TRC Final Report

Volume 1

Chapter 11

Part OtherDepts

Subsection 22

Management and Operational Reports

MENTAL HEALTH UNIT

■ INTRODUCTION

1 The almost complete lack of reference to the issue of psychological support in the Promotion of National Unity and Reconciliation Act created some ambivalence with issues relating to psychological support services remaining an ongoing source of debate throughout the life of the Commission.

2 This dynamic was most demonstrably played out in the development of the statement-taking process. Initially, statements took the form of personal story telling to empathetic listeners, who recorded what was being said in a relatively informal manner. Due to the huge volume of statements, however, the process evolved into a more formalised fact-finding effort. In order to capture, process and corroborate each statement, a standard (but comprehensive) form was used to record victims ‘stories’. This could be used even where no ‘listener’ was available.

3 It must be acknowledged that this compromised the healing potential of the encounter. It took away much needed emotional space. This affected the experience of making a statement and denied statement takers the opportunity to make broad assessments and, where necessary, refer people to appropriate support services.

■ THE NATURE OF TRAUMA

4 The people who suffered most from traumatic episodes fell into five categories: the victim, the perpetrator, their families and dependants, the community and, in a different way, Commission personnel. Commission personnel and some dependants and family members formed a distinct group in that their traumatic experience was often of a vicarious nature. However, all groups vicariously or directly shared classic symptoms of post-traumatic stress syndrome. Symptoms included lowered self-esteem, depression, emotional blunting, avoidance behaviour, impulsiveness, uncontrollable anger, substance abuse, paranoia, relationship difficulties (social and interpersonal), complicated bereavement and sleep disturbance. Often such symptoms had become a part of life for the sufferer and were so deeply entrenched in the individual that they had to be viewed as part of that person and not merely a passing crisis.

5. It was important not to generalise or simplify diagnosis or, indeed, understanding of treatment. Often the trauma that individuals presented had been complicated by a range of socio-economic and medical problems and was also affected by the time that had elapsed since the traumatic event. Often living conditions caused a new range of emotional difficulties that conflated with previous ones, resulting in a complicated traumatic cocktail that demanded more then a mere therapeutic or healing intervention. The mental health of a person could not be seen or understood in isolation from socio-economic realities.

■ SUPPORT FOR WITNESSES AT HEARINGS

6 Support for witnesses at human rights violations hearings was the most visible part of the work undertaken by the Mental Health Unit. The public perception was of a briefer giving solace to a witness who had found the process of giving testimony deeply upsetting. This essentially ‘snap shot’ perception gave an impression of short-term interest and solace on the part of the Commission and did not reflect the interventions made by the Commission both before and after the hearings.

7 Such interventions included the preparation and briefing of witnesses before hearings, the containment and advocacy of witnesses during hearings and, after the hearings, the debriefing and referral of witnesses to regionally appropriate service providers who had a knowledge of local resources and who followed up accordingly.

8 The development of the Commission’s witness support strategy could best be described as the quest to bridge the gap between the need for and the provision of emotional support.

9 Although constrained by the limitations of the Act and overwhelmed by witnesses’ understandably high expectations of direct and immediate service delivery, the Commission, on the whole, managed to navigate a path that went some way towards restoring human dignity and facilitating the delivery of support.

10 The witness support strategy represented a creative and successful response to the problem of service delivery for witnesses in need of urgent follow up. During hearings, the Commission’s briefers provided direct support to witnesses. Outside of hearings, they tried to perform a co-ordinating role, auditing regional support services, enlisting the involvement of community briefers, training them in debriefing skills and monitoring the referral process. Community briefers also assumed the critical task of supplying longer-term support to people in need. As local service providers, community briefers endeavoured to ensure that people received the sustained interest and support that they required, although they met with different levels of success. The ability to provide ongoing support to those in need of counselling was ultimately, however, beyond the resources of the Commission.