Dear Nomathemba Mokgethi (MEC),

Earlier this year you reported that Helen Joseph Hospital has seen a tenfold increase in the number of mental healthcare patients showing up at the Johannesburg facility over the past year.

The SA Federation for Mental Health (SAFMH) appreciates the transparency of what may be attributing to this increase (including the pandemic and the closure of Charlotte Maxeke Johannesburg Academic Hospital) and the fact that your department is trying to improve capacity to accommodate the increase, including planning to reopen the mental health care unit at Charlotte Maxeke Johannesburg Academic Hospital in November 2023. However, we are still very concerned about this.

We understand that the fire at Charlotte Maxeke Johannesburg Academic Hospital has resulted in Helen Joseph Hospital experiencing limited capacity and resources to provide safe, sustainable, and effective care for mental health care users, as well as the safety of staff and other medical patients. Whilst we commend the heroic efforts of the staff, nursing, and medical and allied health disciplines from Helen Joseph Hospital who have worked tirelessly to ensure that psychiatric patients receive the best care possible, we believe that the current conditions at the hospital, particularly in the emergency department, are intolerable, and are drastically compromising patient care and safety.

The measures in place are insufficient to address the systemic issues of bed shortages, an inadequate staff complement in the context of increased patient volume, and the failure of the provision of resources or a budget to adequately manage the crisis at hand.

We are therefore calling for a clear, co-ordinated, and integrated approach that maximises efficient use of resources and enhances an effective response system. This includes:

1) The inclusion of extra psychiatric beds in the general hospitals that must be developed with the appropriate infrastructure and staffing. This would require that the Charlotte Maxeke mental health care unit (doctors and nurses) and infrastructure (beds, equipment, etc.) be split between the general hospitals with available space. It is critical that this process is closely co-ordinated and managed to ensure the adequate delivery of services and accountability.

2) Allocating appropriate budget and resources. The provision of resources and the operational budget that was allocated to Charlotte Maxeke Johannesburg Academic Hospital for the provision of psychiatric services should follow the development of additional beds and human resources needed to help Helen Joseph Hospital manage the increased patient volume and the burnout of frontline workers.

3) Adequate investment and up-scaling of community-based mental healthcare in Gauteng. Investing more community-based mental health support for the province can help reach more people and reach them earlier before they get so sick and require long-term hospitalisations.

The preservation of mental health care users’ human rights and dignity should be the cornerstone of all mental health services, including hospitals. We call on you to urgently implement these recommendations to protect the welfare of mental health care users at Helen Joseph Hospital, as well as the mental health care users across the province.

Sincerely,
Michel’le Donnelly, Project Leader [Advocacy & Awareness], for the South African Federation for Mental Health (SAFMH)