A nervous tic in Jude Stober’s eye is the only hint that the tall teenager has already battled with adult-sized demons.
‘Basically, I did have a rough time in my young teen life. I did wrong things. I didn’t want to listen and I fell into the wrong group,’ says 19-year-old Stober about his brushes with drugs and gangs in Bonteheuwel on the Cape Flats.
By the time Stober was 14, he had already started to live the gangster life ‘ experimenting with drugs and fighting at school.
‘At school I was physically abused but I only had my mother to support me. I wasn’t coping. I was very short tempered and angry. Someone told my mother about William Slater Centre so she brought me here,’ says Stober.
The Centre, officially a ward of Groote Schuur Hospital, is a rundown house in Rondebosch that offers help to teens with psychological problems.
Headed by Dr Nick Shortall, an overworked but dedicated psychiatrist, William Slater faces the difficult task of trying to meet a growing need with dwindling resources.
The only institution of its kind in the province, the Centre is classified as a tertiary institution. With health resources now being directed to primary care, this means that as staff have left or died, they have not been replaced.
Yet the need for places like William Slater is growing. At any one time, there are 60 kids on the waiting list which means that children who have tried to commit suicide may wait two months before being admitted.
‘The kids we are seeing now are more damaged than they were even six months ago,’ says Shortall.
‘Ten years ago, the average kid here was a white under-performer. Today, 80% of the kids come from the Cape Flats. They are failing academically and socially. They are on the fringes of gang culture. Frequently, they have been raped or sexually abused and are on the periphery of drugs,’ he said.
Shortall believes that the damage is the result of the lethal combination of increased pressures of society on children, poverty, unemployment, crime, drugs and prostitution.
‘Families are disjointed and find it difficult to contain children and adolescents,’ he adds.
The teens come to William Slater suffering from depression, attempted suicide, disruptive behaviour, post-traumatic stress and drug addiction. Many are on the brink of being expelled from school, and have been referred from their schools, doctors or hospitals.
‘We always see the family,’ says Shortall. ‘You can’t change the adolescent without the family changing. We might have one to three sessions with the family, Thereafter, we offer individual, family and group work,’ he says.
Parent seminars are also offered, where parents can share experiences and give one another support and guidance.
Around 125 teens and their parents benefit from short-term interventions, while there is space for 50 teens a year to get more intensive attention as day patients.
Day patients are offered a term of psychotherapy in a group of 12 with two facilitators. The rest of the staff watch sessions through one-way glass.
They are expected to attend sessions three times (CHECK) a week from 9am to 2pm and at the end of the term are encouraged to go back to school.
Two principles guide the group work: shared responsibility and working together. Each teen is allocated tasks such as ensuring the therapy room is in order and the snooker table is well looked after.
‘We are not here to teach them but to help and support them,’ says Shortall, adding that the teens are helped with life skills such as ‘how to set long term goals and short term tasks’.
But it can be hard going. ‘Often they are not used to structure in their lives and cruise in and out,’ says Shortall.
‘Sometimes they fight, tease each other, make racist or sexist remarks. They come late, or don’t pitch or run away. We try to strike a balance, by offering understanding but also ensuring that they know there are certain norms that they don’t cross.’
Stober says that at first he was scared to attend sessions: ‘I was told by people that this is a mad house. This is rehab.
‘I was sceptical about the confidentiality. I had a relative working here and I thought ‘what if what I say gets back to my family’.
‘But I had nothing else, so I decided to take a chance. I opened up and spoke to the group. Then I found it wasn’t only me with problems. I built trust with the staff and the other group members. I started to feel at home. I felt surrounded with love.
‘I never ever believed there was a way. But there’s this X factor that grabs you at William Slater. Actually, they don’t teach you. They let you see what is within yourself. You teach yourself. You’ve got the time. You can cry, you can shout if you need to. You can take off the mask and let it all out.’
Pyschotherapy is the mainstay of treatment and few of the centre’s kids ‘ less than 30 — are on medication, usually anti-depressants.
Diagnosis is complex because one child is usually suffering from a combination of different problems.
‘One kid can be depressed and suicidal and have a conduct disorder with a background of a dysfunctional family and violence,’ says Shortall.
However, he hastens to add that the Centre doesn’t blame the parents: ‘It is far more complicated. There may have been inadequate parenting over generations so it makes little sense to blame this generation of parents.’
Shortall is assisted by a psychologist, social worker, three nurses (one who works half days), a registrar, a psychology intern and four support staff.
In the past, drama and art therapy were offered but budget cuts no longer allow this. Repairs to the once-grand old house also seem out of the question, and one therapy room is no longer in use as part of the roof has fallen in.
‘William Slater has been under threat of closure or relocation for the past 10 years,’ says Shortall. ‘But the department of health has finally accepted it is a centre of excellence that should be cloned not closed. So we may now supervise a similar institution in George.’
Shortall is a man who is short of time, as he divides it between helping patients, administering the centre and teaching responsibilities at the University of Cape Town.
‘It is incredibly demanding but also very satisfying. I wouldn’t leave the centre for anything.’