Mental health should become every nation’s wealth. South Africa is no different from any other country or nation whose people experience debilitating mental illnesses caused (directly or indirectly) by myriad factors. That is to say, mental ill-health is a global phenomenon. A journey to recovery.
Gauteng, specifically Johannesburg, is the economic heart-beat and powerhouse of South Africa’s economy. Johannesburg is driven by the sophisticated financial sector, top retail, commercial and manufacturing services. This city can pull you into success or push you out into oblivion. It is a place where only the fittest can survive. Having worked in the corporate sector myself, I’ve seen how people’s dreams are made and lives shattered. People struggle to survive emotionally, economically and socially. Those who don’t survive, end up abusing variety of substances, as a coping mechanism. Others, end up in doctors’ consultation rooms with diverse mental health related disorders. In most cases, due to the stigma attached to mental illness, these individuals ‘hide away’ and suffer in silence. Here’s how:
- Highly competitive, high performance, cut throat private sector organisations drive people into stress, often depression
- High cost of living drive people into debt, stress, often depression
- Peer and social pressure drive people into debt, stress, often depression
- Broken relationships/marriages drive people into depression, often suicide
Any combination of the above factors does not bode well for the mental health of people. Professionals in particular, find it hard to ask for assistance or support. When confronted with a mental illness, they withdraw, lose interest, ending up with a diminished sense of purpose.
Experience elsewhere, shows that community based rehabilitation facilities do play a crucial role in creating opportunities for people living with mental illnesses to become re-integrated back into society and work places. One such example of a community based rehabilitation facility is Fountain House, based in Observatory, Cape Town. This centre plays a vital role in the lives of people living with psychiatric disabilities. It creates opportunities for them to begin the journey of recovery, find meaning in life and actively contribute to the social and economic wellbeing of each other and their families. This is achieved through participation and training in four work units at the centre: administration, catering, a paper making workshop, and the employment/communications unit (Fountain House, South Africa).
A Fountain House model or clubhouse was first developed in New York in 1948. Cape Mental Health pioneered the establishment of the Cape Fountain House. I am privileged to have worked under Cape Mental Health and interacted with persons affiliated to Fountain House, between 1991 and 1994. When I heard about the recent deaths of more than 100 patients in Johannesburg, I thought about the caring and diligence of staff, the well-being of patients and the overall effectiveness of Fountain House. South Africa’s mentally ill community can benefit from such facilities.
The severity of psychiatric disability will dictate the required level of care. Majority of patients who attend Fountain House are individuals who are independent, productive and can easily be integrated into society. Indication is that there are very few places which create opportunities for the economic and social well-being of patients. South Africa’s reforms of the mental health systems should introduce programmes that seek to address the stigma, recreation, training and vocation, nutrition, supported employment opportunities and many more. Rehabilitation should take into consideration the vitality needs, welfare, intellectual stimulation, lifestyle and caring of people living with mental illness or disabilities. The current deaths of patients due to alleged negligence points to a need for a complete overhaul of the mental health care system in South Africa. However, the responsible authorities need to tread carefully between institutionalization and de-institutionalization. The veracity of any policy choice need to be thoroughly investigated and tested, before major policy decisions are made.