Schizophrenia is treatable, and the majority of individuals with schizophrenia live productive and healthy lives within their chosen contexts. However, some individuals require ongoing support and inpatient care. Medication and psychosocial support within collaborative, shared decision making, and recovery orientated approaches have been found to be most effective. However, despite the availability of treatment, a large proportion of people with schizophrenia living in low- and middle-income countries do not receive appropriate treatment. Many also do not have sufficient access to general health care services and are vulnerable to physical health problems.
People living with schizophrenia are vulnerable to exploitation, health and human rights violations within institutional forms of care, as well as the communities in which they reside. The Life Healthcare Esidimeni tragedy, which involved the deaths of over 140 mental health care users in Gauteng Province (following deinstitutionalization efforts and the termination of an outsourced care contract with Life Esidimeni by the Gauteng Department of Health in 2015) is one such tragic example. Stigma and discrimination against persons with schizophrenia negatively affects their access to health care, as well as education, employment and housing.
PsySSA calls on government and civil society to advocate for individuals with schizophrenia, by ensuring that:
- Health care professionals are properly trained in mental health screening, diagnosis and treatment, and that treating teams include a multidisciplinary team approach;
- Essential drugs for the treatment of schizophrenia and other mental disorders are available;
- People with schizophrenia are treated within the least restrictive and community forms of care, and that these forms of care are available to people who require it;
- Those individuals requiring more acute or long-term forms of care are accommodated in fit- for-purpose, well-staffed and therapeutic facilities that are close to the homes and communities of those who require mental health care, treatment and rehabilitation;
- Families/caregivers have access to ongoing psychosocial support;
- Advocacy for inter-sectoral collaboration to maximise independent living/assisted living through the provision of supported housing and employment for those individuals who require these;
- Independent living is maximised through the provision of collaborative and recovery-based approaches to care;
- Social activism remains on the public health agenda in order to reduce stigma, discrimination and human rights violations;
- Research into gold standard forms of treatment within the South African context is funded and considered an ongoing programme;
- Mental Health policy reflects best practices in screening, diagnosis and treatment of persons with schizophrenia.