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

CHAIRPERSON: Sorry Doctor, sorry Doctor.

UNKNOWN: The lack of resources and the almost complete absence of any psychological services for such individuals means that the frustration and inability to deal with traumatic events, leads to acting out in the form of spouse and child abuse as well as substance abuse.  The cycle of violence continues.
 In a chilling statement, around the issue of AIDS in KwaZulu Natal among a segment of youth in the townships, a chilling statement is infect one, infect all which essentially says and let me preface this with the explanations given for the cohesiveness and the togetherness of youth, is that in the struggle, in the time of the struggle, they bonded.  They work together, they supported each other, they looked after each other.  That bond still exists.
 Now, what has happened, is that AIDS has presented itself and in the context of that particular event, they have recognised for themselves that there is little hope for them.  These individuals have now embarked on a cycle of self-destructive behaviour.  They don't want to have any tests done on them that would reflect whether they are AIDS positive or not.  They recognise that sexual conduct or sexual behaviour is closely linked with interpersonal violence, the use of safety measures is often issues around the demands of the male over the female, which often results in violence.
 So both males and females recognise that they are trapped in the situation and that they will live life for the day.  I am not going to give a lengthy submission of this, I will in the report that I submit to you,  that the effects of the apartheid system are I think only, my view is that we are only beginning to understand the sort of deep-seated effects of this.
 Not only among people, older individuals, but among the youth.  The premise for the existence of OASSA was that the State was neglectful at deliberately destructive with regard to the mental health of its citizens.  The New South Africa has not changed reality for most South Africans, and especially those in KwaZulu Natal with political conflict is still ongoing.
 Shobashobane and Richmond are points in example.  If mental health workers are to break the cycle of violence, which is now feeding on itself and it can no longer ignore, desperate need for mental health service is part of a primary health care model.
 The need for training institutions to examine the relationship to broader context, especially with reference to an African character was recognised as early as in 1986 at that first OASSA conference.
 Training student nurses, students, nurses and volunteers as lay counsellors and Sats has already mentioned the model that SAISA is adopting and pursuing, is a useful and important first step in helping to break the cycle of violence because my submission earlier on was that if one does not provide services, especially to these individuals where nothing really exists, the cycle of violence continues.  It simply reproduces itself in different forms and it may not be called political any more, but the violence continues.
 Trauma counselling skills can and should become part of the training of primary health care personnel.  Systematic efforts that bring together the training programmes of health departments, community organisations, including churches and various NGO's involved in doing trauma counselling, should be prioritised as a major mental health initiative.
 Whereas previously the State and progressive organisations were in opposition to each other, the need is for new partnerships between these two sectors.  The need is greater in fact, than ever.
 The Department of Health Education and Welfare should strife to promote delivery of services through partnerships with those community organisations, NGO's, etc rather than attempt to say we will provide mental health services to all.  It is not going to happen.
 Professional associations such as SAISA as I pointed out earlier, promoting the broadening the (indistinct) such as lay counsellors in various areas, is vital to creating a humanitarian psychology, and must be applauded.
 Prevention programmes that focus on developing viable conflict reduction models within our schools, should be seriously considered as part of an Education curriculum.  If you talk to youth today, the solution to any problem is to fight or engage in some form of behaviour that leads to injury of another person.
 It is almost an automatic response.  NGO's such as a Trauma Counselling network that is active in Port Shepstone on the south coast of KwaZulu Natal, play a vital role in service delivery.  They are in fact the only ones who train individuals around trauma counselling.
 Currently various models are available to make this a workable prospect and I will present a separate submission where these models are provided.  It is not for me to go into them here.
 What I would like to say in conclusion merely is that the State needs to enter into partnership with such NGO's to provide training that is relevant to the needs of particular communities.  It should not rely or even expect the formalised health sector to be able to meet the needs of survivors of violence.
 I would stop there.

CHAIRPERSON: Thank you for saying what you did, not stopping.   I've got a question before I put it to the panel.
 We put your submission underneath a section of contributions of progressive organisations.  I know in such short notice, you had to do a broad, but I am curious.  Are we saying that progressive thinking or organisations or - have sort of somewhat been diluted since?

UNKNOWN: In terms of the way in which OASSA operated, or even NAMDA for example, the single minded focus that they have because there was a common enemy, the differences could be simply ignored and work towards a common goal, was often something that motivated many people.
 What has happened since is that in the (indistinct) between the transition and a transformations that are taking place, defining roles, relationships, where people fit etc, has not occurred in a very smooth way.  Which is with hindsight, to be expected.
 In addition, individuals have, some individuals and a lot of those individuals have experienced burnout and have said I want time for myself, etc and have gone off to do things which they have felt they have neglected in all this time.
 Many of these individuals have also joined the government, so their world continues, but no longer as this easily identifiable common united force for social change and I think to some extent that role is slowly being picked up by the NGO's, etc, and they should be fully supported because I think it is important for those sectors to be the conscience of the State to point out the inadequacies, to point out the need for services etc, and where they should be delivered etc.
 Because they are closer to the people and their needs than any State department, health department, any education department, etc.  I think that is where the shift is occurring.

CHAIRPERSON: Do you think there is a racial split in terms of progressive thinking about psychology or I mean, is there a split within psychology, different schools, essentially Afrikaans schools or I am spreading them, I am polarising them, but I mean is there a black culture of psychology developing and the white, is it integrated?  Can you fill me in?