Issued by: Department of Health
15 February 1996
Having realised the adverse effect that years of neglect had brought about in the delivery of patient care in psychiatric facilities, the Department of Health conducted an overview of these facilities.
We then established the directorate of Mental Health to specifically strengthen and facilitate the transformation of the Mental Health Care services. I subsequently appointed a committee to look into issues relating to the provision of Mental Health services. The committee had its first meeting in February 1995 and was chaired by Professor T B Pretorius of the University of Western Cape and included prominent persons working in the field of Mental Health.
The brief of the committee on Mental Health was extended to include an investigation into psychiatric hospitals after the Department had received reports of alleged malpractices and abuses in psychiatric hospitals.
The committee interviewed the management and staff of mental health facilities as well as patients. The interviews were conducted on a confidential basis. Members of the committee visited facilities in the nine provinces. Three types of facilities were visited namely; public psychiatric institutions, state subsidized institutions administered by a private provider and psychiatric wards in general hospitals.
The committee's report showed deficiencies in some facilities in relation to management, health standards, resource allocation and utilisation and contracts with the private company. The committee also reported on allegations of human rights violations.
We are deeply concerned about the findings of this committee and will implement measures to address this situation.
The Plan of Action will include immediate and medium term measures. Immediate action will include:
- facility based task teams to address management issues including the establishment of a mechanism to address patient and staff complaints. - closure of those facilities or wards found to be unsuitable for patient care. - investigation into allegations of human rights abuses. - the private provider that has been contracted to provide Mental Health services, will have to immediately address identified deficiencies.
Medium term action may include:
- the development of national policy and protocols for patient care in mental health facilities. - the development of national norms and standards for mental health facilities including staff/patient ratios and patient safety. - the appointment of hospital boards at each facility to oversee the management of the facility. - the inclusion of mental health facilities in the National Health Facility Audit which is assessing the physical viability of buildings. - review of legislation governing mental health matters. - review of resource allocation to facilities. - review of the contracts with the private providers concerned.
This matter is regarded as urgent and will receive immediate attention in the National and Provincial Departments of Health. The Director General of the Department of Health will oversee the implementation of the immediate and medium term measures outlined above.
For further information contact:
Mr. Vincent Hlongwane Telephone: (021) 45 7713 Pager: (011) 804 2777 CODE NAT 1192