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12 March 2004

Prejudice the greatest obstacle to mental health

Sufferers might no longer be regarded as possessed by demons or imprisoned, but the vicious cycle of ignorance, suffering, destitution and even death is perpetuated by prejudice.

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Despite the great strides made in treating mental illness, the greatest obstacle remains the public’s perception of the mentally ill. Sufferers might no longer be regarded as possessed by demons or imprisoned, but the vicious cycle of ignorance, suffering, destitution and even death is perpetuated by prejudice.

So said Prof. Tuviah Zabow, deputy head of UCT’s Department of Psychiatry.

“We do not know how many people are not getting access to care they need. As many as ten percent of the population may at some time be affected. Help is available and the cost is not great relative to other illness and the consequences.

“Many suffer silently. Many suffer alone because of stigma, shame and exclusion. We have the means and the scientific knowledge to help these people.”

According to Prof. Zabow, there have been four major revolutions in the approach towards mental health. The first development took place in the eighteenth and nineteenth century.

For the first time, insanity came to be regarded as a disease that could be cured. There was considerable social pressure to take care of the mentally ill. This was a far cry from the days when the mentally ill had to fend from themselves on the streets or had “the devil beaten out of them” as King George III had.

The role of the environment in affecting personality and mental functioning was recognised for the first time by pioneers such as Philippe Pinel.

Sigmund Freud heralded the second revolution at the turn of the twentieth century. This era was marked by a move away from the perception that mental illness was a crime and should be treated as such.

The development of psychotropic medication had a major impact on the treatment of mental illness. Not only did the population of mental hospitals decline significantly, there was also a general move against discrimination.

“Psychiatry no longer was portrayed as a means of control or to dispose of people who annoyed others,” said Prof. Zabow.

We are in the midst of the fourth revolution. Patient rights are being addressed, and a process has started to reduce the stigma of mental illness, said Prof Zabow.

For more information on mental health, contact the Mental Health Information Centre at (021) 938 9229.

- Ilse Pauw, health24 reporter

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