In addition, the government’s bid to build new facilities had failed, said national Department of Health’s director-general Precious Matsoso.
She was giving evidence on the fourth day of the hearings chaired by former deputy Chief Justice Dikgang Moseneke in Johannesburg.
“When I look at the facilities, these facilities were built before 1994, am I right? Cullinan, Sterkfontein, or Weskoppies - the names tell you they were built before 1994. Have we built any after 1994, for mental health in particular?” Moseneke asked Matsoso.
She said: “An attempt to build one, I can say, was an absolute disaster. This is a facility that was built in Northern Cape. It consumed huge resources, (but) was not appropriate for mental health care.
“With the provision in the Mental Health Act, that we should not move towards keeping people in institutions, rather move towards community-based mental health care, we should rather make investments in our primary healthcare facilities, our existing health facilities where outpatients’ services are appropriate. The investment cannot be in building more facilities where people are going to be institutionalised”
Moseneke pointed out that in spite of the policy, mental health facilities were still being used widely.
“But we are still using clinics, we are using Life Esidimeni - I have seen it here in your report back. Once there are difficulties with community-based health care, the department ran right back to those institutions. So the question that begs an answer is, don’t we need a mix of institutions and the public health care facilities?” Moseneke asked Matsoso.
The director-general conceded that the country did need mental health institutions.
“Precisely, we do. A balance between facilities that we call facilities for acute care, for mental health, and those that are for long-term care. This is the difference between your Weskoppies, Sterkfontein versus these other facilities,” said Matsoso.
Moseneke said: “So the question still remains - do we need facilities for acute and long-term care? Do we need more of them, so that we won’t have the temptation to move them (mentally ill patients) out of clinics, to move them out of Life Esidimeni?”
Matsoso said the country did need more long-term care facilities.
Patients died after being moved from the Life Esidimeni facilities last year.