I’ve read about the mental healthcare systems abroad, some of the “things” that are available (like therapy) and thought a lot about ours. I’m not suggesting that things are rosy everywhere else, but merely to reflect on the system we have here. I live in South Africa and most of the laws and policies here are like Nelson Mandela authored. We put the D in democracy and the humane into human rights, thereotically. In practice, it doesn’t work that way.
For example, I once “trained” a group of women in a rural area in our country on the beautiful domestic violence act we have. Thereotically the police can intervene, you can obtain a protection order, and again thereotically, be protected. In your home. In your house with your children. They listened, dilligently took notes and smiled when I paused. When I found their silence too much I asked why they weren’t talking / participating. One of the older women stood up and said: “The closest police station is at least 300 km away for most of us. The court is even further. And you’d be lucky if they serviced you on the same day, IF you have transport money to spare / get there. We have our own act. If your partner is threatening violence, we hang a certain item of clothing on the line, which means I need help. The woman who sees it alerts others in the street, and we all come for “tea”. We stay there, with endless conversation, until the situation is diffused. Sometimes it works and sometimes it doesn’t. But that’s what really helps us”.
I kept quiet. I was humbled by what these women went through and how they tried to help each other. But that didn’t mean that they shouldn’t be helped more, and that resources and attention shouldn’t immediately be directed to make their lives better. In the context of mental healthcare things are even more ominous. There are people with chronic mental illness who died because they were dehydrated. Yes, there were other factors, but dehydration? Not being fed? If I consider what it’s like to have mental illness and to die for these or ANY reasons just isn’t ok. No matter how we try to dissect it. If you don’t have the money for private health care (it cost me about 800 US Dollars for myself and my children on private medical aid per month) you will find that there aren’t any services that are responsive enough to cater for people with mental illness, no matter how ill they are.
For example, you can’t get into a psychiatric ward without being suicidal. This based on my own and other people’s experience has meant that you need to have tried to commit suicide and required immediate hospitalisation / care. Not if you were intending to. No, preventative is nice. We don’t (although there are a few attempts) have a sufficient suicide call in number for people who feel suicidal, or their families who are a concerned. And I will not go onto describe the ambulance service, which as the rural women teacher taught me, is just not realistic in some parts of our country. There are frequent drug stockouts, a lack of psychiatrists in the public health system and therapy is a luxury.
I have to face the reality of this system now. I was retrenched and do not have the resources for private healthcare. My psychiatrist costs $150 per session, my therapist $80 and private psychiatric hospitals (which are funnily still like jails) are thousands and thousands. The implementation of our far-reaching mental healthcare act, like the domestic violence act is failing the people who it was designed to poetically protect. And most people with mental illness do not in our country, have communities of support where they can hang the “I need help underpants” on the line. We need to draw attention to the state of the system (or perhaps the lack of it), the way people with mental illness are treated and the services they are subjected to, and the not so silent genocide of people with mental illness in our country. I intend to. Be part of those who support us as opposed to those who don’t. I am 4 M’s Bipolar Mom.