The Life Esidimeni tragedy, in which 144 mentally ill patients lost their lives, along with the numerous reports of patient abuse in healthcare facilities and health professionals’ suicides, are giving Professor Bonga Chiliza sleepless nights.
The recently appointed president of the South African Society of Psychiatrists (Sasop) said these all point to the neglect of mental healthcare and changes need to be made immediately.
Growing up in KwaZulu-Natal, Chiliza decided to study towards a medical career at the University of Natal, now known as the University of KwaZulu-Natal (UKZN). During his six-year medical degree, he was exposed to various disciplines in the medical field.
For him, the most intriguing was psychiatry because it proved the importance of the mind to a person.
“During this time, we were assigned to work with a patient who suffered from a severe mental illness, what you would refer to in medical terms as ‘psychotic’,” he said. “In the four weeks we spent with the patient, providing the required treatment, the patient’s health had improved so much that I was even able to have a conversation with him at the end of our training.
“This experience changed my whole outlook on the discipline because it showed me that the mind is an important part of who we are and I became fascinated by the power it had to affect our well-being.”
After he got his degree in 1997 and completed his community service and internship, he returned to school with the intention of becoming a specialist in the field of psychiatry.
He developed an interest in research and academia in the field and decided to move to Cape Town where he worked towards a PhD with a focus on schizophrenia, consultation liaison psychiatry, health services and medical education.
After 10 years at the university, he moved back to his home province in 2007 to head up the department of psychiatry at UKZN.
In 2018, he was elected president of Sasop and vowed that the organisation would “rise and answer the call for advocating on behalf of mental healthcare users and our profession”.
Chiliza said: “Mental health conditions are often misunderstood, mismanaged and stigmatised, particularly for those who rely on the public health system for treatment.
“They are extremely vulnerable to abuse and Sasop, as the professional body for psychiatrists, must take the lead in ensuring better services to our people.
“We will live out the promise we made to society when we engaged in a social contract with our community as practising, professional psychiatrists.”
Chiliza emphasises the two major issues that the healthcare system faces at the moment – a lack of sufficient resources to serve the high demand of people who need the service, and the insufficient amount of practitioners available to serve patients.
He said the country simply did not have enough psychiatrists and it was not impossible that a post in this field could remain vacant for months.
He said the country needed more trained practitioners – and fast.
It is for this reason the organisation would focus on the young psychiatrists, registrars and medical officers by carrying out campaigns that will highlight the state of mental health illnesses and the dire need for psychiatrists in the country in a way that will make them “fall in love with psychiatry”.
It would also provide support to them during their studies, as well as ensuring that they have ample opportunity to intern and gain experience in the discipline.
“We need to push harder for psychiatry to be truly recognised as a major discipline in undergraduate medical education and get young people who can think outside the box interested about learning about the mind,” said Chiliza.
He also said government needed to provide additional wards and facilities as currently, the public healthcare system was struggling to deal with the number of patients who were demanding the service.
“We are just starting to learn how big the problem is with mental healthcare issues. There are a lot of people that suffer from mental health issues but don’t know what to do.
“For instance, they may be suffering from back pain and get treatment for that without knowing it might be related to mental illness, like stress. They are therefore not adequately treated for their illness.
“We will re-energise our efforts to transform the leadership of Sasop and psychiatry in general. The leadership of Sasop will continue to transform until it is aligned with the demographics of South Africa and is able to fully engage with issues that plague our country, such as racism, sexism and other forms of discrimination.
“We will thus embark on a strategic drive towards succession planning for all key positions of leadership in psychiatry,” he said.