Special Hearings — Mental Health Workshop — UNKNOWN

PAUSE: ) Okay. We took very seriously the point that Wendy made validly this morning that your investigation team is overwhelmed with things they absolutely have to investigate and cannot not investigate. But our concern is both that the TRC has unique powers that's it likely no other body will ever have in terms of search and seizure and subpoena to get documentation. And that in many relevant areas including the whole of the mental health and human rights field, documentation that is very relevant has already been shredded, is today being shredded and will tomorrow be shredded. And we're suggesting that it should be looked at seriously by your investigations division, whether in areas where there have been complaints about institutions or specific parties. Whether you shouldn't use your powers to seize documentation and have copies of it at least placed in archives so that they will be accessible for other investigators who will come on after the TRC. Because if not, the likelihood is that any other mechanisms you set up to succeed yourselves (a): won't have the power to get access to that sort of documentation or (b): when they get there the cupboard will be bare and the shelves will be empty. Thank you.

PARTICIPANT: Okay. Then let's structure a discussion. Maybe we start off with, ja okay. Wendy is already determining as to where, at what time should this process end. But let's look at a main proposal from group 1 really. What they struggled with, where do we locate, where do we locate our concerns? When we started we said we deal with people really who are survivors of human rights violations, who have appeared before us with what, emotional pain and suffering. So because we should always go back, I know we will take this thing back to our context at the end of the day. And they have looked at, the proposal that they looked at, there was this suggestion of a Department of Human Service which will get rid of Welfare and have a multi-professional health and guidance centres. That was the amended proposal.
 And issues which fall under classical psychiatry will remain in the Department of Health with psychiatric hospitals, if they're still in existence and hospital care remaining under the Department of Health. But most conflicts in living will need to be looked at under a human service department. That's one part of the proposal. And that will impact on a Mental Health Act, the future one.

MR GREY: Can I just say, is it a Department of Human Sciences?

PARTICIPANT: Services.

MR GREY: Services okay. I mean I'm thinking of a rose by any other name. Could somebody articulate what it would be that would be so different about, I mean amalgamating? I mean what's the end point? What is it, where is the suggestion coming from? So that what can happen? So we change the name but then what?

PARTICIPANT: Maybe somebody who was in group 1 an explain the rationale, where does it come from as it was explained by Victor Nel?

PARTICIPANT: What they said, there is a, there are people who don't have psychiatric syndrome, who have got psychological problems. So that do not need to go to, you know to be viewed as people who really are mad. These people have got the psychological problems that have not been resolved. So the approach of the service will be more centred towards the psychological problem than being deep=seated psychiatric syndrome. I think that was part of the rationale. My concern with that proposal was that if we are looking at creating that service how long will it take and how long more can these people wait and what are the time frames that we can at least implement this? And we also talk about the pilot study to look at the areas where really there are victims and so on. Where we could start.
DR. ORR: I'm going to try and summarise from what Victor Nel said and I'm not sure myself yet if I agree with everything he said. It's a new concept for me and I would have to think through it. There are a number of motivations for creating a Department of Human Services. I think one of the issues which Professor Nel was very concerned about is that the Department of Health at the moment has control over all the professions and this control is exercised largely through the South African Medical and Dental Council. There is a separate professional board for nurses. But otherwise the SAMDC controls all health services. And he finds it very problematic that the scope of the profession of psychology is determined in effect by the medical profession. And that's not, not the way it should be.
 There are no public low cost psychology services in South Africa, particularly in rural areas and this is a huge gap in the provision of services. And even in tertiary hospitals psychologists are few and far between. It's very difficult to render appropriate mental health services in a medical setting and he quoted the U.S. model which I think has been referred to previously in the workshop, of the U.S. Department of Health and Human Services which provides comprehensive care, which includes health care but also looks at issues of welfare, of socio-economic well-being, of housing. In other words all the kinds of services that one needs in order to live as a dignified human being. And I think that was the rationale behind it. Is let's be comprehensive and holistic rather than splitting people up into little bits and pieces which are looked after by different ministries.

PARTICIPANT: Thank you very much. I should think that's background, it's helpful. Because if you come up with a recommendation having not identified problems and concerns with the previous arrangement it's easy to dismiss it. Thank you Wendy. Michael and then Zanele.

MR GREY: Maybe I'm missing something but I don't quite understand the special status of Victor Nel as a briefly visiting guru to our process. But his proposal as articulated is so full of massive factual errors that I think it would be grotesquely irresponsible of us to support it in any way. Having worked, I don't know about his background, but having worked in the Americas during my years in exile under the Health and Human Services Division I think you'd be hard found, hard pressed to find any expert, let alone any patient or any client in America who feels that the existence of a governmental Department of Health and Human Services has solved any of the problems that he articulates. Or has provided in any way more articulate or more holistic sense of care to people or a better sense of well-being. There is an overall government department with that name but in fact whatever point of access people have still comes under separate divisions. There's still the interprofessional problems of who controls what. None of those problems have been solved where the model he's proposing has been attempted. And his, even his understanding of the structure of the Medical and Dental Council and Professional Board for Psychology seems to be strangely unrelated to facts. So I strongly oppose our support for that. The proposal should be articulated like anybody elses on the free market with whatever factual background, whatever references, whatever arguments there are and should be examined in the broad intellectual and social commerce and not be given any special status.

PARTICIPANT: (...indistinct) is another trouble maker. Okay.

PARTICIPANT: I think (...indistinct)

PARTICIPANT: Wait for the microphone.

PARTICIPANT: Ja wait, wait.

PARTICIPANT: Ja I think (...intervention)

PARTICIPANT: Sorry Zanele, since we are discussing a proposal Wendy has just given a motivation for her proposal which was made around why we should look at a possibility of having a Human Service, Health and Human Service Department. (...intervention)