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“Under apartheid some mental health professionals called for political and social reform. After Esidimeni it’s clear we still need such activism, write Jason Bantjes and Leslie Swartz.”

“Recent public hearings have again focused attention on the deaths of psychiatric patients in government-funded community-based organisations. The Esidimeni tragedy occurred against the backdrop of broader concerns about mental health in the country.

It is estimated that fewer than 10% of people with mental disorders receive treatment. Where treatment is available, it is often provided under stressed and difficult circumstances.”

In addition, research conducted at Stellenbosch University’s psychology department over the past three years has documented the experiences of healthcare professionals working with suicidal patients in various settings. “This research makes for depressing reading. Mental health care providers working in state hospitals, prisons and addiction treatment centres consistently describe being overwhelmed by their work and feeling powerless to provide the care patients need. 

Under these circumstances, it is somewhat disappointing that the central concern of contemporary professional psychology seems to be the policing of fine distinctions among different fields of psychological practice. At the heart of this discussion is a turf war within the profession about what services can be provided by which category of psychologists.

Health Minister Dr Aaron Motsoaledi has been given until November 2018 to revise the regulations about the scope of the practice of psychology, following a ruling by the Western Cape High Court that the psychologists’ Scopes of Practice regulations (issued in 2011) were invalid.

It is important that no psychologists should undertake work which they are not competent to perform. But the reality is that in June 2017 there were less than 13 000 psychologists in the country, serving a population of about 57 million people…It is not a simple matter to undertake research on effective mental healthcare, especially in a diverse and unequal country. But surely this is where psychologists should be investing their energy, rather than attempting to police boundaries among professional categories?

In the future, organised psychology and the current generation of mental health professionals may well be judged by the extent to which they took up the struggle to reform mental healthcare delivery… But this is unlikely to be achieved unless the majority of the country’s psychologists put aside their inward focus on demarcating boundaries within the profession, and rather turn their attention to questions about how best to promote mental health in South Africa.”

Jason Bantjes And Leslie Swartz

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