SA: Hope Papo: Address by Gauteng Health MEC, during the commemoration of World Mental Health Day, Gauteng (10/10/2013)

10th October 2013

Your Worship, the Mayor of Mogale City, Councilor Calvin Seerane;
Member of the Mayoral Committee for Health in Mogale City, Clr E Mathe;
Members of the Mental Health Review Board;
Ladies and gentlemen.

The ANC government has always maintained that people with mental health problems have a right to a place in society, and a right to education, training, work and social inclusion. We acknowledge that we still live in a society where ignorance about mental disabilities results in unfair discrimination.

We have to break through the barriers of ignorance, prejudice and discrimination that are still present when we discuss issues related to mental health. I believe that we are beginning to fully understand the psychological consequences of various social and personal disruptions that are prevalent in our society.

Here in Gauteng we have to deal with victims of untold misery that resulted from violence which characterised our transition to democracy as well as victims of women and child abuse and other social ills. Quite often the psychological consequences of these traumatic experiences are far worse than the physical ones.

Research here in South Africa and elsewhere indicates that one in five people presenting themselves for general health care require Mental Health assistance. However, the negative social stigma that is associated with Mental Health problems contributes to people not acknowledging that they have such problems.

That is why we have stepped up our efforts to equip our health care workers to become sensitive to patients who present themselves with Mental Health problems in order to provide appropriate care.

People with mental health problems are excluded from the main stream of society and experience difficulty in accessing fundamental social, political and economic rights.

This is even worse among the aged. Mental health problems are not a normal aspect of aging. Most older people do not develop mental health problems, however old age do pre-dispose some of them to mental illness.

Older people face special health challenges which find expression in being unable to live independently due to limited mobility, frailty or other physical or mental health problems thus requiring some form of long-term care.

Mental health problems among the elderly are under-identified by health care professionals and older people themselves. The elderly in turn, are often reluctant to seek appropriate care. A myriad of social, demographic, psychological, and biological factors contribute to a person’s mental health status.

Factors such as poverty, social isolation, loss of independence, loneliness and losses of different kinds, can affect mental health and general health. Difficulty in coping with bereavement can affect one’s emotional well-being and can result in poorer mental health.

The elderly are sometimes exposed to maltreatment at home and in care institutions. On the other hand, social support and family interactions can boost the dignity of the elderly.

The World Health Organisation has identified the following as the common mental disorders that affect older adults worldwide: depression, Alzheimer’s disease, dementia, anxiety and late-life schizophrenia (World Health Organisation, 2002).

These conditions can and do cause severe impairments in the daily routines of older persons, influence their ability to maintain personal care, housework, social activity and ultimately well-being and can even lead to death.

Too often, however, these and other mental conditions affecting the elderly are undiagnosed, treated inappropriately or not treated at all (World Health Organisation 2001; World Health Organisation 2002). It is therefore important that we familiarise ourselves with common mental health conditions which afflict the elderly.

This will assist us in making informed decisions regarding appropriate referral of our loved one’s in case they need specialist treatment. We have decided to encourage establishment of Non Governmental Organisations which collaborate with us in re-integrating people with mental disabilities into the mainstream of society.

By integrating Mental Health Care programmes into Primary Health Care, we want to ensure that patients receive care next to where they live. As government we are trying to move away from confining people to institutions as this does not contribute to their rehabilitation.

Program Director,

The physical, emotional and mental scars that we carry from the conflict of our past have also resulted in the increase in the incidence of mental illness.

The West Rand district has also not escaped this scourge. As most of you will remember, in the Eighties and early Nineties, townships such as Kagiso were in the forefront of the struggle against apartheid. The apartheid army and the police were deployed to crush the popular revolt that ultimately led to our liberation as a country.

In the process of crushing that popular revolt, a number of our people were traumatised. The violence that was unleashed in this area against our people in the early 1990’s further dehumanised them. Parents who lost their children and loved ones were never afforded the luxury of bereavement counselling. All of these were catalysts to the mental scars that were inflicted on our people.

The subsequent decline of the mining sector in the West Rand resulting in job losses further contributed to the mental anguish that was visited upon the people of this district. Even school leavers had diminished prospects of employment.

The picture I have just painted, partly explains the current mental health status of some of our people in the district.

According to available statistics, there were 32 860 visits to our clinics seeking Mental Health Care services in the 2012/13 financial year in the West Rand District. This amounted to an average of 2 738 visits per month.

We have eight Adult Mental Health Specialist clinics and five Child and Adolescent clinics in West Rand where complicated Mental Health cases are seen. Uncomplicated cases are seen in all clinics.

From the figures I have just mentioned, it is clear that we need to pay closer attention to the mental well-being of our people. Surely, this is a challenge not only for government, but for society as a whole.

As government we have embarked on programmes to address mental health conditions. These include empowerment programmes ongoing on management of day to day crisis. Early identification and diagnosis contributes to successful management of mental illness.

We also encourage the elderly to engage in physical activity, to maintain social connections, eat and live healthily, and refrain from harmful use of alcohol. Programmes such as active aging also contribute to successful management of mental health illness among the elderly.

Active aging programmes assist in effective and efficient management of physical problems such as the control of blood pressure, blood sugar and cholesterol levels.

We will therefore intensify our programs which are aimed at identifying and treating mental illness among the elderly as early as possible. We will involve communities and families in supporting of older persons suffering from mental illness.

As communities we need to fight against the ill-treatment of the elderly adults which stems “ageist” attitudes by inviting the full participation of older adults into everyday life.

We will continue to raise awareness about depression and anxiety among the elderly including its contributory factors and where to obtain further information and treatment using relevant media. We will intensify screening and treatment of depression among the elderly.

The elderly are our treasure, any society is judged by how it treats its elderly citizens and the ANC government continues to treat them as reservoirs of wisdom and knowledge.

The message from the ANC government regarding Mental Health Care is very clear: