Institutional victimisation in post-apartheid South Africa

Abstract

Objective. Institutionalisation of psychiatric patients was a prevalent treatment approach in the apartheid era of South Africa. Allegations of patient victimisation in the form of violence and abuse arose frequently during that time. From 1994 the process of democratisation introduced a strong human rights ethos. The post-apartheid Department of Health prioritised improvements in mental health care by recommending, inter alia, deinstitutionalisation and reintegration of patients into the community. Ten years later these interventions have proved difficult to institute and many patients are still hospitalised. The present study investigated whether currently hospitalised patients continue to experience violence and abuse. Method. This was an exploratory naturalistic study in which both qualitative and quantitative data were collected by means of a questionnaire and individual interviews. Results. Of the 127 patients who completed the study, more than 50% reported experiences of abuse. The main perpetrators were other patients, although violence on the part of staff was reported. Almost 44% of patients were frightened to stay in the hospital for treatment. Conclusion. A balance is needed between provision of care and protection from danger, and respect for the individual liberty of those suffering from serious mental illness in our society.