Me being me, I therefore did a bit of reading around policing, mental illness and criminal justice in South Africa – the natural Venn diagram:
During the last few weeks I have managed to make a couple of loose links with the University of Cape Town, who have circulated the blog to a few staff in the psychiatry and criminology departments! Not sure if they’ll be quite at the stage to put the kettle on when I get there in a week or so, but good to make links and see what comes from it.
Having spent a few hours on the internet looking at mental health issues in South Africa, I know that the South African Police Service, of course, face demands like any other police force for intervention with people suffering from mental ill health and who are in crisis. There are also numerous internet stories of crimes both BY and AGAINST vulnerable people with mental health problems. Quite how the presence of mental illness affects police responses to such crimes – if at all – is less clear. The evolution of the South African system and the interface between law and psychiatry has, in part, been affected by high profile incidents like elsewhere in the world. In 1966, the South African Prime Minister Hendrick Verwoerd was stabbed and killed by Dimitri Tsafendas, a temporary employee in Parliament in Pretoria. Found not guilty of murder by reason of insanity, Tsafendas was detained until his death in a psychiatric hospital, suffering from schizophrenia. This incident triggered a commission of inquiry under a judge into the issue of Mentally Disordered Offenders and to the updating of South African mental health law – the 1973 Mental Health Act. This was modernised again in the Mental Health Care Act 2002.
There is a shortage of trained mental health professionals in South Africa – fewer than 400 psychiatrists for a population of around 50 million people; half of them working in private practice and only a few dozen forensic psychiatrists. (In the UK there are over 3,000 consultant psychiatrists as well as the junior doctors in mental health, for a population of 63 million. This includes hundreds of forensic specialists.) As demands for criminal justice intervention in mental health crisis often result from an inability to access or maintain support from mainstream services, it is hardly surprising that the police are involved given the number of psychiatrists available to the public of a developing nation. One tweeter based in Durban indicated that in her experience mental health issues rarely affect police responses to criminal incidents where suspects are thought to be mentally ill.
Recently, I came across a YouTube clip of Dr Vikram Patel presenting on the subject of global mental health and what he calls ‘task shifting’ – an initiative to have certain aspects of medical care administered by non-clincial, but trained volunteers. This is in operation in South Africa, though the PRIME programme at the University of Cape Town and is partly funded by the UK Department for International Development.
Here are a few links:
1. The South African Mental Health Care Act 2002
2. Dr Vikram Patel talking about global mental health in developing countries.
3. The PRIME website.
4. The South African Mental Health Federation – an umbrella organsation for mental health charities.
5. The World Health Organisation (UN) report on South Africa’s mental health system.
Not much more to say than that – I’m now signing off for two weeks amidst celebrations by Mrs MentalHealthCop that we will be well within an internet, wifi and twitter free zone for much of the fortnight. I will try to send a picture from the top of Table Mountain, just to gloat.