Articles

STAIGHT TALK: FOOD IS ALSO ON THE ROAD TO MENTAL HEALTH
STRAI[GH]T TALK (Articles published in Walk my Way)

STRAI[GH]T TALK: WEIGHT GAIN AND ANTIPSYCHOTICS
TRADITIONAL HEALERS IN A MODERN WORLD
STRAIGHT TALK: REALIZE YOUR DISABILITY BY BEING POSITIVE
BRIEF OVERVIEW OF THE REVIEW BOARDS ASSEMBLY AND MENTAL HEALTH MONTH CELEBRATIONS ON 13 JULY 2006

STAIGHT TALK: FOOD IS ALSO ON THE ROAD TO MENTAL HEALTH
BY: JARRET CLARK

We with mental illness are so focused on medication and other material or metaphysical ideas that we ignore the value of sound psychological therapies, support groups and those who represent us, our human rights and policies, research in to our conditions continually and be informed and lastly how food play a role in our mental health. Without these other factors in our management toward better health we are rather lost, for medication can not by itself correct our condition. It also needs an informed and personal effort.

For this edition I want to focus on food, our diet and how does it play a role in our lives. It is a well known fact that some of our medications play a role in our weight gain, become inactive and even in some cases develop diabetes mellitus, otherwise known as diabetes two, which may develop into the more serious diabetes one, if not properly controlled. You just have to search the internet for your condition, take care in obtaining official, legal and medically professional advice when searching for medications relationship in relation to diabetes or other conditions to find out how relevant it could be.

Another good source is to as your medical doctor or professional health care provider about such side effects and relationships with your medication, and to make sure if you have more doubts to have your blood sugar levels evaluated periodically as it can be a life saving exercise as taking your blood pressure.

Besides preventing diabetes, weight gain, hypoglycemia (low blood sugar), Coronary Heart Disease (CHD), Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD), malnourished athletes and physical active people and even being vegetarian can be dangerous without the aid of a qualified and registered dietitian as part of your health or mental health multi disciplinary team.

We should note that there are over 400 000 people according to world statistics with schizophrenia in South Africa and about the same number for Bipolar Disorder, a great number is not even diagnosed and receiving treatment.

 The actual statistic should be higher because of our stressful history and a current demand on society, stressful factors generally triggers these illnesses but is not the cause or origin of them. There are shortages of psychiatrist and psychiatric nurses in South Africa and most of the consumers with chronic illness do not know how to utilize the facilities provided for them, and this will impact on their ability to use this information correctly.

Note that schizoaffective disorder (a combination of schizophrenia and bipolar disorder symptoms), schizotypal personality disorder and schizophreniform disorder have a relation with schizophrenia and sometimes jointly referred to as the schizo-spectrum disorders in an effort to group them, yet each one is specific to their diagnoses and treatment.

Not to mention of the financial status of mental health consumers and mental health ability to cope with dietary needs, for many may qualify for a disability grant (about R820-00 a month) which should also include a bridging facility similarly used for pensions and a program to self-sufficient employment or entrepreneurship to reduce the burden on the state and should not just suddenly fall away.

There is a need to bridge and finance an expectable timeframe and a reducing scale for financial support as mental health recipients do not want to find employment or work in the fear to lose this grant and the time and difficulty to reinstate it, this also influence their ability to afford proper food. Some families jointly live of these grants as they do with state pensions as the sole income, therefore is there a need for employment and better financial control. To provide for better treatment and dietary needs for the intended recipient.

This is why social workers dedicated to mental health are important in a physical and direct involvement to success in mental health and possible cooperation with the multidisciplinary mental health team which should include dietitians.  A bout 25 percent of the USA homeless suffer from metal illness, I can just wonder bout the numbers in South Africa. The following information will reveal how important food is to our mental health.

Another factor of research and food is the role food played a role in the human evolutionary development, not only in our ability to digest food but in the role it played in our brain development, just read the book “The Madness of Adam and Eve (How Schizophrenia Shaped Humanity)”, by Dr. David Horrobin.

I quote Dr. Horrobin in his book on page 268, “However, two fatty acids, both of which were present in the fish oil used in the first study, do have potential effects on the brain. One of these is DHA, which is present in the brain in large amounts and in reduced amounts in both brain and red cells of schizophrenic patients. The other is EPA, which is present in the brain in only very small amounts. However, it also is reduced in red blood cells from schizophrenic patients and is potentially important for a number of reasons. It can give rise to a large number of active cell-signaling molecules. It can reduce the activity of phospholipase A2, the enzyme which is overactive in schizophrenia, and it can regulate the functions of FACL one of the enzymes in the phospholipase cycle which is under active in schizophrenia.”

In his second study Dr. Horrobin said he had an improvement of around 22 percent and it was comparable to what can be achieved in patients by standard anti-schizophrenic drugs, with all their side–effects. I do not know what ratio he used and the grams of fish oil that was used in this second study only that his result that was obtained with 25 percent EPA (Docanol) and little DHA (Kirunal) and there was not much better response as the placebo with the DHA replacing EPA in the same ratio. However with the first study they used a high dosage of 10 grams of fish oil a day but the ratio and quantities of OMEGA 3’s are not listed, only that it produced improvement of around 15 percent in a group of chronic patients resistant to treatment with conventional drugs.

This was my first encounter with OMEGA 3 oils, most people do not realize that there are three main categories of OMEGA 3’s (ALA, DHA and EPA) of which (ALA) is mostly found from cold pressed flax seed (linseed) oil which have little relevance to mental illness. The fish OMEGA 3 oils (DHA and EPA) which make up for the other two types play a major role, especially the EPA type (sometimes refer to as E-EFA).

According to Professor Robin Emsley a psychiatrist from Cape Town, who research the role OMEGA 3 fish oils play a role with mental illness and particularly schizophrenia, revealed that the average therapeutic dose is around 2 grams of (EPA, I believe) OMEGA 3 fish oil for treating people with resistant schizophrenia and it is still under research and not standard practice. Please note that this quantity of OMEGA 3 fish oils is extreme and needs professional medical supervision as well as the support of a dietitian. A person can find good result with rather a much reduced but constant amounts. I have noticed when testing for blood sugar that I bleed more freely and it takes more time to seal.

High concentrations are mostly found in sardines (pilchards), herring, salmon, tuna, up to nearly two grams OMEGA 3 oil to 100 grams of fish. Beware to rather use fish at the bottom of the food chain as those higher may contain substantial amounts of mercury which may harm developing children and expecting mothers. It has now become the modern trend to make OMEGA 3s claims for and on products such as breads, milk and even eggs. However the real quantities are usually rather small in comparison to the mentioned therapeutic dose.

Read the labels on the tins and packaging these days they indicate the OMEGA 3 contend. I was found that OMEGA 3 help with over a wide mental health field from thick blood which can produce blood clots, resistant mental illness in particular schizophrenia to benefiting better behavior in prisoners, it also help against infections.

However avoid mixtures of OMEGA 3 with Omega’s 6 and 9 as these combinations could be harmful without proper guidance from a dietitian and preferably use some vitamin E (the oil-soluble free radical scavenger and anti-oxidant) with a high OMEGA 3 fish oil intake. Our immune cells use essencial fatty acids to make oxygen “bullets” to kill infectious foreign invaders; similar to the anti-oxidant of vitamin C does in our water-soluble system.

Care must be taken with large quantities of OMEGA 3 oils, especially used in conjunction to medication thinning your blood, consult your medical doctor and dietitian always when changing your dietary behavior it may influence your health.
 
I know to add another professional on your list would raise the cost and financial difficulty especially when you are considered disabled, unemployed, on a small disability grant or pension or just provided for by family and friends.

However my experience through reading the Pick ‘n Pay Update Summer 2006 “Health & Nutrition News which I took from my local Pick ‘n Pay Mini Market and with Pick ‘n Pay’s dietitians provided a more cost effective and practical way which I would suggest other large retailers should follow. Pick ‘n Pay not only have the Health Hotline: 0800 11 22 88 or (011) 856 7626 and E-mail: healthholtline@pnp.co.za, which are headed by Juliet Fearnhead a registered dietitian. Pick ‘n Pay currently has shopping tours in a small number of Pick ‘n Pay Hypermarkets over the country.

The two hour tour includes a 15 minute introductory briefing, covering the introduction of Diabetes to people with diabetes or those who look after them, the risk factors, diabetic foods, health claims and the Glycaemic Index (GI) and the accompanied Glycaemic Load (GL). To know more about GI and GL please contact the Glycemic Index Foundation SA (GIFSA) at www.gifoundation.com, you will not only find the South African Glycemic Index & Load Guide, but the bestseller and tasty recipe books for the whole family called Eating for Sustained Energy One and Two as well as Eating Smart and Stay Slim which is also available in Afrikaans.

Other conditions was also part of my tour at the Faerie Glen, Pick ‘n Pay Hypermarket on 8 May at 09H00 that was related to diabetes as I have identified in this article, the introduction by Hildegard Strydom a registered dietitian in Pretoria included covering the topics under six broad groupings: fats/oils/dairy, proteins, carbohydrates, condiments, fruit/vegetables and drinks.

The remaining 105 minutes tour covered, dairy, sugar & sweeteners, fats (including salad dressing), fiber, carbohydrates, fruit & vegetables Alcohol, convenience / instant meals, salt, water, soft drinks, nuts, desserts, legumes (beans, lentils, ect), Meat / poultry / fish.

At the end we all received food hampers in the Pick ‘n Pay Environmental Initiative Green Bag which in my case valued about R 100-00 (including the Green bag) and a qualified dietitian earns about R 200-00 an hour or consultation. My contends was two pamphlets (Healthy Eating Guide “Diabetes” and Healthy Eating Guide “The Glycemic Index of Foods”, 400 gram Nola Yum Yum peanut butter sugar free, 33 gram Trufruit (Apricot),  400 gram tinned Pick ‘n Pay’s Choice “Red Kidney Beans” and “Four Bean Mix”.

It also included a one liter box of First Choice (Skim milk), 500gram box Nola Ouma Sliced Rusk’s, 250 gram Provita Whole-wheat Crisp bread, 500 gram Pick ‘n Pay No Name Elbows (Durum wheat pasta), 500 gram box Bokomo Pronutro (Whole-wheat Original), 1 kilogram packet Tastic Brown Wild rice with split peas, 800 gram Sasko Natures Harvest “Brown Seed Loaf” and lastly one 500 ml Pick ‘n Pay’s Choice Sparkling Bottled water and if you wondered the water had an expiry date of 13/12/2006, not many people know bottled water had an expiry date.

I want to thank every body who made it possible from the dietitians and Mr. Iggi van Rooyen (HOD) and helpful staff of the Faerie Glen, Pick ‘n Pay Hypermarket, I understand they sometimes have two tours during the day for up to eight people per tour and bookings must be arranged through the Pick ‘n Pay Health hotline as provided in this article.

The same accounts for bookings over the country at relevant Pick ‘n Pay Hypermarkets who participate in this program and we valued dearly your effort and cost to run it. I just hope we can include al those with mental illness on such a program with dietary problems, for our numbers are vast, between bipolar and schizophrenia sufferers in South Africa we should number over 800 000 people and of the poor we are usually the poorest because of  our disability and not being treated or diagnosed.

To conclude I want to mentioned to my other mental health consumers that the diet reflecting to diabetes is healthy and appropriate for normal people and we with the aid of our professional medical multi disciplinary team and including a dietitian (which is recognized by most medical aids) can be of a great benefit for us.

I am suffering from paranoid schizophrenia, my inactivity, choice of food, probability of genes, but also the anti psychotic medication to some extent helped my weight gain and onset of diabetes above all the other side effects which mimic diabetes, such as thirst and dry mouth, drowsiness and being tranquilized and Parkinson like shakiness.

With the right treatment my medication was changed as well as my dosage by the psychiatrists, my diabetes blood sugar level are stable as well as my cholesterol al though I take 10 mg Lipitor and my blood pressure is stable as I watched my salt and fat intake. Not all fats are bad for you according to Dr. Udo Erasmus from Canada in his book “Fats that heal fats that kill”. But you are still advised to consult your dietitian and medical professional on this matter as it is still new and uncharted waters.

I quote Dr. Udo Erasmus on the following interesting animal points related to humans during research, “We have witnessed hyperactive, nervous horses calm down by simply correcting their Essencial Fatty Acids (EFA) intake. A horse’s natural diet, grass, contains more OMEGA 3s than OMEGA 6s (ratio is about 60:40), but they usually only get refined, cheap corn oil (ratio of 1:100) rich in OMEGA 6 (About 65 percent of total oil), but lacking OMEGA 3s (Less than 15 percent of total oil).

We have improved behavior in dogs and cats by adjusting their Essential Fatty Acid (EFA) intake to the levels and balances that they might have obtained under ideal conditions in nature. Most commercial pet foods contain no OMEGA 3s.”

(The same apply to modern human foods such as fast foods and very refined foods in their OMEGA 3s contend if taking in account also of fast blood sugar releasing carbohydrates in relation with the Glyceamic Index. Note that even Bipolar disorder, Cyclothymia, Post traumatic tress disorder (PTSD) and Schizoaffective disorder can benefit from OMEGA 3s, not only in relationship with Schizophrenia and stress as mentioned above but also with Depression as mentioned below.)

I quote further, “In animals, essential fatty acids benefit skin, hair (feathers), and nails (hooves) in all species with which we have worked: dogs, cats, horses, tigers, lions, a leopard, a panther, a mountain lion, elephants, wolves, hyenas, monkeys, and birds.

In humans EFAs may prevent leaky gut syndrome and food allergies and lowering high Triglycerides by uptown 65 percent in OMEGA 3s case. They help reduce cravings and addictions to food, cigarettes, alcohol, and drugs. EFAs also elevate mood and can lift depression – a reason why some people overeat. Elevated mood and increased energy levels also make us feel active.

The limits to EFAs, if we take them too close to bed time, we may not be able to sleep because we have too much energy so it is best to take before 8 pm. If we take more than our liver can handle at one time, we may feel full, heavy, or nauseous.

Occasionally someone has allergic response to EFA rich oil and should take it with digestive enzymes. If that does not work another source of EFAs should be found. Allergy to EFA oils is rare, even in allergy-sensitive individuals, because proteins trigger allergy reactions, yet EFA oils are protein free. In fact good oils more often relieves allergies,”

I have lost weight from over 120 kg to less than 80 kg and do not only look well again but feel much better (confident in my life and success) and a little hard work and profitable exercise help not only for my health but my pocket also. I must also admit I subsequently gave up smoking and the recreational use of alcohol after being diagnose on 08 November 2005 with Diabetes Mellitus at One Military Hospital with a blood sugar level of (26.7), two drips and three doses of insulin later I when home to take 850 mg of Glucophage Forte Tabs three times a day and to wise up to a better living standard.

Finally it is important to utilize qualified and registered dietitians in choosing to use them for medical purposes and weight management and it is important that you alter you diet accordingly under professional advice and guidance as you may cause other serious complications, such as gaining excessive weight after dieting or other serious disorders.

I list the following facts from my dietitian, the source are foreign as we do not yet test for OMEGA 3’s in our food as extensively. I only found some mention of it on sardine (pilchards) tins without the break down of the OMEGA 3 types. For instance there is no mention of Snoek or other such fatty South African cold water fish. The list for OMGA 3 per 100 gram portion follows;

  • Anchovy                     
  • Blue fish                  
  • Herring (Kippers)           
  • Mackerel                     
  • Salmon (Atlantic)           
  • Salmon (Chinook)          
  • Salmon (Pink)              
  • Sardines                     
1.4 gram
1.2 gram
1.6 gram
2.5 gram
1.2 gram
  1.4 gram
1.0 gram
3.3 gram

( The new 425 gram tin of “Glenryck” only indicates OMEGA 3 (DHA + EPA) as 2.2 grams for every   100 grams of contend. The new 425 gram tin of “Lucky   Star” only indicates OMEGA 3 (EPA + DHA) as 0.850   grams for every 100 grams of contend. The overall   OMEGA 3 is indicated as 1.2 grams for the same portion.)

Dietitians are registered and recognized medical health personnel and are recognized by medical aids and should be used as you do you medical check ups and consultation as their work is related and not much different. Please feel free to contact me at (012) 6633452 (E-mail: jarretc@connectit.co.za and Website: www.thehouseofclark.co.za) as I deal with mental health consumers issues and currently am the Guateng psychiatric consumer representative for the SA Federation of Mental Health.

(Please note the contents of the food hampers may vary and values may not be the same, after all it is only a gift and we should not rely on it. We can just thank Pick ‘n Pay for the opportunity provided for us. For the second time the contact numbers for the Pick ‘n Pay tours are, Health Hotline: 0800 11 22 88 or (011) 856 7626 and E-mail: healthholtline@pnp.co.za, if you missed it in the text.)

STRAI[GH]T TALK
By Jarret Clark

STRAI[GH]T TALK is a column the author writes in a local mental health consumer publication “Walk My Way” which was established 2005 in South Africa. The publication’s email is admin@witsmhs.co.za if you want to contact them.

STRAI[GH]T TALK: DISCRIMINATION BECAUSE OF MENTAL ILLNESS
(Walk My Way, Issue 1, 2005, page 6.)

I have found that the mentally ill, particularly people with schizophrenia, are discriminated against by the wider community. This seems, to be more apparent in the western world than in developing countries.

Many people do not know what schizophrenia is at all, or confuse it with multiple personality disorder. Very few can distinguish between the various sub-categories of the illness and fewer still understand other illnesses and substance abuse which may show similar symptoms.

The professional community is not immune to criticism. People with mental illnesses have certain rights which may be ignored or overlooked. Mental illness is real, it is a sickness, but sufferers are still persons in the Gestalt and existential sense. If professional behaviors, assumptions and points of view are observed and taken for granted as the truth, the lay public may absorb incorrect attitudes, to the detriment of the mentally ill. All therapies should be holistic and one day when we find the cure, we will discover we have to be holistic too.

Few carers will start and attend support groups and even fewer will immerse themselves in intense study to help the affected person. Another drawback is that those with mental illness sometimes discriminate between themselves, in terms of symptoms, side effects of medication and general prognosis. Most often the mentally ill, however, do form a cohesive group.

The triad of professional health workers, carers and sufferers can positively influence the perceptions of employers and general community.

People with mental illness must stand up for their rights, particularly as a forum, and lobby for the Employment Equity Act to be applied to them. Why can’t we with mental illness not have the same rights and opportunities as the rest of society and particularly those with physical disabilities?

I have managed to break through prejudice – people did not want to believe I was a person with schizophrenia, even with my negative symptoms and medication side effects. They accepted me as a normal, but extraordinary person.

I say to people with mental illness, “Come into the open with your diagnosis; educate people around you. They will more than likely not have a problem, once they understand you have a point of reference”.

The Phoenix Project is a result of my personal experiences. It is a proposal for the National Department of Health which includes a self help support group system with the community (carers, friends, employers, partners and the community at large), and a support group represented by professional care workers. It focuses on psychosocial rehabilitation assistance and the socio-economic upliftment of disabled people with mental illness. We need to work together as a holistic team and have a creative and open mind. In conclusion I would say “One is not many, but it is the beginning of a crowd”.

STRAI[GH]T TALK: THE DANGERS OF BEING SILENT
(Walk My Way, Issue 2, 2005, page 5.)

Dr David Horrobin in “The Madness of Adam and Eve, How Schizophrenia Shaped Humanity”, suggests that we should not hide or be hidden by others.
Dr Bernie S. Siegel in his book “Love, Medicine and Miracles” argues that a positive attitude and favourable environment will not cure the illness but can provide a longer and better life. It is precisely the will for a better life and conditions which call us to break the silence and bonds placed on us.

We can for the most part function as extraordinary people and we do function because of our extraordinary experiences and abilities. We, the people with mental illness ourselves can and must determine our needs, projects and actions in a joint effort with family, employers, Non Government Organisations (NGO’s), or Non Profit Organisations (NPO’s), professional mental health services and the community. At present, when we ourselves communicate with the media, we are generally ignored. However, when something like the Cresta murder occurs there is media attention for weeks, because it sells airtime and periodicals. There are over 400,000 people with schizophrenia in South Africa and if one commits murder it is on the national news. How many ‘normal’ people commit crimes and they do not receive the same treatment? Therefore a great danger of remaining silent is that of local and national media will remain sensation seeking.

The facts of mental illness in South Africa are not known to the public. To remedy this, there is a great need for professional advocacy and public relations by a national forum of people with mental disorders as well as local and international alliances of supporting organizations. Mental health should be a multimodal and holistic process, especially with the integration, psychosocial rehabilitation and socio-economic upliftment of people with mental illness in what could be seen as a hostile society. The fact of mental illness is that a great number of people in South Africa are never diagnosed by professional health workers or receive medication, services and briefing about their condition. Those who are lucky enough to have access to and can utilize the services still have to combat ill treatment, stigma and discrimination, even when we are stabilized on medication and treatment. If you try to open group homes in the suburbs, source transport and funds to start viable workshops and projects, find employment and training, clubhouses and even self-help groups, you are bound to find added difficulty. What seems to be even more difficult is finding meaningful, full employment and informed and capable management for people who disclose their disability and their mental health status even when acting with the support of the Employment Equity Bill.

Disability due to mental illness and treatment is lifelong in chronic cases and between bipolar and schizophrenia disorders, there are over 800,000 people in need in South Africa, a statistic which is approaching that of the AIDS pandemic. Despite this, the nation and the world remain silent. Many health services such as clinics and social services are not specialized and we have to share the facilities and services with non-mental health consumers. I believe that attention is mainly on AIDS, but there needs to be a fair equilibrium in services.

STRAI[GH]T TALK: THE RIGHT TO EMPLOYMENT
(Walk My Way, Issue 3, 2006.)

In many cases mental illness is not seen as a disability, yet many like me are medically boarded and certified with such a disability. This disability is real and is a factor that can not be ignored by an employer, as it needs to be fairly managed on an individual basis. The other disabled are provide with support such as ramps, brail and even dedicated computer programs, the mentally ill only require that management have the knowledge of how to manage the specific individual with his or her mental illness.

It is often thought that people with such disabilities cannot work and that they are expected to provide for themselves on a disability grant or by work in sheltered employment for the rest of their lives. Persons with a mental illness are, however, capable of much more, provided their special needs are recognized.

Mental illness is a disease causing disturbances of mood, observation abilities, thoughts, will power, memory and behavior. I have for instance paranoid schizophrenia, one of the major mental illnesses, is a condition where different functions of the brain are not coordinated. Spoken words may, for instance bear no relationship to what the person is experiencing or trying to convey, and what the person hears or sees may be distortions of reality.

The willing individual with the appropriate medication and other techniques by medical professionals (including psychologists, occupational therapists and social workers), relevant support groups and NPO’s such as the SA Federation for Mental Health, the immediate family or carerers, and the employer. Through such a joint effort it is however, possible to successfully treat and manage mental illness. As with other illnesses such as diabetes, high cholesterol and so forth, there are various degrees of mental illness. Whilst some persons with mental illness remain functional and in control of their lives, others certified or medically boarded like me achieve success much later and others more disabled need ongoing support.

People with a mental illness may need training to suit their needs. Firstly, they may need work conditioning to restore lost confidence, instill good working habits, and increase work tolerance. Secondly as I have experienced, to learn new marketable skills based on my remaining strengths as the illness may have affected my ability to use some previous skills.

People with a mental illness is statistical speaking far less likely to be violent than the average person. A willing person who has been receiving treatment for a mental illness, however, recognizes the problem within him or herself and is less likely to be a source of conflict.

It is important that management consider each person according to his or her merits, and if possible, to turn apparent weaknesses into assets. The mentally ill are provided for by the Employment Equity Act; we are equal citizens and should enjoy equal rights and responsibilities. It is important that employers develop an understanding of mental illness as they do with other disabilities, it then becomes manageable, barriers are removed and stigma is eliminated.

(I have used the brochure of the SA Federation for Mental Health “Mental illness the right to employment” as basis as I support it and want to provide for a joint message.)

STRAI[GH]T TALK: THE ASPECT OF MENTAL HEALTH
(Walk My Way, Issue, 2006.)

Mental health is not only the domain of mental illness for the mentally ill can suffer from the full spectrum of mental health concern which can be beside their mental illness, from having standard neurotic and phobic disorders which has no relation to their mental illness to the spectrum of traumatic conditions produced by the environment and their mental ability to deal with it which may be the scope of normal people.

The mentally ill may focus as the centre of departure for mental health but the whole human environment then extend from it to that of the ordinary man, woman and child. They all have some kind of mental health concerns during their lives.

One in four people will develop some serious case of mental disorder during their lives and others will suffer from some lesser mental health concerns even if they are not considered psychiatric or psychological diagnosed. This would mean that everybody develop some mental health need or situation in their personal lives and relationships to others. We need to depart from the mentally ill to the concerns of the individual, how he or she deals with themselves and how the environment impacts on them.

These two aspects can be quite different from individual to individual which can not just be taken as a social norm that everybody should think or behave in the same way. Take for instance persons in appropriate behaviour, being diagnosed HIV positive, illness or an accident. The first behaviour will be how the individual deals with it according to their own mental structure and psychological make up. Then only do the factors of the environment plays a role as the family, social and legal behaviours has an impact.

These impacts with the persons resolute behaviour in response is the concern of trauma and mental health counselling in helping the person to deal with the situation appropriately. In an other scenario can mental health deal in the case of a serious incident related to a group of individuals such as a death of a close friend or a family member. I this case did the primary victim shifted to secondary victims, their associated relationships consisting of related individuals in a closed group such as an immediate family or a group of friends. The impact of the event on their personal selves’ and the relationship of the affected group is also a mental health issue.

Therefore need peers, children and dependants need special mental health care. The work environment also plays a leading role in the area of mental health of the individual in the same way as family and social pressures have their own impact in the workplace. The individual is a whole unit and can not suddenly cut of environmental problems and personal problems as a machine besides the desires of management, fellow workers and the pressures of production.

The individual is a biological being as his associates we can not compare us as a mechanistic resource where we can have full control of service and production without the human element being primary present. This economic environment is in a great need of the services of mental health for all the people from management to the lowest employed.

The social environment also plays a role on an individual’s mental health not just his or her peers and friends but the close community they find themselves in. We just have to focus on the local relationships between sex, religion, ethnicity, culture and race. There may be other social impacts such as substance abuse, crime, disability and even gangsterism. These are also the concerns of the mental health of the individual and the community they find themselves part of.

The same apply to special competitive and conflicting events such as war and sports for their impacts is great on the individuals of the related societies. Some sporting initiatives have in the past lead to war, people being killed and supporter hooliganism. The same behaviour can be seen in war and conflict where soldiers and peace officers take humanitarian laws in their own hands and commit atrocities.

They may be seen as a few isolated cases in need of mental health services but the social infection may become infectious and increase to genocide and even national and political hijacking such as in the case of Hitler and his Nazi’s in Germany where nearly the whole social order became sick in their support of its ideals. It’s for this reason we need an independent and publicly owned mental health structure such as Non Profit Organizations (NPO’s) in relationship with government structures and services.

They act not only as service providers of mental health services but also acts as non political watchdogs, advocates and facilitators of a forum for the individuals in need and the society’s mental health status in concerned communities. But we must not forget that we have departed from our centre, that of the mentally ill to discover the whole aspect of mental health.

The mentally ill should not be stigmatized, discriminated against or be forgotten as we will forget ourselves and our mental health needs and therefore will not only live with the uncared mentally illness and inappropriate mental behaviour but also with mentally sick societies. NPO’s of mental health service providers and advocacy groups may initially deliver a specialized service a cording to service level contracts and mandates but they must not neglect the whole aspect of mental health.

STRAI[GH]T TALK: WEIGHT GAIN AND ANTIPSYCHOTICS

This comes as a warning from my own experience, the fact of weight gain with Atypical antipsychotics. When I was first diagnosed I thought due to the experience of these medications I was poisoned and try at every given point not to take them, as I experienced some involuntary body movements. And for a few years at about a six month breaks I had a relapse and was hospitalized again. They tried even monthly depot injections but my denial as my weight gain remained.

It was only after I started to work with support groups and jointly managed my medication responsibly with my psychiatrist that the medication side effects improved, yet the weight gain remained. At my start of point before the medication I was my whole adult life slim and nearly under weight between 68 kg to 75 kg. My co-operation with the psychiatrist remains positive and I was trusted to take Risperdal in a pill form which was not just a moral but a medical success. The dosage was first lowered because of side effects from 6 mg to 3 mg’s at night.

It all was great for a while, many successes have been achieved but the weight gain remained. I did a little voluntary work at the VIVA College a school for recently diagnosed youth with psychiatric disorders which bridge the gap between the hospital and actual school. The medical doctor that was then working there was herself over weight commented on my weight gain. I said to her “The medication may not be all responsible for weight gain but it definitely helps for it”.

With further meetings with my psychiatrist I mentioned that some side effects remain, I was sleepy and remained tired, thirsty the whole time and my hands were shaking. She maintained the new anti psychotic’s side effects can not be that bad and contribute all my success to the pill, contrary to much use of psychological principles in my self management.

It was only that faithful day I decided that I must have taken a double dose of the psychiatric medication that night as I could not always remember when it took it and that I now need some professional attention. It was only with the mention of a colleague that it is diabetic week and my signs to him look as if I have diabetes and that I should test my self. It was then discovered by the nurse that my blood sugar was 26.7 points, which at that stage meant nothing to me as I did not know that it should be between say 7 and 3 points of the scale. It was only when they rush me to casualties to receive two drips and three doses of insulin with the medical diagnosis of Diabetes II that I realized what those so-called anti psychotic symptoms were.

Currently I am doing much better my weight of 120 kg was reduced with a diet to 75 kg, my blood sugar, cholesterol and blood pressure is all stable. The 850 mg Glucophage Forte tabs work well with my 200 mg Seroquel (An atypical antipsychotic which according to my psychiatrist is les diabetic-genic.) The Seroquel was recently being reduced to 100 mg at night as I was still sleeping to much and I use an effective low Glycemic Index (GI) and relevant Glycemic Load (GL) diet with a little exercise. See the South African Glycemic Index & Load Guide by Gabi Steenkamp RD (SA) and Liesbet Delport RD (SA), published by GIFSA, website www.gifoundation.com.

The problem most of the additional side effects are known such as hyperglycemia, diabetes mellitus, and in some cases ketoacidosis or hyperosmolar coma or death, heart attacks, strokes and NMS, but they are not revealed as inclusions in medical labels or by doctors to patients. In the USA there are lawsuits because of these actions, just type in antipshycotics diabetes, you will even find a hit with Risperdal diabetes. Risperdal should not be singled out as there is information on aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal).

You just have to go to www.diabetes.org/diabetes-forecast/dec2004/research.jsp and read about Professor Paul E. Keck, Jr., MD whose professional focus is in psychiatry, pharmacology, type 2 diabetes. For more information you may search for the USA’s drugrecalls.com, in this case go to www.drugrecalls.com/rispedal.html.

Care must be taken to talk to qualified medial doctors before taking any action. It may have been a better option to have a mental health consumer national office which is owned and run by consumers so that we can act and speak on our own behalf and not always by others or those that claim they represent us.

Such an office is currently under the attention of the SA Federation of Mental Health but will require funding to run projects, such as sensitizing employers, assisting employers, housing, bridging the gap between disability grants and employment, advocacy, informing consumers, media liaison, national and international relations and affiliations, but also the training and remuneration of own staff is needed as this office is responsible towards the South African consumers or may be even the Pan African consumer.

I want to attached the following correspondence from the World Schizophrenia Fellowship Newsletter, Fourth Quarter, 1999, titled “Growing Pains (Weight gain and schizophrenia: no laughing matter) which were extracted from the S.I News, July 1999.

The newsletter starts; “Weight gain is a serious problem for some 10 per cent or more of people who take medications for psychiatric conditions. Very little is known about it. All we know is what we hear from anecdotal reports from people who start a new medication and within about two to three months find they have developed a large paunch and their face looks rounder.

For the most part, they say that they have not changed their diet. Sometimes their doctor recognizes the discomfort that arises from having a new and less attractive body shape and reduces or changes the medication and sometimes it works. However, for many the penalty they suffer in order to remain well is being overweight, sometimes to the point of obesity. 

It seems unfortunate that the only suggestions that psychiatrists can come up with at this time is to take more regular exercise and reduce one’s sugar intake. It is therefore interesting to read in the National Post (August ’99) of scientists who are researching obesity and have discovered that there is a gene that helps mice store fat. They have found a way to turn “fat, blond mice” into skinny ones by blocking this gene. According to the research, “the POMC gene, which provides signals that regulate fat storage early in infancy, continues to send signals later in life that prevents fat from accumulation.”

The research demonstrates that mice lacking POMC-derived signals are obese. The research, by Miles Brennan and his team in Denver, USA, was reported in Nature Medicine. It would seem reasonable to imagine that it is the effect from medications upon one’s biology which is at fault in weight gain.

Despite its limitations in terms of a real solution to the actual problems which often occur despite the fact that diet has not changed, the following article which first appeared in the Irish newsletter S.I. News provides a good overview and some useful suggestions to consumers battling their weight:

All medication has side effects and since antipsychotic became available in the 1950s, it has been obvious that weight gain is one of the most difficult problems for people who take them. This does not mean that everyone using antipsychotics will gain weight, or that there is nothing which can be done about the problem.

However, excessive weight gain can have a bad effect on general health, and may cause someone with mental health problems to stop taking their medication, with unhappy results. It often means that the person concerned loses confidence and self-esteem, a problem often ignored by doctors.

Which antipsychotic cause most weight gain?: This is a difficult subject to research because many people are underweight when they start to use antipsychotics, and it is impossible to know how much of someone’s weight increase is due to the medication or whether they have gained weight because their condition has improved and they are better able to look after themselves. However, it seems to be certain that all antipsychotics cause weight gain in some patients.

In the 1990’s, it has become noticeable that people taking the new atypical antipsychotics are generally more likely to gain weight than those on the older drugs. This is disappointing because these new medications, for example, clozapine, risperidone, olanzapine and quetiapine, do not usually cause movement side effects and in most respects are more acceptable to people who need antipsychotics.

Why do antipsychotics cause weight gain?:  There are probably a number of causes which could include the medication increasing factors such as: appetite, tiredness (so the person takes less exercise), and thirst (so that the person drinks a lot of sweet tea or coffee or high calorie soft drinks). The medication may also affect the body chemistry, which results in increased weight.
What can be done about it?: Doctors need to discuss the possibility of weight gain with patients when they start to take antipsychotic medication and to keep an eye on a change of weight. People need to be aware that: it is difficult to predict how much their weight might increase and that it usually happens in the early stages of a new treatment and then levels off; and that the level of dose does not seem to affect the amount of weight gain.

There is no effective medical treatment to prevent weight gain. However, some common-sense changes to diet can be made. For example, stop putting sugar into tea and coffee; switch to calorie reduced soft drinks; cut out cakes and biscuits (eat fruit if you feel hungry between meals); eat wholemeal bread, which is less fattening than white bread; fill up on baked potatoes, rice and pasta (not chips); avoid fatty foods, including butter and margarine; use skimmed milk; remember that alcohol and chocolate are fattening.

Will a change of medication help?: If weight gain is excessive, it might be sensible to switch to a different type of medication in the hope of some improvement. However, if someone is regarded as treatment resistant and is taking clozapine for this reason, the situation is very difficult.

What else can you do?: Daily exercise may help. Many people find that this makes them feel good. Some doctors will even provide an exercise prescription, which will allow you to use your local sports or leisure facilities at little or no cost.”

TRADITIONAL HEALERS IN A MODERN WORLD
By Jarret Clark

The sociological nature of medicine and its support services in particular South Africa and Africa in general need to integrate with the cultures of the community and individuals aspiring to their version of world cultures. South Africa consists out of diverse cultures and attempts to generalize it in to ethnic groups than individual choice, this goes against fundamental human rights. The right to choose an individual identity for yourself with a particular culture even if you are not of the ethnic groups prone to it.
We need to understand the basics of the African traditional culture, Professor of sociology, Henry Lever of the University of Witwatersrand said the following on page 9 in his book South African Society, {In a study based on questionnaires administered to a group of fairly well educated Africans, Biesheuvel found evidence of the tenaciousness of the belief in witchcraft. “It is surprising” he says, “That even a well-educated group does not wholeheartedly endorse the view that it is only the fear of being bewitched that make people ill.” It is fairly common practice in the cities for Africans to consult both a medical doctor and a witchdoctor.}
The same factors are found in other cultures for example, Hindu, Muslim and even in the Christian faith where evil spirits are seen by some as the cause of mental illness. I once facilitated a self-help group in the Sandton, Johannesburg area for about ten Europeans with serious mental illness at a time and found that about half had the experience of attempts by family, friends and the church to have evil spirits (Demons) to be exorcized – driven out from them. These youth came out of the higher middle class of Afrikaans and English families.
The witchcraft professor Lever and Biesheuvel referred to in the African culture are now generally known as traditional healers. These traditional healers practice along the lines of African religion and traditional medicine which is also largely bases on spirits, it accounts for both evil and good spirits with a sole Creator (God). This is not much different from other religions and cultural beliefs. These cultural beliefs and traditional medicine is part of modern alternative medicine which many people with mental illness may and will consult. Modern western professionals of medicine can not whish this phenomenon away.
People with mental illness because of residing symptoms and experiences from there illness and sometimes driven by the side effects of their medicine would approach alternative medicine and some will indicate that this treatments work for them. Other people with mental illness will stop prescribed medicine and start to self medicate trough substance abuse or utilizing other methods such as taking vitamins an even extreme exorcise.
Alternative and traditional medicine parallel to western medicine is therefore a reality; one of the reasons which make them effective may be that they act as a social and cultural support group. It is well documented that social support of the family, carers and from consumer self help groups provide better prognosis and health after hospitalization and episodes.

Another factor is that in underdeveloped communities such as Africa and Asia their cultures and religious believes for centauries had a system which provided for the acceptance for people with mental illness which measured against modern western culture provide for a better prognosis of mental illness as there social structure are more tolerant.
These factors alone argues in favor of alternative and traditional medicine as social structural support with out research in the other services and medication (muti) used by them which themselves may reveal medical misfortunes or benefits. However people with mental illness should and must have the right to choose the bases of their treatment in respect of their chosen culture and beliefs.
It is from this bases western medicine must work jointly with traditional medicine because of cultural and sociological needs of those with mental illness. Together it will provide a holistic and multimodal process of healing. We can not just enforce western medicine above the human rights of the mentally ill because they are not capable of sanity. Sanity, like human rights should be part of a constitutional liberty and their rights should be respected as long as they are not a danger to themselves or to the community. But these two exclusions should not give western medicine or and medicine the cart blanch the community and cultural groups should be educated and control this decision through the appropriate governance. It is better to use the best of both worlds, western and alternative (traditional) medicine.
Our communities need to be better informed and be part of the decision making process, we can only do this by the utilization and educating all community members in rural and urban areas which comprise out of different cultures and groups. Traditional healers should be considered part of these groups as they play a leading, social and cultural role in both rural and urban communities. They are sometimes the only service for local people with mental illness, so traditional healers in the modern world in areas where western medicine and services lacks can act as volunteers and lay councilors in support of both worlds.
Meaning western medicine and social workers should reach utilize and educate traditional healers on the line of social services, the utilization and support of facilities such as psychological, psychiatric, medical and suitable forms of pastoral counseling. These traditional healers can then form part of the social services and net work in their areas and can from this bases be used and educated by western medicine disciplines in regard to mental illness.
They therefore should be educated in western medicine, the relation of their muti (traditional medicine), psychological methods and social guidance which then compliment traditional healing in the modern world. These findings should also be researched and communicated in the relevant communities.
There should be some medical recognized form of control and accountability for traditional healers which could include a registration role, code of ethics and certification. Future mental health policy should jointly be drafted with the inclusion of traditional healers. To conclude traditional healers can start to work together with modern mental health services and care in the following areas;



STRAIGHT TALK: REALIZE YOUR DISABILITY BY BEING POSITIVE
BY: Jarret Clark (15 June 2006)

Not all mental illness can contribute their influences or origin as being related to a direct biological and physical disability. Mental illness is not always readily visible to others as those disabled that are blind, deaf, or even paraplegic. Yet we have biological and physical short comings as the others have and we as a society should not deny it.

I sometimes refer to the disability in mental illness as the unseen disability because to the average person who could not easily identify with it, it may look if this person who does not openly display their disability and thereby having these mentally disabled people refrain from expressing themselves further enforces the concept that they are not disabled and should not qualify for it.

I know the drive with disability should be a positive drive in to being more abled and more coping but it can be a form of stigma and discrimination if our example does not provide for every individuals unique condition that may be different even when diagnosed with the same disorder. For each disabled individual to be constructive still have the same situation as the snake and ladders game you win some and you loose some. But the individual aim should be in the end to gain much more good out of life.

Some may ask why can I claim disability for my mental illness? I can because I was diagnosed with this illness and its related disability to my special case. I had three different psychiatrists, I was medically boarded twice and each time three psychiatrist was physically present adding another four different psychiatrists.

I was scrutinized by Sanlam’s psychiatric advisor (psychiatrist) and reviewed again for my disability by my psychiatrist, an occupational therapist, speech therapist and clinical psychologist. After their reports my disability insurance was paid out because of a biological disability.

Professor Louw Roos (psychiatrist) of Weskoppies Hospital in Pretoria also reviewed my diagnosis in his genetic studies of Afrikaner people with Schizophrenia in association with the Rockefeller University (Laboratory of Human Genetics) in the USA, where a blood sample was taken from me. For a country with about four hundred psychiatrists, I was physically assessed by over two percent of psychiatrist alone.

To some we should even compete well against the able bodied, but in reality this is unfair. For if the disability is biological and physical it is real, it is no different as to ask a legless man to stand up. And if a person with a disability can compete with the able bodied on a 100 percent basis, the disabled say being 30 percent disabled actually contributed 130 percent. Yet that disabled person will only be recognized for their 100 percent.

I know some people who are diagnosed with mental illness who is to proud to utilize their disability grants or disability insurances because of the view to always be able and not to consider being disabled. Yet every time I saw the stress it placed on those families who must provide for them and how these very same people even decline to take their medicines motivated because of this view and then place further stress on the medical services and resources.

Yet those families and individuals won’t feel it inappropriate to replace their assets and lost income with similar insurance where they them claim the situation impeded on their performance and gains. But the very message of being seen as biological mentally disabled seems to be an personal insult and to be avoided by all by using other terms or philosophies which only serve to delay the solution.

We should face the situation as what it really is and make peace with its reality and not deny it as the longer we do so by only projecting the positive view without recognizing the differences in disability in individuals with even the same conditions. We select only those who is exceptional and then place their burden on others as an example to follow.

However we should rather positively and constructively promoted the others uniquely who have that condition as I tried with my “The Power of One” philosophy in which we all remain equal to any other individual no matter all their personal success and achievements.

For most mental health consumer advocacy is in the same spirit as that of the civil servant, who have to remain as a-political as possible from party politics, so that they can effectively serve the government of the day in providing professional service for their communities.

For like civil-servants we tend to remain in office no matter of those political figures, authorities and their policies may have change. This was always my personal and individualistic motto in my life and the origin of my philosophy “The Power of One”. Because for any of us to follow a political party in particular is too nationally and internationally divide our unity. We must remain as a group alone and independent as the light of our cause and the political interpretation must be as the shadows that flow from it.

What we need to do is not to deny disability but to recognize the individual scope of it and then work to benefit from those other assets, skills, abilities and resources we have. For example with the current disability grant, if a recipient would find paid work it stops immediately as a whole sum.

But the nature of mental illness is usually stress related and a few months or weeks down the line and these individuals lose their work or become ill again and now has to go through the rigorous and time consuming process of claiming that disability grant again. For I am not trying to promote myself as I am now well capable but I must now stand for those silent others who find their situations more difficult as we are rather all different even in the same condition or diagnosis.

This is one of the main reasons why people with mental illness refuse even to attempt to find employment or self employment and another factor is the family seeking financial stability as I am quite sure some families are jointly living of this disability grant as they do with those who receive such state pensions.

We can not rely to wait for people with mental illness to demand services, because the very nature of mental illness is mostly antisocial. Therefore should the approach rather be to reach out and accommodate their direct involvement than to wait for it.

My proposal is that we should recognize the disability in mental illness for what it is and always relate to all the individuals with that condition uniquely and not only use our best suitable examples. We should review the disability grants and insurances to rather cater and promote a scaled bridging finance as done with state pensions to ensure people with mental illness related disabilities can maintain their employment or self employment in the long term before terminating this facility.

Being disabled is not a swear word or meaning you must give up on life, it only act to identify your particular situation so that you can qualify and utilizes the special recourses and services provided for such conditions. They are there to promote you constructively as the great person you are in our society. For if we do not utilize these provisions,  they will become redundant, ineffective and the little benefit they provide for others in greater need will in effect fall away because nobody want to be associated with being mentally disabled.

As employers may claim because of statistics that they already employee people with mental illness but very few will be able to identify and produce those employees without then claiming for secrecy and confidentiality. However to be rendered disabled you have to have a proper medical assessment and forward at least your identity number to the state to benefit from government grants.

The reason is to prevent people who do not qualify to claim this benefit and that a disabled person can not claim the same benefit twice. If this is the government standard why can the employers at least not provide numbers who can be followed up with identity numbers for the investigation by the appropriate authorities to verify their claims?

We finally need originators such as those who organize house loans in banks to help us utilize all the benefits provided for our disability, such as housing, training, transport, grants, insurance benefits, employment assistance and even entrepreneurship assistance.

We would not mind helping ourselves with self-help groups but need at least some professional mentorship to meet all the requirements, certain professions such as social workers and community development workers can assist us, if not organizations such as Rotary and Lions.

Because currently we are not aware where and how to utilize all these uncoordinated benefits that is allocated for us by different state departments and organizations, nor can we currently successful manage and administrate these benefits as required by law or prescribed fiscal policies.




JULY 2006 MENTAL HEALTH MONTH CELEBRATIONS WITH THE MINISTER OF HEALTH
BY: Jarret Clark

I have been a member of Amnesty International for some years and have renewed my membership again. I really want to dedicate some of my time to the Health Professionals Group relating to issues particularly to human rights for mental health services users.

Mental Health Service Users numbers in South Africa relate well to our current HIV and Aid’s sufferers, just utilizing normal WHO statistics of one out of about four people could in their lifetime be diagnosed with a mental health condition.

And even conditions such as HIV/Aids suffer sometimes from depression and with the high demands and stressors of the South African society should our mental health incidences be even higher than the WHO average.

Other issues such as discrimination and abuse also are seen part of the jurisdiction of mental health issues, which in fact covers the whole human rights scope and health.

With my meetings with the Department of Health prior to the 13 July 2006 Mental Health Month Celebrations, it became clear that NGO’s are needed to contribute in advocating the human rights issues of mental health service users in South Africa and the region.

I feel the group under Amnesty International South Africa can assist with developing such advocacy for which there is a great need. The Department of Heath have indicated they are accommodating and willing to promote the idea as well as other related organizations such as the SA Federation of Mental Health of which I am one of their psychiatric service user representatives.

Amnesty International is in the ideal position to assist in the legal advocacy needed in this regard and Professor Freeman which I mentioned below said he is willing to provide you a briefing and we could see if we could establish some movement. The other speakers mentioned below could also be of assistance.

I have lastly included some questions which are raised by me on regards to mental health service users which could affect the role of Amnesty International. I know we are not suppose to be political and only impartial. But the legal interpretation at the International Court for human rights play a role in identifying individuals who should be hold responsible and this is only my interpretation in the last issue and nobody else’s.

BRIEF OVERVIEW OF THE REVIEW BOARDS ASSEMBLY AND MENTAL HEALTH MONTH CELEBRATIONS ON 13 JULY 2006

FIRST SPEAKER

Professor Melvyn Freeman of HSRC, Pretoria Group “Social Aspects of HIV/AIDS and Health”. (Currently assisting WHO in developing a policy package and manual on mental health legislation. Below follows some of his points of his address on 13 July 2006 at the general training assembly of Mental Health Review Boards, he concentrated on human rights issues relating to mental health service users.)

SECOND SPEAKER

Next was K. AGNUS MABPTJA, from legal unit of Department of Health, discussed the mental health care act.

She discussed the human rights of the mental Health Care Act, such as carerer application to administrate the mental health user’s estate.  Her main focus was the licensing of community facilities rendering care and housing for mental health service users, it is not any more under the jurisdiction of Department Social Development. These facilities need to apply to the Department of Health now. In the end she raised a question “Are their any provisions made for minor children in the act?

THIRD SPEAKER

DR. BARIDA DHALI (From the Human Rights Commission, Specialist in the Neuro Science a specialist in schizophrenia). She mentioned Professor Freeman covered most of the local and international legal issues relating to the human rights of mental health service users.

She raised the following points;

QUESTIONS  RAISED BY MEMBERS OF THE REVIEW BOARDS:

Some of the questions asked by review board members were “that if a service user has complaints that they (the review board) were compelled to reveal to him or her that they have also access to legal aid if required to argue it further in court?”

The other question was asked that if a service user has the right to refuse care, what the procedure should be, as they have a right not to have care. (As long as they can maintain themselves and is not a thread to the public.

Some review board member stressed to appease the mental health facilities management and administration to gain confidence and cooperation and not resistance (But the question I as a service user representative must ask “Must it be at the cost of mental health service users and our human rights as revealed a cording to numerous international agreements the mental health care act and the national constitution which was also addressed during this meeting?”

OTHER HAPPENINGS THIS DAY:

The service user had a small art exhibition in the hall with the review boards, the need to develop the artist of communities where high lighted, because of the lack of resources and information as other socio-economic upliftment means.

Was invited to the evening gala with the Minister of Heath Dr. Manto Tshabalala-Msimang, where Ms. Charlene Sunkel’s from Central Guateng Mental Health’s play “MADNESS REVEALD” which are based on a women living with schizophrenia was a great success.

The minister and approximately 80 attendants gave a standing ovation and the general feeling the play should be promoted to the public and in particular the mental health facilities in the country.

I made the suggestion to some Department of Health staff that the play and members could become part of the Aid’s road show and use the same stage as not to duplicate cost, when the public are considered.

Not many people know that the WHO statistic is close to one and four people in the world can be diagnosed with some mental condition during their life time, which in real terms alone could closely mach even the figure of the Aid’s pandemic in South Africa but South African mental health service users alone which may qualify.

And many Aid’s sufferers can also suffer from depression as well, which bring them also in the camp of mental health service users.

Mental Health is a wide field and should not only be confused with diagnosable mental conditions and illnesses, mental health features in abuses, such as crime, torture, physical abuse, psychological abuse and general discrimination by people and groups.

SOME GENERAL QUESTIONS FOR AMNESTY INTERNATIONAL:

How can we establish NGO and NPO legal advocacy to help implement the South African Mental Health Act and related international policy on human rights in particular to mental health service users?

Because service providers do not want to enter in to legal disputes with other service providers and mental health professionals and aim rather to appease them to try and change them. This is even a problem for the Mental Health Review Boards.  This is a difficult position for the as they need assistance of organizations such as Amnesty International.

The SAPS now apparently have a code of conduct when gathering and transporting mental health service users. The question need to be asked does the Metro and Provincial police, Military Police and other security services also utilize these procedures?

And if they do different, in which way do they differ from the standard and are they approved by the Department of Mental Health as being relevant to our constitution and international obligations?

The other question for security departments as do they follow the mental health act in addressing and accessing mental health review boards and their procedures for their mental health service users and prisoners, such as prisoners of war?

For instance I am a mental health service user who although on pension and decommissioned still utilize the SANDF medical services, do I fall under the normal review boards or are there special review boards for us or are they only for SANDF members as the SANDF seem to have their own courts?

And how can NGO’s such as the Red Cross and Amnesty International access these prisoners?

And are those who abuse the human rights of such mental health service users, also applicable to be prosecuted by the international court?

Who would psychological warfare or undercover operations, political abuse by groups and interrogation and psychological torture could be subjected to this interpretation?

The last question for medical health professional are they oblige to reveal to Department of Health in particular or to International Human Rights Court their findings which may be inhibited by some security departments policy as they are first obliged by their medical oath which is an international standard on which they can be rated and also lose their world wide status to practice?



 

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