Detention of mentally ill in jail ‘illegal and inhumane’

2010-09-05 11:22

Detaining state patients in prison while they await placement in a proper ­psychiatric hospital contravenes the Mental Health Care Act of 2002, the Criminal Procedure Act, the Constitution, the ­Patients’ Rights Charter and all the principles of government’s Batho Pele initiative.

Last year the National Prosecuting Authority warned the health department that keeping patients in prison is not humane and “may lead to huge claims against the state and more ­specifically the department”.

Judge Hennie Lacock of the Northern Cape High Court visits provincial prisons yearly and says the correctional services department cannot be expected to solve this problem.

“They’re always saddled with problems other departments can’t solve, but they don’t have the capacity to deal with psychiatric patients.”

In one prison Lacock saw two ill psychiatric patients cuffed to their beds.

To try and meet the requirements of the Mental Health Care Act, psychiatrists?– with the backing of Lacock, who threatened a court order if progress was not made?– convinced correctional services to declare a wing of Kimberley Prison a ward of the existing West End Psychiatric Hospital. They want state patients to be transferred there from other prisons in the province.

Psychiatrist Dr Zygmunt Piotrowski says the temporary measure has allowed about 14 state patients who are stable on treatment to begin the journey towards reintegration into society.

They start by leaving the hospital for weekends, then longer, until they can be granted a six-month leave of absence and, ultimately, conditional discharge.

While West End in theory has 107 beds, personnel constraints and poor maintenance mean they only manage about 85 patients.

When building on a long-awaited new hospital came to a halt, the health ­department renovated a ward for state ­patients at West End at a cost of ­
R11?million.

A doctor, who wishes to remain anonymous, says the upgrade was wasteful and inappropriate.

The ward has a normal ceiling that patients could ­escape through.

There is underfloor heating which doesn’t work, expensive orthopaedic beds with adjustable bases, slippery floor tiles that will need to be replaced or modified and an expensive close­circuit camera system without enough staff to monitor it.

It has now been decided another old ward will be more suitably renovated for 12 state patients.

The health department has overspent parts of its budget, while under-spending on district health services?– which includes mental healthcare at primary clinics?– by R25?million as well as a R72-million underspend on health facilities management in the 2009/10 ­financial year.

Despite a staff shortage, 41% of the posts in the department are vacant.

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