According to a 2007 WHO report, there was no official mental health policy present in South Africa at the time at all. Upon reading this, I became curious as to how the situation has evolved since then; what help is out there for South African people struggling with mental illness? What have President Cyril Ramaphosa and other government officials been doing to help the situation? And what, specifically, needs to be done?
In light of those questions, I began reaching out to mental health organisations in South Africa, and was pleasantly surprised to come across a number of them, including ‘Global Mental Health Peer Network’ (GMHPN) and the ‘South African Federation for Mental Health’ (SAFMH). In this article, I interview the CEO of GMHPN, Charlene Sunkel, as well as Masutane Modjadji, project leader for SAFMH.
Charlene Sunkel, Founder/CEO of Global Mental Health Peer Network (GMHPN)
Charlene was diagnosed with paranoid schizophrenia in 1991 and her journey since then has exposed her to the challenges experienced by persons with mental disorders within and outside of the mental health sector. This encouraged her to commit herself to fighting the cause for mental health and human rights. In 2003, she became involved in volunteer work in the field of mental health, and in 2006 accepted a position in mental health advocacy and awareness with a Gauteng provincially based organisation. In 2014 she joined a national mental health organisation in South Africa as Program Manager for Advocacy and Development until 2018.
In 2018 she established the Global Mental Health Peer Network, where she commenced her position as Founder/CEO in January 2019. The GMHPN embarked on a quest, through its “Our Global Voice” Project, to discover perspectives from persons with lived experience around receiving a diagnosis.
Masutane Modjadji, Project Leader for South African Federation for Mental Health (SAFMH)
Masutane Modjaji is the OurHealth Project Manager for Health-e News, South Africa, responsible for Health-e News’ team of citizen journalists. Prior to this, she worked as an editorial and marketing assistant at Africa Check.
Currently, Modjaji works as project leader for information and awareness within SAFMH – the biggest mental health federation in the country which acts as a mental health resource centre – an important lobby group for the government in terms of human rights and mental health policy and legislation.
According to a 2007 WHO report, there was no official mental health policy present in South Africa at the time at all. How have you experienced things evolving since then?
CS: In terms of policy development, South Africa has progressed since then in terms of mental health – the National Mental Health Policy Framework and Strategic Plan 2013-2020 was definitely a positive effort. As often with many policies of this nature, the lack of financial backing to implement a policy, often makes it just print on paper. However, South Africa has made an attempt to accelerate the implementation of this policy through the establishment of the Ministerial Advisory Committee on Mental Health to provide guidance. But unless there are sufficient resource allocation to mental health, the implementation rate will remain slow and some areas unachieved.
MM: The South African government developed, in consultation with organisations such as ourselves, the National Mental Health Policy Framework and Strategic Action Plan 2013-2020, which calls for great reform in the mental health sector in the country. There have however been ongoing concerns about the lack of implementation of this policy. Also, it comes to an end this year and there has been little direction on “what next?” Concerns also exist about where and how mental health will feature in the new NHI framework.
How do you perceive current attitudes in South Africa towards mental health?
CS: After the Life Esidimeni tragedy where 144 people with mental health conditions died as a result of a haphazard attempt by local government to implement deinstitutionalisation, although a terrible tragedy, this scandal highlighted mental health, as it was plastered all over the media. It further exposed the neglected and inadequate mental health system in South Africa but also the lack of accountability.
Stigma broadly, in my experience, has definitely seen a reduction – people have become more at ease to talk about mental health issues and there has been greater recognition of the rights of people with mental health conditions. This positive change I would definitely say has been a result of continuous advocacy and awareness of local NGOs, and exposure and positive reporting of mental health in the media. Off course, there are still stigma in South Africa that continues to impact on many people’s lives – but changing attitudes is a long-term process, and hopefully the reduction trend in stigma will continue.
MM: Mental health is one of the often-neglected areas from a Government perspective and, as already stated, receives a small percentage of the total health budget. There is a need for more streamlining of mental health spending in the public health system as well as the integration of mental health care services in the primary health sector to broaden and increase access to services. We also need more public awareness campaigns around mental health in order to reduce stigma and discrimination.
People with mental health conditions in the country still face stigma including from health facilities that should ideally be places where they received assistance and are treated with dignity. There are also important cultural differences in terms of how things like mental illnesses are understood, meaning that, as a nation, we still have a long way to go to ensure that persons with mental illnesses are understood, respected and supported adequately. This requires constant and ongoing awareness, in an effort to try and ensure that more positive attitudes may be observed across future generations.
If you were able to give President Cyril Ramaphosa any advice for how to better tackle mental health issues in South Africa, what might you suggest?
CS: Establish an independent (from government) lived experience council that comprises of diverse lived experience voices (youth, LGBTQ, women, men, rural/urban communities, older persons, etc) to advise on mental health issues in the country and who monitors and evaluates services. And further, integrate peer support work (peer support specialists) into mental health service delivery – recognise peer support work as a discipline in mental health.
MM: The South African Federation for Mental Health has been calling for more investment in mental health for many years. Earlier this year we wrote a letter to President Cyril Ramaphosa advising him on the importance of investing in mental health. In our letter, we urged President Ramaphosa and the government to make mental health a priority as part of the country’s economic recovery following the COVID-19 lockdown that has impacted on people’s lives. To date, there has been no response.
This week we are entering into a month-long campaign where we will be joining organisations across the globe calling on their governments to invest more into mental health. October is celebrated annually as Mental Health Awareness Month, and this year the theme focuses on calling for greater access and investment into mental health. Our message would be – there is no health without mental health. If you want a healthier, happier and more prosperous future for the country, invest in mental health. Not tomorrow. Today!
If you are interested in learning more about the mental health situation in South Africa, check out the following:
Read the 2007 WHO Mental Health Report: https://www.who.int/mental_health/evidence/south_africa_who_aims_report.pdf
Selected pages from SAFMH’s Information Library: