Mental Health News Non-Communicable Diseases (NCDs) Policy and Legislation

Halfway between help and home

Written by Ayanda Mkhwanazi

When the voices stop and their thoughts become their own again, people with schizophrenia may be ready to leave psychiatric facilities – but the next step may be anyone’s guess.

Like many men diagnosed with schizophrenia, Paul’s* illness first began to show itself in his early 20s when, in 2003, he began experiencing paranoid delusions and believed that people were plotting against him.

Like many men diagnosed with schizophrenia, Paul’s* illness first began to show itself in his early 20s when, in 2003, he began experiencing paranoid delusions and believed that people were plotting against him.

Like many men diagnosed with schizophrenia, Paul’s* illness first began to show itself in his early 20s when, in 2003, he began experiencing paranoid delusions and believed that people were plotting against him.

“I was sitting near the window on the veranda when I saw two students walking past,” he told Health-e News. “They were laughing and I remember thinking that they were talking and laughing (about) me.”

When Paul was admitted to Pretoria’s private psychiatric hospital, Vista Clinic, he remembers being convinced that nurses were trying to kill him.

One month later he was released, and it was a new world for him and his family.

Paranoid delusions are just one of schizophrenia’s symptoms, which can include auditory and visual hallucinations as well as feeling out of control of thoughts.

As in Paul’s case, symptoms typically arise between the ages of 16 and 30 years, and tend to occur earlier in men than women.

About one percent of South Africans are living with schizophrenia, according to the South African Federation for Mental Health. With many people undiagnosed or misdiagnosed, the federation warns that this percentage could be higher.

Paul’s sister, Christine, admits she did not understand her brother’s illness and dismissed it as a ploy for their mother’s attention. She remembers telling him to “get his act together.”

Despite being well-versed in the condition, mother Louise called her son’s diagnosis a huge shock.

“I have an Honours in psychology so I knew about schizophrenia, but I never thought it could happen in my family,” she said.

Returning to a new normal

When people like Paul are well enough to leave psychiatric facilities, they – and their families – may still need support to adhere to treatment or to better understand mental illness. Halfway houses can provide patients and families with this kind of support and help re-integrate patients into communities, according to the federation’s Resource Centre Manager Fatima Seedat.[quote float=”right”]“Sometimes their families come and visit them but they feel rejected because their families don’t know how to deal with them”

About 60 halfway houses operate nationwide, according to the National Mental Health Policy Framework and Strategic Plan. Creating more of these “step-down” facilities in partnership with NGOs is one of government’s goals under the plan.

“These facilities assist in the process of re-integration of these mental healthcare users into their communities by helping them with coping strategies and treatment adherence,” Seedat told Health-e News.

Seeing this need, Louise quit her job in 2011 to convert her home in western Johannesburg into a halfway house.

“I was motivated by own son’s condition,” she said. “I wanted to help young people reach the services they need so they may get better.”

Louise’s home currently houses eight patients, which she ensures make their regular appointments with psychiatrists and occupational therapists at Tara Hospital in Hurlingham. She also helps them to stay on their treatment and on Fridays holds art classes with her tenants.

She says that she hopes to bridge the gap between facilities and home and also between patients and their families.

“Sometimes their families come and visit them but they feel rejected because their families don’t know how to deal with them,” she added. “They feel isolated and long to be with their families.”

Eight illegal halfway houses closed in 2014

According to the Mental Health Care Act, community-based care facilities like halfway houses are licensed and regulated by provincial health departments.

The Gauteng Department of Health has closed down about eight illegal halfway houses in 2014. Louise is in the process of applying for a license for her facility.

Funding for halfway houses remains in short supply, according to Seedat who adds that they can be costly to run as they need specialised and trained staff.

“These facilities play a role in encouraging the people (with schizophrenia) to contribute to the economy,” she said. “They are very crucial because they provide basic necessities such as food and shelter, transport and stimulation”. – Health-e News.

*The family asked that their surname be withheld

About the author

Ayanda Mkhwanazi

Ayanda Mkhwanazi is a senior journalist with Health-e News.