Cape Town - Psychiatric services in the Western Cape are under strain as a result of soaring rates of drug abuse.
About half of all mentally ill patients smoke dagga, tik, methamphetamine and drink alcohol, which worsens their mental health issues, said provincial Department of Health spokesman Darren Francis.
Last year, the department recorded 43 921 outpatient mental health problems.
With July marking mental awareness month, a spotlight has been cast not only on the challenges the department is experiencing, but the serious issues that affect people suffering from mental disorders and the families who have to shoulder the burden of their care in the face of poverty, gang violence and crime in impoverished areas.
The department has four psychiatric hospitals - Alexandra in Maitland, Lentegeur in Mitchells Plain, Stikland in Bellville and Valkenberg in Observatory.
The Cape Argus visited the Mitchells Plain Community Health Centre where a grandmother spoke of the difficulties she faced taking care of her 25-year-old son, who suffers from schizophrenia and abuses drugs.
In addition, Caroline Rhoode, 60, from Eastridge, also takes care of five grandchildren, with her pension being her primary source of income.
Rhoode said she often feared her son, who would have occasional bursts of violence, would eventually become uncontrollable.
She said he demanded impossible things from her pension and did not hide the fact that he used the money she stored away for food, on tik.
She said she prayed that doctors would admit her son to a mental institution for her safety and that of her grandchildren.
“I am getting old. I cannot handle the stress of looking after my son anymore. At times I feel like giving up because it feels as if I have to carry this burden alone. I love my son, but he needs help,” Rhoode said.
The Department of Health said substance abuse disorders were high in the province, including foetal alcohol abuse, the tik epidemic and the growing problem of heroin abuse, with people suffering from mental disorders often experiencing high levels of co-occurring physiological and physical health problems.
“Substance abuse not only increases the burden of disease in the province, but also compromises education outcomes, destroys families and fuels insecurity, all of which threaten economic growth and job creation.
“It is also important to highlight that when a mental health problem goes untreated, the substance abuse problem usually gets worse as well. And, when alcohol or drug abuse increases, mental health problems usually increase too,” said Francis.
He added that the most common issue connecting mental illness and substance abuse was the intention of patients to medicate their mental health symptoms by using alcohol and drugs.
“Therefore, in instances where there is a dual diagnosis of both a mental health disorder and a substance abuse issue, it is imperative that the individual first receives psychiatric assistance, before addressing his or her substance abuse problem.
“Once the individual’s mental condition is stable, he or she can be encouraged to join a rehabilitation programme or facility to address his or her substance abuse problem,” said Francis.
However, once a patient was discharged from a psychiatric hospital and returned to their communities, the responsibility of care fell on the shoulders of the parents, guardians, grandparents or extended family - as was the case for Rhoode.
She said dealing with her son’s mood swings was an issue.
“What if he hurts someone unintentionally?
“I don’t want him to go to jail, he is not a gangster, but I am not a young woman anymore and Ilack the strength to take care of him.”
Cape Argus