Prison warders guarding inmates with mental disorders

Already overstretched correctional services workers are being put in danger by having to deal with state patients, Popcru says


Nearly 100 Eastern Cape inmates who have been declared state patients and are meant to be housed in state psychiatric institutions across the province are instead being held in prisons, with warders tending to them.

A disturbing incident last week in which a state patient in the province attacked a social worker has thrown the problem into sharp relief. 

A state patient is someone arrested and then detained under a restriction order after having been deemed by a court to be suffering from a mental disorder and who should be kept in a psychiatric hospital.

By the department’s own admission, correctional service workers are not trained to deal with these patients, nor do they have the capacity to do so.

Department spokesperson Nobuntu Gantana said Section 77 of the Criminal Procedure Act 51 of 1977 mandated that state patients were to be detained in a psychiatric hospital or prison, as determined by a judge.

Gantana said there were 93 state patients in correctional facilities across the province.

“A working arrangement between the department of health and [correctional services] is for state patients to be transferred the moment beds become available, as it is not desirable to have them at DCS facilities.”

In Gqeberha in a single weekend, at least 28 patients presenting with mental health issues were attended to.

The Police and Prisons Civil Rights Union (Popcru) said its members were being put at risk by keeping state patients in prisons.

Last week, a Butterworth social worker was attacked by a state patient while consulting with him.

It is understood that the man was facing a murder charge.

Gantana said he was admitted to the facility on December 2022 and was declared a state patient on February 22 this year.

It is believed that the social worker was interviewing the inmate when he asked her to take off her spectacles.

He then allegedly told her he loved her.

Within a minute, he was allegedly strangling her while kissing her at the same time.

She screamed and the official who was with her tried to pull him off her. 

“He is still at the centre as he is a state patient and he is awaiting the availability of a bed at a psychiatric hospital,” Gantana said.

“There are 14 state patients at Butterworth Correctional Centre, waiting to be transferred to Komani Psychiatric Hospital the moment beds become available,” she said, adding that the state patients were separated from other inmates.

“The inmate has been criminally charged.

“The department of health has been consulted to fast-track the availability of a bed in a psychiatric hospital.

“The challenge of state patients is addressed monthly by the department of correctional services at all relevant stakeholder meetings.”

It was reported in August that the province’s biggest psychiatric hospital, Fort England in Makhanda, had only one forensic psychiatrist and a sessional doctor to assess the mental state of awaiting-trial prisoners facing a range of charges, including murder and rape.

Between January and August last year, 232 accused were admitted to Fort England for observation.

Of those, 116 were found to be mentally unstable.

Popcru secretary Xolani Prusente said it would call a meeting with the department to raise its concerns about state patients being kept in correctional services facilities.

Should that meeting not yield results, it would withdraw its members from the facilities.

Prusente said Popcru members were already working under difficult conditions with a shortage of staff and overcrowding in facilities.

“Safety here is the main thing. We don’t have the expertise to deal with people who are declared to be state patients.

“Whenever they are in their [episodes] and we try to stop that and if there’s an injury, regardless of whether that patient intended to harm our member/s, once there’s an injury our members are charged for assaulting an inmate.

“We condemn this practice.

“We don’t care if it’s correctional services or health [which has the mandate to care for state patients], but we don’t want our members working in those conditions.”

Golden Miles Bhudu of the SA Prisoners Organisation for Human Rights said keeping state patients in correctional services facilities was dangerous.

“The Correctional Services Act is clear that you keep such category of prisoners not only in a different section in a prison, but you take them to a facility that is well-equipped to deal with those prisoners.”

The province has four specialised psychiatric hospitals — Fort England, Elizabeth Donkin in Gqeberha, Komani Psychiatric and Tower Hospital in KwaMaqoma (formerly Fort Beaufort) — and mental health units at Cecilia Makiwane in East London, Dora Nginza in Gqeberha and Mthatha Regional Hospital.

Health spokesperson Sizwe Kupelo said: “The mental health issue in the province is perpetuated by drugs, which is a societal matter.

“In almost every village or townships, there are drugs that are easily accessible.

“Due to drug abuse we are seeing hundreds of clients who come to our facilities presenting mental health symptoms.

“The procedure is that we put them on 72-hour observation and in the past in early 2000 we used to have selected district hospitals that were designated to do such observation, but now all district hospitals were forced to create a space for mental healthcare users.”

Kupelo said the department was increasing its capacity to handle mental health care. 

The province had more than 2,000 beds in psychiatric institutions across the province. 

“We have just renovated the mental healthcare unit under [Mandela Regional Hospital].

“At St Barnabas Hospital [in Libode] we have built a fully fledged hospital at [a cost of] R105m and are finalising that.

“We are increasing capacity but cases we have to see on a daily and monthly basis are putting pressure on the department. 

“Health will not solve this problem.

“Society needs to play its role in ensuring that drugs usage in communities is minimised through policing forums because they [community] know who is selling drugs.” 


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