Special Hearings — Mental Health Workshop — 1997-11-20

CHAIRPERSON: Thank you Professor Cooper.  Thank you for that and also for the personal angle, because I think really I mean it isn't the usual hearing this, and it is nice to get more anecdotal material.  It is all being recorded.
 Can I bring you back to the legislative part of it?  You mentioned the Mental Health Act and that it is being considered.  Could you perhaps say a  little bit more about what the, where it is at at the moment, your thoughts about the actual sort of philosophical strand overhead as it stands at the moment, and where it needs to be changed?

UNKNOWN: The Chairman, of this Commission was the Chief Director of Mental Health and (indistinct) and abuse, and she will know that when you are in such office, what happens is that you get put into a situation where you have to carry a lot of bureaucratees.  There is almost an environmental push to get certain existing things sorted out, without consideration of the greater vision.
 And I think that the current encumbrance are actually trying to grapple with that mix.  There is Melvin Freedman and there is Dr, who was previously at UDW, Ugan Pillay, who are in that division and are trying to get better legislation, but I think the philosophical basis of it should be our society has been a peculiarly disturbed one, given its abnormalcy.
 Our Mental Health Act ought to be predicated on that abnormalcy.  It is not denying that we ought to make the apartheid base a precept, a key precept of well-beingness and that that Act ought to become rather than merely a reactive enablement for people, suffering mental distress and discomfort and serious illness, ought to be a proactive one towards creating a well-beingness, towards creating psyco-sosio oneness, equity, the intent of this Act under which the Commission is operating, so that we truly can integrate Mental Health into positive ways rather than just simply labelling them as we have done in the past.
 So I think that that vision ought to be there, and the Commission would do well if it can impact on that legislative process, otherwise you can get State Attorneys who simply do (indistinct), alteration of Acts and try to bring them in line with the new constitution and new dispensation, but it is really the old functionalism in a new order, and will we not then be perpetuating a reactive process, rather than create a very proactive stance saying well-being is paramount and how do we look at the different elements of assisting create that well-being.
 Yes, being reactive, providing tertiary but providing secondary and very importantly providing that primary preventative approach to Mental Health, and that means dealing with the issues arising out of race.  In our society, right now, even though apartheid does not exist, it exists deeply etched in our individual and collective psyches.
 When we look at each other, we say well, that darkie, that whitie, and we are in two's about how good we are, what a great man Mandela is, but in our heart of hearts, we believe that actually kaffirs shouldn't be ruling.
 How do we attend to that type of aspect in our society? I am talking about a deeply engrained racism which if we continue to gloss over, we will be creating future nightmares for our children to confront.
 Let the nightmare of the past be one that we at this time, hopefully in our maturity, come to terms with.  All those things, I believe, ought to be informing that Mental Health legislation.

CHAIRPERSON: Thank you.  Can I maybe put it to the panel if they would like to ask Dr Cooper any more questions?

GLENDA WILDSCHUT: Although my name is here, I will say my name first as instructed by the Chairperson, Glenda Wildschut speaking.  I wondered whether you have any comments on whether in the legislation, we should be considering (indistinct) more specifically, I know legislation is often more broadly written, so that people have some interpretation into the legislation, but we have had quite a lot of difficulty in the past with that legislation being interpreted in a very narrow medical model and should we not consider something in the legislation which would help us to include other treatment modalities in Mental Health care?

UNKNOWN: I think Glenda, that is very pertinent to what I am sure many of my colleagues, as I see them here, I see Dr Baqwa, I see the other colleagues in front here.  I think that we and I am not excluding the other people, it is just because my line of sight is there, I think that it is important to include or make some sort of a preambilatory statement about utilising the richness of our cultural variables in society.
 Because sometimes, and this is a debate that some of my colleagues know during the post-detention sort of interventions, sometimes, it may not be one on one, once a week intervention for years on end, that is going to work.  It may be actually helping the person to connect with a few other people, doing some group work, or doing some community rehabilitative stuff where they can interact with others who have gone through the process and have come out more whole, that those types of modalities may be more important than doing text book one on one, classical western interventions, which actually are going to be very, very costly and you are going to then find you are creating like we have created fantastic jobs for lawyers in our new society, we are going to be creating fantastic jobs for psychologists, psychiatrists, psychiatric social workers and so on.
 I think the sooner we can put that in a sense down, away from those elites to community based interventions, so that if there is a serious community based intervention preference will be given to that, rather than keeping me in money and paying me to provide that service which is going to be too expensive and there are not enough psychologists as you know, and psychiatrists certainly, to go around to help.
 So I would say the more community based there are and the more they have related to doing other things, getting on with your life like the stuff that I am sure, my colleagues, particularly Professor Seedat will address and the work they had been doing, in treating people like ordinary human beings, letting them get on with their lives rather than treating them as a special case that always needs to be continued with that umbra of this person is unwell, this person will continue being under the pall of receiving some tertiary intervention.
 So I think community intervention is very important.

UNKNOWN: Just one question, because to me knowledge is the gist of everything, including intervention and whatever functionaries we have to do as Mental Health profession.  How do you think the Acts can facilitate the issues of creation of knowledge and the acquisition of knowledge or ownership of knowledge that integrates the cultural knowledge, the experiences which people have said in the field, as well as the social aspects.  What I am trying to say here is that at the moment, we talk again and again about the fact of how we have used the knowledge, that is foreign to our practices as a guideline for what we are doing but I think we haven't done very much in terms of how can we facilitate the process of we as people, I shouldn't be saying as blacks, but everybody else who have had enough experience in the field, including the traditional healers, how can we facilitate a process where we can have, create our own knowledge, the knowledge that we can own and recognise and that will guide us in our operation?