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2 December 2016

Every year 3 December is celebrated as International Day of Disability. According to the United Nations, “More than one billion people, or approximately 15 per cent of the world's population, live with some form of disability. 80 per cent live in developing countries.” In South Africa we have legislation such as the Bill of Rights, the White Paper on Disability, and the United Nations Convention on the Rights of Persons with Disabilities that protect the rights of persons with disabilities. However, without correct and timeous implementation, this legislation is unable improve lives.

Mental health received a great deal of media coverage this past year, mainly due to the ongoing Life Healthcare Esidimeni case and the unfortunate deaths that occurred following the relocation of mental health care users from the Life Esidimeni facilities to community NGOs selected by the Gauteng Department of Health. SAFMH has been vocal over the fact that we believe the relocation of these mental health care users was not handled according to the recommended process of deinstitutionalisation laid out in the Mental Health Care Policy Framework and Strategic Action Plan (2013-2020). Deinstitutionalisation is a process of replacing long-stay psychiatric hospitals with less isolated and institutionalised community mental health services. For deinstitutionalisation to be successful, it needs to go hand in hand with the upscaling of community mental health services.

This year a decision was taken that the National Disability Day event on the 3rd of December will not be a celebration as usual, but rather a commemoration to honour the 37 lives lost. The South African Federation for Mental Health supports this decision, and will be attending the National event, where we will present Government with a report compiled through research of the community based mental health care system in Gauteng. The aim of the report is to show how better implementation of the Mental Health Policy Framework is needed to improve the services and care offered to mental health care users.

In the report, SAFMH has made the following recommendations:

  • ·         The Health Ombudsman’s report on his investigation on the Life Esidimeni case must be made public to ensure transparency and accountability
  • ·         Mental health services need to be prioritised and developed with an equal level of (high) importance across all provinces in South Africa, and across rural and urban areas
  • ·         Services and resources at community level should be developed in consultation with mental health care users, their families, NGOs and other key partners to ensure that the development of such services are done in an informed and collaborative way
  • ·        The prioritisation / resourcing / implementation / monitoring of the Mental Health Policy Framework and Strategic Action Plan at provincial level is essential, and provincial Departments of Health need to be held accountable for failure to do so
  • ·     Savings generated through budget cuts in tertiary Psychiatric Care Facilities (such as what happened with the termination of the Life Esidimeni contract) need to be transferred to support community-based care
  • ·         Government needs to address the widely pervasive shortfalls in resources needed to adequately facilitate deinstitutionalisation policy requirements
  • ·      There is a need for NGOs to become more recognised as key partners in the delivery of mental health services and to be respected and treated as such. Government needs to recognise that without the upscaling of and provision of community-based services South Africa’s commitment towards deinstitutionalisation will never be realised
  • ·      South Africa requires more consistent and more comprehensive subsidisation of community-based services, with adequate increases and timely payments of subsidies to ensure continuity in community-based mental health service delivery
  • ·      There is a need for more family empowerment programmes to ensure that MHCUs who return to their homes are able to receive the support they require from their families and that family members are sufficiently equipped with the necessary skills to help them take care of MHCUs within their homes

SAFMH is alarmed by reports that that the relocation of 240 residents of Eastern Cape Frail Care is being handled in the same manner as that of the Gauteng Life Esidimeni patients, and we are concerned over the wellbeing of this vulnerable group. This Disability Day SAFMH would like to appeal to government to recommit to upholding the rights of persons with psychosocial and intellectual disabilities, and to take every possible step to ensure that no service user in South Africa is subjected to inhuman and degrading treatment through system and service weaknesses.


Bharti Patel - This email address is being protected from spambots. You need JavaScript enabled to view it.

National Director


Marthé Viljoen – This email address is being protected from spambots. You need JavaScript enabled to view it.

Programme Manager Information & Awareness

SA Federation for Mental Health