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Opposition to psychiatry in South Africa: A Web Archive
Discussion Document No 1

Human rights in psychiatry and the S.A. Federation for Mental Health's relationship with the state

Paul Serebro & Martin Terre Blanche

The S.A. Federation for Mental Health is keen to distance itself from the state. It wants to be seen as in independent non-government organisation providing for the needs of people with mental illness in the community. The reality, however, is that the S.A. Federation for Mental Health in its various guises since its establishement in 1920 (as the "SA National Council for Mental Hygiene and for the Care of The Feeble-Minded", Vitus, 1987) has always had a 'parastatal' quality. The S.A. Federation for Mental Health has always been heavily subsidised by the state, and state employees such as the first "commissioner for mental health", Dr J.T. Dunston, have frequently enjoyed ex-officio representation on the management committee of the National Council.

An interesting example of the S.A. Federation for Mental Health's close ties to the state can be found in the controversy surrounding the American Psychiatric Association's (1976) report on South African psychiatry under apartheid. Harsh criticisms of the report came from the then Commissioner for Mental Health, Dr P.H. Henning as well as from Professor L.S. Gillis on behalf of the Psychiatry Society of South Africa. Professor Gillis was also president of the National Council for Mental Health and had been closely involved with the organistion for many years. One prominent figure in the S.A. Federationfor Mental Health who did endorse the APA report was deputy director Lage Vitus, but his view was not generally accepted within the organisation (Vitus, 1987, 1999).

According toVitus (1987), "one of the main reasons why the National Council has perhaps neglected human rights issues, is that it has feared being classified with anti-psychiatric groups like the scientologists. During the 1970s, these groups were very vocal. Unfortunately their criticisms were so exaggerated that these had the effect of making the authorities regard even mild criticism as anti-psychiatric propaganda " (p. 87).

Currently the S.A. Federation for Mental Health is consciously trying to become more psychiatric user-orientated and to play down its image as a state-funded bureaucracy. To that end the Federation has revised its constitution to ensure that people with mental illness serve on its management committee and the committees of its affiliated mental health societies (Vitus, 1999). So far this endeavour has not been very successful and only a few current or previous psychiatric service users have been elected to such positions. An empowerment programme has accordingly been established which attempts to encourage people with mental illness to assert their rights, but the programme is run by the same cadre of individuals who have in the recent past interacted with psychiatric service users in a paternalistic manner and the success of the programme must therefore be in some doubt.

The likely scenario for the immediate future is that the S.A. Federation for Mental Health will point to instances where service users do occupy executive positions as evidence of their success, but that in fact these will be token appointments and that the S.A. Federation for Mental Health will continue to operate in an essentially top-down, professional-driven, paternalistic manner.

August 1999

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APA (1976). Report of the committee to visit South Africa: Official action of the American Psychiatric Association. American Journal of Psychiatry, 136(11).

Vitus, L. (1987). The role of the National Council for Mental Health and government agencies in developing mental health policy. Unpublished Masters Dissertation, University of South Africa.

Vitus, L. (1999). Personal communication, Paul Serebro, June.

This is the first in a series of discussion documents that form part of a larger project of building an archive of historical materials on opposition to psychiatry in South Africa. Please feel free to use the information in this document with reference. For more information contact Paul Serebro ( or Martin Terre Blanche (