The families of people suffering from mental illnesses and substance abuse with no medical aid or financial means to afford high-priced private care may find it increasingly difficult to get the care they need.
In 2015, the Department of Health did not renew its contract with the Life Healthcare Group. This left patients in need of constant mental health care, and their families, with nowhere to go and no other options.
This was cited as de-institutionalisation in accordance with the Mental Healthcare Act 17 of 2002, meaning that the provision of mental health care was transformed from in-hospital care to community-based rehabilitation.
This method sounds good in theory, but in reality it places immense pressure on care-giving families as well as the mental health NGOs who are dependent on donations to run their institutions successfully.
Patients who are in need of constant care and medication are expected to visit the out-patient facilities at hospitals to be treated. Many of them will not get the care they need, as they will not stick to this programme. Event if they are admitted to hospitals with psychiatric wards, these wards are often full and the patients are just stabilised and then discharged.
Anthea Barriel, the PR Manager of the Westview Clinic in Florida said, “It is a struggle for people who cannot afford private care. Their options are very limited.” She said that the worst problem is dual diagnosis; that is, when a patient is diagnosed with substance abuse as well as mental illness.
“When this happens, a decision must be made as to which condition needs the most urgent treatment.
Many mental health professionals often argue that the mental illness is the result of the substance abuse,” Anthea said.
The clinic can help with a referral letter to a public hospital, but this is no guarantee of immediate help. “There is a waiting period for patients – you could either be admitted on the same day or be asked to come back in a week or even three months’ time. The public hospitals are swamped,” she said.
According to Anthea, it is sometimes easier to first be admitted to a rehabilitation centre where there are psychologists who visit the patients, review their mental state and then decide whether to have them admitted. “Even this is no guarantee of immediate help, as an application for rehabilitation can take anything from six to eight weeks to process,” she warned.
Tshilidzi Ngoveni, PA to the CEO of Sterkfontein Hospital, says that patients can receive care at the hospital at no cost, but they only work on referrals from psychiatrists at public hospitals.
“When you suffer from a mental health condition you need to visit your nearest public hospital or doctor.
You will be assessed by the hospital’s psychiatrists, which might include a 72-hour stay in the hospital. Only after that will a decision be made to either discharge you or refer you for further treatment,” said Tshilidzi. “If the doctors at the public hospital do decide to refer you to a mental health care institution, you will then be assessed by that institution’s psychiatrists before a decision will be made on whether you should be admitted, or not.”
The reality of the matter is that people might not receive the care and medication they need, because of this lengthy and difficult process, with the result that many cases are not reported and many patients do not receive proper treatment.
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