Third Mental Health Advocacy Symposium in Durban
By Suntosh Pillay
“Do not curse the darkness, light a candle”. Quoting a Chinese proverb, Dr Suvira Ramlall, specialist psychiatrist, opened the third annual Durban Mental Health Symposium as part of Mental Illness Awareness Month in July. Reflecting on the Life Esidemini tragedy in Gauteng, she encouraged more public-private partnerships and innovation to tackle the increasing burden of mental illness at a community level.
Hosted by the KZN Mental Health Advocacy Group, organizer, Suntosh Pillay, a clinical psychologist from King Dinuzulu Hospital Complex, said they began this event to create a common space in which mental health care stakeholders could meet and network.
“Too often we work in silos, unaware of the fantastic work being by another organisations, or unaware of how our resources and expertise could be shared. While we lament the lack of financial capital, there are many missed opportunities to build social capital. This symposium, and our annual walk in October, is just two examples of interprofessional and transprofessional collaboration to build more mental health social capital”.
Six speakers were invited to share their expertise under the theme ‘Voices from the Community’.
Liza Aziz, founder of the NGO Action in Autism, is herself a mother to a child with autism. Rather than lament the poor services for children with autism, she made a difference on the ground. Her centre hosts support groups, free diagnostic clinics, early intervention programmes, and social events. She shared her struggles and victories in getting the Department of Education in KZN to allocate funds to schools to cater for autistic children.
“In 2005, there was only one school in KZN catering for 19 children with autism, even though KZN had 150 000 people living with autism”.
She warned that “over 40 percent of people with autism are non-verbal and therefore vulnerable to abuse, so we need to start working from a human rights framework.” A Human Rights Watch report in August 2015, ‘Complicit in Exclusion: South Africa’s failure to guarantee an Inclusive Education for Children with Disability’ gave alarming statistics that over 534 000 children with disabilities are not in the basic education system.
Gita Hari, executive director of Durban and Coastal Mental Health, shared her NGO’s best practices. One example is the Circle of Hope project to prevent foetal alcohol syndrome.
“Through a funding partnership with the South African Breweries, we initiated our Circle of Hope Programme. Activities included reinforcing behaviour change in the community, by capacitating 1338 women, shebeen owners, community health workers, and educators on the harmful effects of alcohol consumption during pregnancy.”
Hari also said that it makes financial sense to integrate patients into communities, instead of long hospitalisations. “The cost of maintaining a stable patient in hospital is four times greater than the per capita cost of a resident in a Halfway House.”
Anne Kramers-Olen, a clinical psychologist at Fort Napier Hospital in Pietermaritzburg, spoke about the ethical issues of deinstitutionalization and psychosocial rehabilitation (PSR).
“Despite research advances in PSR, clinical interventions do not reflect the empirical evidence. For example, people with chronic mental illnesses can make decisions about their own care, and treatment outcomes are more favourable when patients actively participate in setting their rehabilitation goals.”
Among the challenges in PSR in the public sector, Kramers-Olen blamed negative staff attitudes towards training, budget restraints, “and an organizational culture that does not value change and a learning culture which does not reward staff for taking initiative.”
Micheal J Theron, CEO of Choose Life Specialist Recovery Centre, explained the neurobiology of drug addiction and its impact on community care.
“There isn’t a single community that is exempt from drug abuse and addiction. But addiction is a treatable disease, and relapses do not mean treatment failures,” said Theron, who emphasized that drug addiction isn’t a moral issue about not having willpower to stop, because the neurobiological changes in the brain caused by the drugs impair one’s ability for self-control.
“The impairment in self-control is the hallmark of addiction, even though the initial choice to use drugs may have been voluntary”. He implored recovering addicts to “avoid the people, places and things that trigger memories the of the drug use”.
The keynote speaker was Mokete Motaung, Deputy Director for Forensic Services at the National Department of Health, who spoke on behalf of his Director, Evah Mulutsi, who was indisposed.
Motaung presented the findings of Mulutsi’s PhD research on the implementation of the Mental Health Care Act across South Africa’s psychiatric hospitals. Her findings painted a depressing picture of non-compliance, ignorance, and ethical and legal failures to protect the rights of mental health care users. For example, 78% of involuntary psychiatric admissions were not authorised by the High Court, as required by the Act, and most shockingly, 34% of involuntarily admitted patients did not undergo 72-hours assessments while 13.8% of the assessments reports appeared to have been copied among health providers, with the same terminology and errors. Mental health review boards (MHRB) were dysfunctional, with only 57% of responses from MHRBs being submitted within the stipulated timeframes.
Martin Harris, a service user, received a standing ovation for sharing his poignant and courageous personal journey of coping with bipolar mood disorder over 30 years. Reading from his autobiography, Heaven holds every tear, he said “my story has been told, but the race is still being run. Bipolar hasn’t wrecked my life, but it’s shaped my life”. His tenacity and creative approaches to living a meaningful and productive life despite the constraints of his illness and side effects of medication was an inspiration to everyone.
The symposium ended with an official announcement of the date for the 2nd annual Durban Mental Health Advocacy Walk, on October 15, at the North Beach amphitheatre. It is anticipated that this walk will be replicated nationally by other organizations in other provinces and will become an annual international event.
The KZN Mental Health Advocacy Group can be contacted via MHadvocacygroup@gmail.com or called on 0312426180/4.
Picture supplied by Kirsten Clark.
Caption: (L-R): Karl Swain, Mokete Motaung, Suntosh Pillay, Michael Theron, Thirusha Naidu, Gita Hari, Liza Aziz, Suvira Ramlall and Martin Harris, at the Third Annual Durban Mental Health Symposium at UKZN.
DPPG Monthly Meetings:
The Durban Practicing Psychologists Group (DPPG) and the PsySSA KZN Branch co-hosted monthly CPD meetings since the last PsyTalk edition. The topic for the April meeting was “The Neurobiology of Addiction”, which was to be presented by the Choose Life Specialist Recovery Centre CEO and Clinical Psychologist, Michael Theron. This had to be postponed and will be presented on 25 October 2017. Lisa Grant Staurt presented on “Rethinking Trauma Interventions” on 28 June 2017, and Dr Cathrin Venter will present on 26 July 2017 on “Sex and Pornography Addictions”. A reminder that these CPD meetings take place on the last Wednesday of every month at Audacia Manor, Durban from 17:30-18:30 and all DPPG and PsySSA KZN members are invited to attend.