Federica Micoli of Lawyers for Human Rights (LHR) said mental illness was particularly complex in the refugee and asylum-seeker community, and was aggravated by a lack of insight.
“This group is more likely to develop these challenges, due to enduring trauma which inludes torture, war, displacement and rape.
“Exposure to some situations of war is already very traumatic [such as] in the eastern DRC where gang rape is used as a tool of war.
“And then they encounter a whole lot of difficulties to get to South Africa, where [upon arrival] they experience xenophobia, crime and difficulties with the asylum system.
“They can’t get employment, don’t have access to social grants and are being turned away by schools,” she said.
She said although LHR had a good working relationship with Weskoppies Psychiatric Hospital in Pretoria, the implementation of a draft directive at other State hospitals in Gauteng made it almost impossible for asylum-seekers to get treatment and medication.
“Asylum-seekers and refugees have a right to free emergency medical treatment, but this directive puts them on the same scale as ordinary foreigners and they have to pay for medical services at a higher scale.
“Because they can’t pay, they are being refused all treatment, even life-saving treatment,” she said.
“It’s been very useful to have training from the Centre for the Study of Violence and Torture, where it gets explained how the different mental illnesses impact on the brain.
“Before, I really thought my clients would be lying. Now I know they block out certain things because it’s simply too painful. They would, for example, build a completely imaginary life because they can’t cope with the pain of their real situation.
“There is still a big cultural barrier because we’re talking about mental illness from a westernised point of view, while mental illness in African society is seen as witchcraft or being possessed by some spirit,” she said.