Psychiatric patients have long been neglected by the health system and hidden from the public eye. Recently, a commission of enquiry heard evidence of gross abuse — including sexual and physical — of psychiatric patients by staff at Townhill Hospital in PieterÂÂmaritzburg. The government has made significant efforts to improve the psychiatric wards over the past decade, but the main refrain remains acute staff shortages.
In an effort to reintegrate psychiatric patients in communities and cut costs, the government has embarked on a programme of ”deinstitutionalisation”: sending stable psychiatric patients back to their families. But, in many cases, the policy has backfired. Families cannot cope. Many patients stop taking their medication and end up being hospitalised.
In another policy change aimed at keeping patients out of long-term care, hospitals are obliged to keep psychiatric patients in short-stay wards to see whether they can stabilise them rather than sending them to psychiatric hospitals. But many health workers do not know how to treat these patients.
At the otherwise well-run Kimberley Hospital, a psychiatric patient was physically abused by a nurse in front of me and it was treated as a laughing matter by staff. The patient, a known psychiatric case who had become psychotic, woke up from a bad dream and bolted out of the hospital. After a long chase, security guards caught up with him and dragged him back like a criminal.
The sister in charge of the ward ordered the security guards to put him in a small lock-up room, then she borrowed a baton from one of the guards. She went into the room, poured out a torrent of abuse and, every few seconds, the sound of the baton being brought down and the groans of the patient could be heard. After about five minutes the sister came out, sweating and heaving with exertion. The guards and nurses laughed, the sister moved back to her station, and no one even thought to look in on the patient.
Prejudice against psychiatric patients, most of whom cannot report abuse, is ingrained and will take years to eradicate.