facilities for people who needed treatment. Given Valkenberg Hospital’s context and resources, she said, treatment levels there fared “reasonably well” when compared to those of international institutions.
On the proposed Dewani extradition, Steyn added: “We are proud of the service we provide, and feel more than prepared to address most situations.”
She explained that the hospi- tal was divided into an acute and forensic section, which completed the observations referred from the courts. “Once patients are classified as state patients, we provide care and services. The acute section is divided into an adult acute admissions unit and an adult in-patient therapeutic unit. The acute admission unit treats adult patients (aged 18-59) with serious mental illnesses.
“This group of patients with serious mental illness constitutes mainly patients with schizophrenia and bipolar disorder, but also other conditions such as severe depressive disorders, anxiety disorder and neuropsychiatric disorders such as dementia,” Steyn said.
Beds at Valkenberg Hospital had been “reconfigured” since 2011 to accommodate more acute patients.
“The current number of acute beds totals 215, and there are 125 beds in the forensic service. The total number of beds for Valkenberg will increase to 432 beds, with the gain primarily in forensics,” she said.
These would be added in terms of the Hospital Revitalisation Project, for which there were not yet any firm dates.
Meanwhile, Cape Mental Health Society director Ingrid Daniels has labelled limitations in the public health-care system a violation of human rights.
Referring to the case of one 31-year-old schizophrenic man, who was admitted to a general hospital five times before receiving attention at a specialist hospital, she said he was among the 75 percent of South Africans with mental disabilities without access to mental health services.
“During one of these admissions, he was given a chair to sleep on. Another time he waited a week before being admitted, simply because there weren’t beds available,” Daniels said.
She said the consequences of bed shortages meant people often went untreated, placing an enormous burden on families and communities who were expected to care for people in need of hospitalisation.
The bed shortages, Daniels charged, created a “revolving door” in psychiatric care.
“Because of pressure on beds in district hospitals and psychiatric hospitals, some patients are discharged before they are completely well. They return home where there is extremely limited community psychiatric services and support. As a result, they end up being readmitted to hospital again,” she said.
Drug abuse and lacking of funding for mental health services were partly to blame for the challenges.
“About 4 percent of the total health budget goes towards mental health. This is simply not adequate when mental illness accounts for the third-highest burden of disease in South Africa. Tik and other drugs can cause drug- induced psychosis. HIV/ Aids can cause depression and even dementia, in some cases,” Daniels said.
Steyn agreed that substance abuse put pressure on hospitals, but said it would be “simplistic” to say that there were not enough beds.
With additional beds, which are being planned, there would be increased capacity for assessments (45 beds), while the maximum secure unit (for patients in need of containment, and those sent by a court) increased from 35 to 50 beds.
For medium secure (for patients allowed out for a certain period), low secure (for patients allowed freedom of movement) and long stay (for patients in need of longer rehabilitation), there would be a total 110 beds.
“What we experience is a perceived lack of beds with a small percentage of people with very serious mental illnesses, who are readmitted to hospital due to the lack of sufficient communitybased, alternative, supervised residential placements,” Steyn explained.
But Daniels said she would like to see an urgent audit of the availability of mental health beds countrywide, with the aim of providing more.
“We also need increased community psycho- social mental health services to assist and support people living with mental disability on their journey to recovery. There is sufficient evidence to highlight that people living with mental illness who receive such services have fewer relapses and significantly reduced admissions,” she said.
WELCOME: Valkenberg Hospital says it is well-prepared to accommodate honeymoon murder accused Shrien Dewani. \
PATIENT: Shrien Dewani is said to have post-traumatic disorder.