The growing list of mental health patients in the Eastern Cape is overwhelming the system, compounding the already chronic bed shortage, poor services, infrastructure and staffing, and with delays also affecting the legal system.
Additionally, reports Daily Dispatch, because of the inadequate resources at several public mental health facilities, families often have to shoulder the burden of caring for relatives with mental disorders – locking them up at home to keep them safe – as healthcare centres are buckling under the load of patients needing help.
The provincial Health Department admitted this week that it faced challenges, including an increase in substance-induced psychosis cases, but said interventions had already been identified and in some instances, implemented.
The resource constraints have also negatively affected the legal system. Court cases are frequently postponed pending the availability of “a bed in Fort England” while accused wait for up to two years to be seen by a psychiatrist.
In May, the Dispatch recorded 10 cases that were postponed for a psychiatric evaluation in a single day at the Willowvale regional and Mthatha Magistrate’s Courts.
Last Friday, another case was postponed in the Makhanda Magistrate’s Court pending the availability of a bed at Fort England – less than 3km from the court.
NPA regional spokesperson Luxolo Tyali said in some cases an accused was referred to a psychologist for screening to establish whether he or she should be sent for observation. In some instances, a relative would have to tell the court about the accused’s psychiatric history while in others, the suspect’s behaviour in court raised questions about his or her fitness to stand trial.
“The delay awaiting the outcome of the 30-day observation period results in cases remaining on court rolls for longer than a year when the accused must be observed by a panel – two psychiatrists and a psychologist – owing to the violence inherent in the alleged offence,” Tyali said.
“Observations for non-violent crimes are done by a single panel of one psychiatrist and one psychologist, which tend to be quicker.
“If the accused is found unfit to stand trial, he or she will be referred to a psychiatric institution, either as an involuntary mental healthcare user or as a state patient. A trial will not ensue in these circumstances.
“Prejudice for the prosecution can result from the lengthy waiting periods if the accused is found fit to stand trial as the trial itself can start only after the accused has been observed.”
The province’s biggest psychiatric hospital, Fort England, has only one forensic psychiatrist and a sessional doctor to assess the mental state of some of those facing a range of crimes, including murder and rape.
Since January, 232 accused had been admitted to Fort England for observation, with 116 of them found to be mentally unstable.
Dr Rolene Wagner, head of the provincial Health Department, pointed to a growing number of patients with substance-abuse issues, which was putting pressure on facilities, while Dr Lesley-Ann Foster, director of Masimanyane Women’s Rights International, said it was a “travesty of justice not to have adequate resources to deal with such a serious problem”.
“The Health Department is doing us a disservice by not employing more specialists in mental health … they need to take the issue very seriously.
“They do sporadic responses … I have a deep concern about that, particularly about women who suffer domestic violence or rapes and who need psychiatric services they can’t access.
“It’s not a direct justice issue, but an issue of health and overall well-being that is neglected.”
The Democratic Nursing Organisation of SA’s provincial chair, Sivuyile Mange, said a shortage of specialised nurses in the field of psychiatry was worrying.
“There’s also a shortage of these designated facilities…the existing ones don’t have capacity to deal with the growing population.”
In September last year, the department established a separate directorate for mental health in the province, appointing Wezile Tshali as the provincial director for mental health.
Daily Dispatch PressReader article – Psychiatric patients overload EC health (Open access)
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