Special Hearings — Mental Health Workshop — UNKNOWN

PARTICIPANT: I think he knows about it, he was part and parcel of the planning. Look, sorry if I'm inferring something. It is, I said it also and Professor Nel was here, I wanted to sort of, I realised what he said. He talked about problems of living you know. And I was quite a bit worried that in South Africa psychiatry is sort of realised as that area of mad people. I really, when I talk about myself to the community I don't say: "I'm the doctor of mad people." I talk about the doctor of people who have psychological problems and also psychological illness, that's where madness comes in, where there's illness and disorder. But there are also problems (...indistinct) and that is an extreme. So that actually it is quite sad that we look at it that way. And I was wanting to join Nel only where we are looking at your so-called, in my language they are called health centres. Where you have a multi-disciplinary, ja conglomerate you know. From what he in his paper called the stuffing. He said it should include social workers, psychologists, occupational therapists and vocational guidance and rehabilitation workers, youth workers, specialists in treating women. Where are psychiatrists in all that? They belong there too. You understand.

PARTICIPANT: (...indistinct) doctors.

PARTICIPANT: Ja as doctors, Actually where are doctors in all this? And I really do not, not want it to be separated in that sense. I rather let's look for the primary health care model. And I do not see how anyone is going to tell the ministry of health and the ministry of welfare good-bye and change or we descend. Rather I should think we should work for conjoining the two ministries. I think that is a most workable option of today actually. It is such a sad thing to see welfare there and health there. In all progress of societies they are part and parcel of one thing. So that your human resources unit should be part of that. It can be added to that and it would be sort of a specialisation in that. But let it not be a branch out. And I remember Tim Wilson, Dr. Tim Wilson in the steering committee of last June, he was worried of creation of this new other structures. We know that we have to deal with the legacy of Apartheid for Christ sakes, that's why I talked of also the pilot work in the two areas in the Vaal and the East Rand. But we know we have to deal with all these people you have seen all this sufferings that are going on. And we know it cannot be dealt with by just welfare and health alone. We need this other space that Professor Nel is trying to create. But let it be part and parcel of the whole or let it be an improvement or should it be revolutionary. I'm getting a little bit worried there that it is, it is been dragged out and made a different thing of itself.

PARTICIPANT: Can we get other views? I mean people are, it's a proposal, it's on the table. People are free to air their views around this?

LIONEL: While Victor Nel's rationale was given as background within the committee, his proposal wasn't accepted. That, that was in fact, what I tried to do as facilitator is to, to try and get people narrowly to focus on what policy recommendations we could make. And I might want to say that we may try to follow the same method here because we really interested in the end to see are there specific policy issues that we can put before government and the public? What we did focus on is that health and naming has had particular power that will continue to exist unless we don't creatively think about naming and how it maintains and entrenches power relations that have existed in the past.  We've also concluded that the hierarchical nature of health and mental health is very clear and
(END OF TAPE 2, SIDE A)
 So our policy proposal in the end under whatever, and I'm not going to go into what Victor was correct about or not, has got to do very specific (...indistinct) that we need to look at naming. That we're not going to automatically through our proposals change whole ministries and whole departments. And that we need to specifically for example look at the Mental Health Act which has apparently not changed much yet. It's only a bill, it's under review. And that we should specifically, in terms of policy look at what we want to put in there. We not going to get all of that out here but that should be, you know fledged out later and specifically in relation to that. 
 So I don't think we're going to come to consensus here where it's suddenly going to be named one thing or another thing but naming has been very important and we should give attention to it.

PARTICIPANT: That, I should think that helps us to focus a bit. Would you like to air your views around what Lionel has just said? Are you referring to the naming of problems that people present this or the body that will look after that?

LIONEL: The issue with health is that, that, that is where the power was entrenched and in the past few years has been continued to be entrenched and it looks like that would be future as well. In looking at what things are named and how people work together and how hierarchies are established, our recommendation is really that in changing some of those names and in flattening out and levelling out those hierarchies that we may end up providing much better services. That's not skewed only in one direction but it allows the whole spectrum of services in an equal way that patients and clients might need. That's really the focus.

PARTICIPANT: I should think it will help if around this issue we tried to limit ourselves to those two points maybe. And see what sort of suggestions can be put forward which later on we can formulate towards proposals and recommendations. (

WHISPERING: )
Any other views on these two points? Naming and the review of the Mental Health Act. Still under issues emanating from group 1. I mean for now it's like the whole issue which we started debating we'll leave at those two. That really what's important to examine is the naming of what we deal with and the body which will look after those people and how we impact on the Mental Health Act. Maybe people need to be familiar with what was, were critical articles of the previous act which lead to the status of psychology in particular. It's not psychology, the whole field of mental health not given, not getting the equal status with that of other health professionals, especially medical doctors. So it's like those are two central issues. Yes (...indistinct)?