In order for a population to be able to be in a good state of mental health (and good health in general), government – as the primary duty-bearer – must create a climate necessary for people to achieve these states.
Positive conditions for growth and development must be fostered and people must have faith that their needs are being met.
Unfortunately many of the actions of government leave a lot wanting in this regard.
Personal circumstances can lead to a person having difficulty coping with the challenges with which they are faced or not being able to contribute in the manner in which they would otherwise be able.
Add to this government failing to provide for and protect its people, thus placing everyone in a precarious position and condemning them to a state of unhappiness and dissatisfaction, and a bleak picture starts to emerge.
According to the 7th World Happiness Report released this year, South Africa has been ranked one of the unhappiest nations in the world- something shocking in a country meant to embrace concepts such as the spirit of Ubuntu.
One example of how South Africans are disempowered and sometimes plunged into a state of despair at a large scale is the failure of State-Owned Enterprises (SOEs).
Eskom is a poignant example. Day after day and night after night, people in South Africa are left without electricity, unable to work or function at school during the day and then plunged into darkness in the evenings, unable to prepare food, charge appliances or engage in other forms of activities for themselves and their families.
The threat of national blackouts looms large for all those living in South Africa and people are bewildered, confused and angered by this state of affairs.
This lost productivity prevents people from making contributions to their full potential, which can lead to an immense sense of anxiety and often a sense that one is failing their employer or their loved ones.
This in turn could diminish their mental health.
According to Stats SA, 55.5% of people lived in poverty in South Africa in 2015, up from 53,2% in 2011, indicating that poverty is on the rise.
It is difficult for impoverished members of society to escape the poverty traps in which they find themselves.
We are all too familiar with hearing about worsening unemployment and poor education, but until South Africa gets out of this economic rut it becomes difficult to create jobs and to provide opportunities for people to gain qualifications- least of all in the face of an ill-managed public purse.
A measurement called the Gini-Coefficient demonstrates income inequality. South Africa’s stood at a high 0.69 as reported by Stats SA in 2017.
Lack of scope for growth on a personal and professional level leads to loss of confidence and hope, and a diminution of the idea that a person can create a better life for their children or make a positive contribution to society.
Financial freedom is empowering. Absence of this freedom leads to disenfranchisement and feelings of worthlessness.
This is also a catalyst for poor mental health, given the sense of insecurity it creates.
Corruption within government also leads to a loss of trust in the state. Mismanagement of funds and criminal charges being brought against high-level politicians leads to a loss of faith in those responsible for the running of the country.
With phenomena such as state capture emerging it sometimes seems as if all hope is lost.
It is nearly impossible to envisage how people can be expected to be in a good state of mental health amid such chaos, and possibly why we have been ranked as such an unhappy nation.
The general elections are upon us. Ultimately, many feel that the party they will choose to vote for in the May elections will be the “best of a bad bunch”.
While all political parties promise positive changes in their own ways, a large number of people have simply lost their faith in the promises of political parties.
According to a poll released by the Institute for Race Relations in 2018, there is likely to be a lower voter turnout in comparison to the 2014 elections due to factors such as high levels of voter discontent, which leads to voter apathy.
The fact that people are not even willing to vote is both telling and concerning.
All that can be done at this point is to issue a reminder and a caution. The people of South Africa must remember that we have a Constitution guaranteeing a full complement of rights, and contains a careful construction of rights and responsibilities of government.
It provides for the clear separation of powers of the three branches of government, striving to guarantee good governance.
We have a comprehensive legal and policy framework, which prioritises human dignity, equality and freedom and a society which has largely embraced constitutional democracy.
Political parties claim to want the best for their constituents. In all of the manifestos is a clear desire to undertake what they feel will better the lives of their voter base.
Not everyone will agree with all of their views, but then one does not have to vote for them. That is the beauty of democracy.
We caution these parties, however, about making promises they can’t keep and betraying those who vote for them.
The problems with SOEs have to be addressed, a decrease in poverty must urgently occur, and corruption must be rooted out.
Finally, the public must hold those serving them accountable. Advocacy and self-advocacy- doing things that empower those around you as well as yourself-surrounding the aforesaid issues are key to realising the Constitutional prescripts of Democracy.
Democracy has not failed as some would have us believe.
The overwhelming majority of us want to get along and co-exist peacefully. For this reason we must band together in ensuring that our common goals- a good life, where services are delivered properly and where the state is honest, open and transparent- come to fruition.
South Africans must take opportunities to voice their outrage with a view to secure redress.
They must make use of the courts system and stage peaceful protests when something objectionable happens, must seek to obtain and provide civic education to remain informed and to place themselves in a position where they can proliferate knowledge, take political stances on important issues, and make use of the country’s vibrant civil society services such as law clinics, advocacy groups or those organisations providing direct services.
Through these endeavours, collective disempowerment can be transformed into collective empowerment- something that is good for morale and will boost the mental health of the people of South Africa.
Our country is presently in a precarious state and the mental health of its people is suffering as a result.
Poor mental health, as a result of collective disempowerment, could lead to large-scale negativity, mental illnesses, apathy, lawlessness, civic unrest and stress if it is not addressed.
Let us improve the state of our country and in turn our mental health.
On the 25th of March 2019, the Director of the South African Federation for Mental Health, Bharti Patel, took part in the Little Eden CEO Wheelchair Challenge. The aim of this initiative was to raise awareness for people who are wheelchair users through having those at the apex of an organisation spend a work day in a wheelchair. This was done with a view to raise funds as well as for those who took part to gain a sense of understanding as to what it is like to be a wheelchair user. We caught up with Bharti after the experience and did a brief interview with her to ascertain her thoughts on the experience and for her to describe what she had learnt as a result. An account of the interview appears below:
Please give us an overview of your experience:
I had to adjust to remaining seated for the entire day, and I found it difficult to perform tasks such as fetching documents from the printer. I was extremely conscious of moving about the office as I realised I would be blocking the entire passageway and I was conscious of the fact that I had to ask for assistance moving across the boardroom. This experience has been a real eye opener and has given me a new perspective on what it is like to be a wheelchair user.
What were the highlights of the day?
The concept of mindfulness of what it is like to be in a wheelchair dawned on me- I was able to see things in a new light. As the day progressed, it was no longer about the wheelchair, it was about getting things done using resources around me. I was motivated to go beyond the wheelchair and get things done and was able to appreciate how it was all very possible despite the challenges that had been so apparent to me at first, however I do realise that those with mental health challenges who also have physical disabilities face even more challenges.
How did people treat you?
Initially it drew a great deal of attention to me. People saw the wheelchair first and me second. People were accommodating but also almost apologetic. I almost felt like a victim at the start of the day. This dissipated as the hours went by.
What were your three biggest challenges?
In terms of context, I must say that I felt like someone who got into a wheelchair just subsequent to a traumatic accident- it felt sudden and confusing. I had to quickly adapt to being bound for the first time. I had to learn how to move around and my office had to be repositioned to allow me to get behind the desk. There were some doors I struggled to get through and it was difficult to pass by furniture and in passageways without being assisted.
Why do you respect wheelchair users more?
I appreciate the fact that people who use wheelchairs are able to go beyond the construct of them having a disability. Using a wheelchair also requires physical exertion and strength. People in wheelchairs are thus more resourceful in both mind and body.
Thank you Bharti for both your participation and taking the time to do this interview.
The right to basic education is a rudimentary entitlement extending to everyone, as set forth in section 29 of the Constitution. People with intellectual disabilities have long since been denied this right and it is vital that this change. Inclusive education is an area that has been chronically neglected and this is an affront to the rights of learners so-situated. Similarly, the right to employment is an entitlement in international law. Like education, the rights of people with intellectual disabilities have been neglected in this regard, with very capable individuals being unable to enter into the labour market. Poor education is directly linked to unemployment and is massively problematic in our society. To this effect the South African Federation for Mental Health has drafted 2 policy briefs setting our how such individuals are situated and possible ways forward. Click on the links to read them.
World Bipolar Day 2019 represents a golden opportunity to look back at the past, examine the present and determine what we want for the future of people with Bipolar Disorder. This year, the South African Federation for Mental Health has elected to commemorate this occasion by launching a media campaign surrounding the idea that Bipolar Disorder does not have to be a life-sentence. People with this illness can live happy and fulfilling lives provided they receive the support they need. SAFMH has composed a press release to this effect. It appears below:
The 30th of March 2019 is World Bipolar Day. According to the World Health Organisation (2018) Bipolar Disorder is a prevalent mental health condition affecting approximately 60 million people worldwide.
According to Harddon, Hayes, Blackburn et al (2013), Bipolar Disorder can be considered a Serious Mental Illness (SMI). This is not to say that this condition is a life sentence. People with Bipolar Disorder can lead happy and fulfilling lives if adequate support structures are put in place for them to do so. Unfortunately, all too often, this is not the case, and these individuals are left in a state of flux, brought on by unmanaged symptoms and a lack of support.
Sifiso Mkhasibe, a Programme Assistant at the South African Federation for Mental Health, refers to himself as a “survivor of Bipolar Disorder.” Mkhasibe struggled with the disorder for years- at times hospitalised and isolated- until he was provided with the right treatment regimen and proper assistance. Today he is confident and successful, having taken control of his life:
“Days, weeks, months went by, until I realised enough is enough. I had to take ownership of Bipolar Mood Disorder. I educated myself about the symptoms I had experienced when I was diagnosed…once I had learned how to manage my Bipolar Mood Disorder, life started to become clearer, I knew what I had to do and how to do it. I was no longer a victim of my Bipolar Mood Disorder. I stopped defining myself as a person with Bipolar Mood Disorder, now I just say I had those symptoms when I was diagnosed. I am on medical treatment and I do not present those symptoms any longer.”
There are different support structures that, if put in place and available to those needing it, can aid in the recovery of people with Bipolar Disorder. According to the South African Depression and Anxiety Group (SADAG) (no date) treatment can take the form of the provision of medication, psychotherapy, family support groups or periodic hospitalisation as a last resort. Authors like Mkize (2003) highlight that assistance from traditional healers is also one of the options available to people with mental illness. A further mechanism which can be used to support such individuals is reasonable accommodation in the workplace as contemplated in the Basic Conditions of Employment Act 75 of 1997. There are thus many mechanisms that can be employed to enable people with Bipolar Disorder to have a good quality of life.
There are many reasons why duty-bearers fail individuals with Bipolar Disorder. One of them is the inadequate number of trained professionals to care for such individuals. According to the World Health Organisation’s Mental Health Atlas (2019), South Africa has only 1.52 psychiatrists per 100 000 people. The same document indicates that there are only 16.56 beds available in psychiatric hospitals per 100 000 people. There is no evidence surrounding support groups. In addition, only R99.47 is budgeted per person for mental health services on an annual basis. What is perhaps the most problematic of all is the fact that, in many instances, there is simply no data available on the state of mental health in South Africa, with the Atlas indicating in many places that there is no information or that no information has been reported on various items such as community-based organisations or length of stay in inpatient facilities. Another reason is the failure to employ adequate numbers of people with disabilities, - let alone take steps to accommodate them. According to the Commission for Employment Equity Annual Report (2017/2018), only 1.3% of the workforce were people with disabilities, in comparison with the employment equity target for employment of such individuals which is 2%.
The challenges faced by individuals with Bipolar Disorder are exacerbated by the fact that existing legislation and policy are poorly implemented. Instruments such as the Mental Health Policy Framework and Strategic Action Plan 2013-2020 often remain paper-based commitments rather than becoming living documents, with the end of this policy’s trajectory looming and no publicised steps being taken to update it. The Mental Health Care Act of 2002 is also becoming outdated and requires review but again, seemingly nothing is being done to facilitate this process. This means that despite protective mechanisms having been created for people with Bipolar Disorder and other mental disabilities, there is very little actually shielding them from the challenges they face within society.
One of the reasons that people with Bipolar Disorder remain underserved is because of prevailing societal stigma. In general, little is known about the fact that Bipolar Disorder can be managed and a perception exists that people who have this illness are capricious, unreliable and incapable. SAFMH strongly dissents from these notions. People with Bipolar Disorder can be strong, resilient and successful in all aspects of life, including relationships, education and employment. More public education and awareness is urgently required if we are going to start dispelling the stigma surrounding Bipolar Disorder.
SAFMH is a non-governmental organisation (NGO) seeking to protect and uphold the rights of people with mental illness, psychosocial disability and intellectual disability. We submit that it is wholly possible for any individual to thrive in their surroundings if they are given the appropriate tools to do so. As such, we call upon the state to work towards improving service delivery for people with Bipolar Disorder by averting the issues outlined above. We also call upon this duty-bearer to ensure that law and policy are implemented and kept properly up to date. Similarly, we call upon organisations engaging in advocacy and awareness-raising activities to provide information to the public to diminish stigma and enable communities to better support their loved ones, employees and school-going individuals, and for the state to actively invest in these types of activities. Finally, we also call upon people with Bipolar Disorder to empower themselves and begin to self-advocate as Mr Mkhasibe has done.
Bipolar Disorder can be disruptive to a person’s life, but it need not be a dominating force. With proper treatment and care the quality of life of persons with Bipolar Disorder can substantially improve. It’s time to #takeyourplace in making this a reality.
Project Leader: Information and Awareness
South African Federation for Mental Health
072 2577 938
011 781 1852
As indicated in another article, March 2019 is Intellectual Disability Awareness Month. World Down Syndrome Day falls within this space of time, on the 21st of March. The theme for SAFMH's campaign for this period is "We are all Pieces of the Same Puzzle." Indeed, while many would see distinctions between themselves and those with Down syndrome, we advocate for the idea that we all fundamentally want and are entitled to the same things- things like education, employment and to live in one's community. Unfortunately prevailing stigma in society leads to these individuals being denied such opportunities. This is compounded by South Africa's failure to domesticate the United Nations Convention on the Rights of Persons with Disabilities, making the legal system fragmented and disparate.To this effect, SAFMH has put out a press release on this topic. It appears below:
The 21st of March is World Down Syndrome Day. It offers an opportunity to examine how we as a society treat these individuals and what improvements can be made to their lives through law and policy reforms as well as through advocacy and awareness raising interventions.
Down syndrome is a fairly prevalent condition according to the World Health Organisation (no date) with the estimated incidence being 1 in 1000 to 1 in 1100 live births.
According to Down syndrome South Africa (no date), people with this condition fall into the category of mild to moderate intellectual disability, meaning that they can function in a myriad of different environments.
Despite their capability, people with Down syndrome are often denied the opportunity to go to school, to obtain and maintain gainful employment or to live in their communities. Often underestimated, they are treated as second-class citizens, denied of agency and stripped of prospects for self-improvement.
For millennia, people with intellectual disabilities have often been kept in institutions or hidden out of sight; with families sometimes ashamed of them. A vast spectrum of research has demonstrated that this is not the case and that hospitals should be used as a last resort only. This is particularly the case for individuals with Down syndrome who can often live with a relative degree of independence.
The law and policy intended to provide for and protect people with disabilities is comprehensive in places but somewhat disjointed and disparate in others. This is largely due to South Africa’s failure to domesticate the United Nations Convention on the Rights of Persons with Disabilities through implementation of disability-specific legislation.
Presently, the rights of people with disabilities are scattered in droplets throughout our body of law. This problem is compounded by the fact that much of the extant law and policy is not implemented as well as the fact that much of it requires review such as the Mental Health Policy Framework and Strategic Action Plan. Combined, these issues can well lead to an individual with a condition such as Down syndrome being left to languish- their rights remaining woefully unrealised.
With a clearly visible disability, people with Down syndrome are often victims of stigma. Corrigan and Watson (2002) discuss stigma in the context of people with mental disabilities. They illustrate that people with these illnesses are “challenged doubly” with the symptoms and effects of their disability on the one hand and stereotypes and prejudices on the other. This diminishes their chances of having a good quality of life.
The South African Federation for Mental Health is a non-governmental organisation (NGO) seeking to preserve and uphold the rights of people with mental illness, psychosocial disability and intellectual disability. In view of our mandate we wish to issue the following call to the state:
First of all we request that the state take rapid and proactive steps to enact legislation enabling people with intellectual disabilities who can function within society to do so through the promulgation of disability-specific legislation.
Secondly we request that the state accelerate efforts to implement existing instruments and to ensure that those with a dwindling trajectory or are outdated are reviewed.
Thirdly we request that the state embark on advocacy and awareness-raising initiatives to dispel stigma surrounding Down syndrome specifically and intellectual disability broadly.
We also call upon the public to work towards gaining an education about Down syndrome so that they are in a position to advocate for the rights of people with this condition and thus to make proper and informed demands of the state.
Down syndrome is something that should neither be neglected nor feared. In a democratic society there is no justifiable basis for the rights of individuals so-situated not to come to fruition. Be it poor implementation or violation there are clearly changes that need to be made with a dash of speed. #takeyourplace in ensuring a dignified existence for these individuals today.
Human rights day is an important day in South African history. It enables us to examine how far we have come and how far we have yet to travel. Unfortunately the rights of people with intellectual disabilities have been chronically neglected abd vulumes remains to be done to ensure that their rights are respected and protected. In this regard, the South African Federation has put out a press release. It appears below:
Human Rights Day reminds us that it’s the fate of society’s most vulnerable that is the true measure of our success – or our failure – in matching human rights ideals, says the South African Federation for Mental Health (SAFMH).
And among the most vulnerable are citizens with intellectual disabilities – whose dignity and rights are often overlooked because they are poorly understood, or all too easily ignored. The voices of those who lack agency or the ability to self-advocate are often drowned out, their wishes and their needs scattered to the wind.
In a country where services are woefully inadequate, can their rights be realised? And what can be done to improve the situation of such individuals and to allow them to live with a sense of dignity?
The right to inherent dignity is violated at every affront to any other human right, for in the absence of any given entitlement, a life becomes undignified. If there are inadequate mechanisms to enforce both civil and political and socio-economic entitlements, a person’s sense of dignity is essentially voided.
When a person is vulnerable the realisation of the right to dignity becomes especially problematic because such individuals require a “leg-up” to place themselves on equal footing as others. This is not aided by the pervasive stigma with which people with intellectual disabilities are contended or the failure to prioritise the rights of such individuals.
So what is there to be done? SAFMH has some propositions. As a non-governmental organisation seeking to protect and uphold the rights of people with mental illnesses, psychosocial disabilities and intellectual disabilities SAFMH aims on Human Rights Day 2019 to highlight the plight of people with intellectual disabilities and to demonstrate the lack of dignity in the lives they lead and the need to change things for the better. SAFMH believes there are steps to be taken, and we have chosen this Human Rights Day, 21 March 2019, to highlight the claims to dignity of people living with intellectual disabilities, and to deliver a three-part challenge aimed at securing real progress towards that objective. This call to action is made in view of our broad mandate as an advocacy body, working to influence both the course of decision-making processes as well as the treatment meted out to people living and working at grassroots level.
First, we call on the state as the primary duty-bearer in upholding the pillars of the legal system to ensure that laws and policies are implemented and further developed in the interests of people with intellectual disabilities. Examples of such an instruments are the Mental Health Care Act Mental Health Policy Framework and Strategic Action Plan 2013-2020.
Second, we call on the families and caregivers of people with intellectual disabilities to become educated in the types of services available and the types of services needed so that they can advocate for their loved ones with intellectual disabilities. This would include finding out how to contact services supporting people with intellectual disabilities and through locating information about the rights of people with intellectual disabilities and what they are entitled to. An example of how one may educate themselves would be through accessing documents designed for this purpose such as the SAFMH Guide to Supporting Loved Ones with Intellectual Disabilities or through approaching one of SAFMH’s mental health societies which operate in different parts of the country.
Finally, we call on community-based organisations providing services to people with intellectual disabilities to provide them with the tools and support they need to self-advocate, utilising appropriate human rights education as an integral tool to do so. People with intellectual disabilities often need to be assisted in order to raise their voices and it is through learning about their entitlements and in being supported to compare what they have versus what they deserve that they can begin to demand what they want and need. People with intellectual disabilities should also be encouraged by those providing services to them to become involved in human rights activism such as the South African Mental Health Advocacy Movement.
As a non-governmental organisation (NGO) seeking to uphold and protect the rights of people with mental illness, psychosocial and intellectual disabilities, SAFMH makes these calls in the conviction that it is possible to change lives for the better and to truly ready South Africa for a new era, one in which the legal guarantees bestowed upon people with intellectual disabilities by legal instruments become a reality in their lives.
Project Leader: Awareness and Information
011 781 1852/ 072 2577 938