Cape Town - Questions around regarding mental healthcare access for the poor have come into focus following a court order for Zandile Mafe, the man accused of setting fire to Parliament, to be admitted for a 30-day psychiatric observation.
Ricardo Julian Rossouw, a mental health activist, said disadvantaged people don’t access mental health facilities because they simply don’t have the money.
“Most people have a lack of funds to access private facilities because if you are poor, you would not be able to afford that and the government facilities are often overwhelmed. These people also work low income jobs and so they don’t have the time to access mental health facilities,” said Rossouw.
He added that poverty and mental health difficulties are not mutually exclusive but more focus is needed on recovering from poverty, which he believes is the root cause of mental health conditions.
“There is a high demand for mental health services for people who are living in poverty which is a social condition and is commonly a precursor for poor mental health,” said Rossouw.
The Western Cape Department of Health has said that mental health services are available to all people at no charge.
Spokesperson Maret Lesch said: “We provide mental health care to every person who is in need of it. Our mental health services are free and can be accessed via our primary health-care facilities or clinics. If further care is required upon assessment, the person will be referred.”
The Rehoming Collective founder Carlos Mesquita said while services are free, homeless people have different priorities.
“People living on the street… their priorities are different to other people and survival is key. If I’m living on the street, the priority is to find money to buy food, cigarettes and drugs, not to go to hospital, and so they leave it for much longer than somebody who has the capacity to go to the doctor whenever they have a headache,” Mesquita said.
He said the reason why there are such high numbers of mentally disabled people living on the street is because families have neglected to take care of them.
“Most of the people who are on the street already have disability grants when they are on the street where they are on psychiatric medication because families can’t handle their situation and the cheaper option is to put them in shelters. Our shelters are full of ladies who are on antidepressants that are difficult to handle,” Mesquita said.
He said public health-care facilities are under strain with regards to the mental health services that they provide and homeless people are often sidelined.
“Weekly I get calls from sisters at Valkenberg and other psychiatric institutions that ask me to place patients in our accommodation unit. The hospital only takes extreme cases in their facilities and when it’s just people taking up a bed as far as they are concerned, they put them in shelters. This is the wrong thing because we are not equipped to handle those cases,” Mesquita said.
He added that homeless people rarely get helped at public hospitals.
“Some hospitals have a bad reputation for helping homeless people because they are not treated well there and I do understand where it comes from… it stems from the fact that they get a lot of people on drugs who pose as mentally ill patients, but hospital staff are not very sensitive towards homeless people,” Mesquita said.