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For a country with first hand experience of the effects of decades of discrimination and unfair treatment against certain groups of people, it is surprising that South Africa, its government and its citizens can still turn a blind eye to what is a blatant contravention of human rights. People suffering from mental illness in South Africa are sadly, due to intolerance, ignorance and fear, stereotyped as being weak, stupid, unstable and even violent, and this in turn is preventing them from getting the treatment they need.

For years the Depression and Anxiety Support Group, South Africa's largest patient advocacy and support group, together with a number of other non-profit organizations, has been fighting the stigma attached to mental illness and educating the public to increase awareness in order to help people recognize these illnesses and know where to get help. Prevention has also been a main aim of the group, with suicide rates for all population groups and ages on the increase.

A picture that the Group is seeing more and more often, is that of a person who after finally finding the correct help for their problem, and who, after three months is feeling better, suddenly finds they can no longer afford the treatment. It frequently happens that because of the limits and specifications of their Medical Aid, after a few visits to a psychiatrist, they find they have used up all the funds available for psychiatric treatment. Going to a State Hospital is also often not much help as the range of drugs the government is willing to subsidize for mental illness is not very wide. More often than not the patient will be unable to get the medication they need. They are now required to cover all costs themselves, and as this is more often than not rather substantial, they find they cannot afford to do this.

The Depression and Anxiety Support Group's latest campaign has been to highlight the inequality of treatment offered in state hospitals to mental patients when compared to the treatment offered to patients with other general medical conditions, as well as the inequality of Medical Aid benefits for mental illness compared to other illness.

Sadly this problem is an international one, with similar discrimination being seen in countries all around the world. Happily though, some countries are taking their constitutions seriously and changes are being made and improvements are being seen in access to mental health care and the quality of this care. Some countries are making swooping amendments to their health bills and passing laws to ensure companies that offer health coverage do so without discrimination.

On the 31st of October, the US Senate by voice vote, passed a sweeping measure that would, starting in 2003, require parity between health insurance benefits for mental health care and other medical care. One of the sponsors of the bill, Paul Wellstone stated: "It's a matter of discrimination. It's a matter of basic civil rights." He thought the bill's cost - an estimated $1.5 billion over 10 years - is appropriate. He asked: "For $150 million a year you don't think it's worth it to end the discrimination, to provide the coverage…that could be a matter of life and death?"

Understandably any changes in policy, either in government or in the various Medical Aid companies, costs money, but surely when placed next to the value of upholding our constitution, which guarantees equal access to treatment and the right not to be unfairly discriminated against, and next to the value of human life, the need can be seen.

According to the World Bank, in the year 2020, mental illness, depression in particular, is going to be the number one disability, costing governments and businesses the most. Surely a touch of prevention in this case would be far-sighted?


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