The locking up of a teenage psychiatric patient at St Albans Prison in Port Elizabeth instead of at Grahamstown’s Fort England Psychiatric Hospital has blown the lid off a human rights crisis, as Eastern Cape Health admits to almost 300 people in the same situation.
Even though Awonke Adam, 19, of Kwazakhele, is mentally disabled and has speech and hearing impediments, the report says he was kept at St Albans – where he was beaten, robbed and abused to the point that he tried to commit suicide by hanging himself. Awonke should have been treated at Fort England Psychiatric Hospital – the only dedicated secure mental health facility for state patients in the province.
The report says Judge Gerald Bloem ordered his release pending a hearing in September into the constitutionality of keeping state patients in prison while they await institutionalisation or observation.
Keeping psychiatric patients in jails is globally regarded as a gross human rights violation and specifically stated by the World Health Organisation as a practice that should be abandoned.
According to the report, the DA’s Celeste Barker said she would be reporting the matter to the Health Ombudsman. “The incarceration of state patients in prisons is inhumane and careless,” Barker said. “It violates patients’ rights to treatment and exposes fragile patients to risk, violence and abuse. The Eastern Cape Department of Health appears to have selective amnesia. Have they forgotten the Life Esidemeni crisis?”
Legal Aid SA, representing Awonke’s mother, Phathiswa Adam, argued before court that the department either had no policy, or at the very least no sustainable policy, to deal with the crisis. At least another 260 psychiatric patients in the province are being held in prisons while awaiting observation. Another 95 are awaiting beds at Fort England.
Health MEC Pumza Dyantyi said in a presentation to Parliament in March that the province had a shortage of 1,600 mental health beds. Patients needing observation have to wait on average 20 months and those needing placement at Fort England wait nine months. Dyantyi said they had dedicated 30 beds at Komani Hospital in Queenstown to try to alleviate pressure on Fort England.
According to papers before court, Legal Aid SA asked the MEC to produce a list with details of all state patients currently incarcerated due to a lack of beds at mental hospitals, and what her plans were to stop this.
Speaking of her 10-month fight to get her son released, Adam is quoted in the report as saying that Awonke was declared a state patient in September last year. As there was no space for him at Fort England, he was sent to St Albans.
Adam said her son was severely mentally disabled, had a hearing impairment and could barely speak. “He did not pass any grades at school and would repeat a grade until the education policy allowed him to be condoned to the next grade. He went as far as Grade 6 after repeating it twice. He left school at 17. Before his detention Awonke was able to wash and feed himself and do household chores. He has never been a threat to anyone and is a very reserved child who prefers to stay at home and watch television or listen to the radio. He has never been involved in criminal activities. He is well liked. Many members of my community expressed concern and shock when he was sent to prison.”
Awonke was arrested on a charge of rape in May 2014 and appeared at the children’s court in Nerina House. The report says the matter against him was withdrawn.
Experts blame failure to fill vacant posts for psychiatrists and psychologists, which is compromising the provision of mental healthcare services in the public sector, for the shortage for what they view as an impending crisis in Mpumalanga and the Eastern Cape, where more than 100 awaiting trial prisoners have been waiting for more than two years to be assessed on their fitness to appear in court.
Business Day reports that data from 2014 from the provinces shows that fewer than 600 psychiatry and psychology specialists were servicing 45m South Africans who did not have access to medical schemes.
Health Minster Aaron Motsoaledi told Parliament in June that 114 people were being housed in correctional services facilities due to inadequate mental health facilities in Mpumalanga and the Eastern Cape. Mpumalanga does not have a specialised psychiatric hospital to render this service.
"Currently, patients are referred to Weskoppies Hospital in Gauteng when a bed becomes available," Motsoaledi said.
Cluster manager of non-communicable diseases at the Department of Health Professor Melvyn Freeman said there was a lot of pressure on the services for observation of prisoners. Freeman said mental health evaluations were often held back by the fact that the panel had to consist of three psychologists for those who were accused of serious crimes.The Herald report Business Day report