Crisis for psychiatric patients

Department of Health in Gauteng bailing out of caring for 2 000

FUNDING cuts could force more than 2 000 psychiatric patients onto the streets – and they could end up in prison. The Gauteng Department of Health will no longer pay Esidimeni Life Healthcare for the 2 060 state patients cared for at various homes in the province.

The funding cuts put pressure on families and NGOs to house severely ill institutionalised patients, some of whom are aggressive.

Johannesburg resident Marion Conway’s mother has been schizophrenic for 35 years and in and out of government hospitals and NGO homes.

Conway said her mother resisted treatment, no longer responded to medication and was delusional.

The provincial Department of Health spends R10 000 per patient a month and the total annual budget is more than R320-million, an amount it could no longer afford, spokesman Steve Mabona said.

Hundreds of concerned family members met at the Esidimeni clinic in Randfontein on Saturday to discuss what would happen to their loved ones.

The Department of Health did not attend, although it was invited.

One of the concerned family members is 85. He said he could barely look after himself, never mind his schizophrenic son, who is a danger to himself. He has been in a home for 20 years.

SA Depression and Anxiety Group spokesman Janine Shamos said 2 000 very low-functioning people and a few hundred children would be destitute when the clinics closed.

There was a concern other provinces might follow suit.

The Esidimeni group has been providing mental-health services for indigent people for 50 years.

It looks after 1 050 state patients in other provinces.

The Gauteng Department of Health wants patients to go home or for NGOs to absorb them, offering R2 800 a month each.

Shamos said NGO homes did not have the resources to look after many of these patients.

“A lot of patients . . . need continual care, with nurses saying: ‘Eat this, take your medicine’.”

Some patients were aggressive and could become even more so if not given continuous care.

“The NGO sector bears most of the burden of the mentally ill and is totally underfunded. It simply lacks capacity for any more patients.”

The Department of Health says its decision is in line with the Mental Health Care Act, which aims to rehabilitate mentally ill people and have them live in the community.

Professor Crick Lund, of the UCT Alan Flisher Centre for Public Health, said: “There has to be a global move to have psychiatric patients de-institutionalised. This means closing down homes and moving them to the community.

“What South Africans don’t realise is that institutions are not common. In the 1970s, Italy closed down psychiatric homes. In their place, there are smaller community-based residential facilities.”

But Lund warned that money had to be invested in these smaller community homes and in reintegrating psychiatric patients in the community, or they could land up in prison.

“If the money doesn’t follow psychiatric patients, then you are in real danger.”

Lund said that, in the US, “patients who are prematurely released from institutions are being re-institutionalised in prisons”.

Mabona said there was space for about 578 patients at Tara, Sterkfontein and Weskoppies. But Shamos said the hospitals were full and had waiting lists.