TRC Final Report

Volume 4

Chapter 5

Subsection 14

■ THE ROLE OF MENTAL HEALTH PROFESSIONALS

77 The area of mental health has historically been neglected in South Africa. Very few psychologists and clinical social workers were trained, resource allocation was notoriously inadequate and very few attempts were made to provide culturally appropriate mental health care to all South Africans.

78 The training of clinical psychologists in South Africa has been criticised for producing mental health professionals who mirrored their (white) environment: urban-based, in private practice and focused on curative rather than preventive mental health care. In addition, the type of treatment modality taught was overwhelmingly that of one-on-one therapy. Although obviously effective in some settings, this kind of therapy was generally available only to the elite few who could access and afford it – that is, the white population.

79 The first black psychologist to qualify in South Africa did so in the early 1960s. By 1998, the Human Sciences Research Council estimated that there were 3 897 psychologists in South Africa, 3 587 (92 per cent) of whom were white. Mental health care for black people consisted largely of institutionalisation (even at the time of reporting). A number of inaccurate concepts about the mental health of black people included, for example, the notion that black people do not get depressed and that black people displaying symptoms of severe stress are suffering from ‘Bantu hysteria’, to be treated with medication. An entire language and terminology was built up around this issue. The effect was to deny the need for preventive and counselling services for black people. Instead, chronic stress and trauma were pathologised and prescription medication was used as treatment.

Involvement in human rights abuses

80 While it was extremely difficult to find any hard evidence of overt involvement in gross human rights violations by psychologists, the profession was undoubtedly involved in human rights abuses through acts of omission. It also displayed a general apathy in relation to issues such as the effects on mental health of endemic violence, detention, solitary confinement and torture. In addition, until very recently, the profession failed to draw attention to the incontrovertible link between apartheid and mental health or to comment on the destructive effect of apartheid policies on the mental health of those they oppressed. According to one submission:

All citizens have had their human dignity denied and degraded through the experiences of living through the apartheid years. Our humanity and common sensibilities have been stunted.

It is evident that the predecessor of the South African Federation for Mental Health at the national level was supportive of the apartheid policies of the government and did little or nothing to oppose other human rights violations in the field of mental health. It even reprimanded committee members or staff who did so.

81 Various submissions reported that individual psychologists were involved in human rights abuses and/or unethical conduct that may have led to abuses. Some of those named were psychologists EG Malherbe, RW Wilcocks and HF Verwoerd who, for example, advocated racist policies like job reservation and prohibition of sexual intercourse between the races. Others mentioned were psychologists like ML Fick and JAvan Rensburg, who were amongst those who propagated ideas of black intellectual inferiority. These views bolstered segregationist policies that resulted in gross violations of human rights.

82 Similarly, there is evidence that at least some practitioners engaged by the prison service acted in collusion with the prison authorities:

Practitioners … tended to adopt an attitude that indicated their subservience to the requirements of the security police or the prison administration. Indeed, many of them …would rather gather information from the warders/jailers than myself. I often wondered who the actual patient was … I, the patient, became invisible…

The psychologist who visited me at Victor Verster Prison … in Nov 1982, really interrogated us … His role was to ferret out exactly what we would do on our release. He actually told me that, if I became a psychologist, I would be dangerous to the state because of the insights I could bring to political organisations – that I would be able to decide who would be an asset and who a liability to the struggle, while sifting out agents!³⁹

83 Breyten Breytenbach described his encounters with prison psychologists thus:

These perverted practitioners of the spurious science of psychology do not have as their first priority to help the prisoner who may be in need of it. They are the lackeys of the system. Their task is very clearly to be the psychological component of the general strategy of unbalancing and disorientating the political prisoner.

84 A former SAP psychologist admitted in an interview that work associated with the use of psychology in torture and interrogation was ‘contracted out’ to outside psychologists, so that the SAP could deny the involvement of their own staff in this type of unethical behaviour.

85 Conditions in mental institutions were appalling and did nothing to foster mental health. Inmates were used as sources of income-producing labour and there are (unproved) allegations that black patients were used as ‘guinea pigs’ in research. Mental health professionals remained silent about this situation. The Department of Health acknowledges:

Conditions in a number of psychiatric institutions are still poor. Some of the worst wards and hospitals (for example, Westford in Gauteng) have been closed down. Many psychiatric hospitals are still faced with staff shortages.