'A new Esidimeni looms': Mentally ill are dying in jail despite warnings
Prisons watchdog flagged a rise in suicide among mentally ill prisoners - then two more deaths were reported
Six weeks after the Judicial Inspectorate for Correctional Services (JICS) warned that suicides were on the increase among mentally ill prisoners, two more unnatural deaths were reported.
This emerged at a JICS seminar in the Eastern Cape last week, where the state of mentally ill prisoners was discussed.
JICS spokesperson Emerantia Cupido told Times Select the inspectorate could at this stage confirm two more unnatural deaths among mentally ill patients since the end of March.
“At this stage we don’t want to speculate [if there could be more such deaths],” she said.
“Due to the DCS [Department of Correctional Services] defunct mandatory system, we cannot be absolutely sure ... The department has only catagorised these two deaths so we don’t know how many of the other deaths were mentally ill inmates. The categorisation of deaths is still outstanding,” said Cupido, referring to the Correctional Services Act 111 of 1998, which states that the head of each facility must keep a detailed record of all deaths.
Inspecting judge, Justice Johann van der Westhuizen, recently said: “If we cannot find solutions to this problem we may be staring at a possible Life Esidimeni incident ... All mentally ill persons are considered vulnerable in our society, irrespective of whether they are incarcerated or not. We need to treat our citizens with the dignity they deserve in order to preserve and protect our society in its entirety.” The two deaths that were reported after March were a suicide and a homicide.
Diagnosed with schizophrenia In the suicide, the inmate, whose name has not been released, was diagnosed with schizophrenia in 2015 while serving a second prison term at the Zonderwater correctional centre.
He attempted suicide in 2016 and had several other attempted suicides shortly before he was found hanging in prison this year.
Inmates at Zonderwater said the man exhibited strange behaviour before hanging himself. They told JICS he had not been eating or bathing, and he screamed at night.
JICS said the DCS referred him to the Kalafong Hospital and upon his return he was housed at the medical facility which was a communal cell.
He was found hanging in the ablution facility of the cell in June 2018.
According to JICS he was never placed on suicide watch.
Homicide ‘under investigation’
There was a second report of a homicide of a mentally ill remand detainee at King William’s Town Correctional Facility. JICS said records show the inmate informed the centre’s medical official on admission that he was mentally ill but did not have his medication.
The man was placed in a cell with fellow mentally ill inmates, including declared state patients.
According to JICS, the inmate was not provided with medical treatment by the DCS and spent five days without his medication before he died.
The report said that on the night of his death the inmate seemed delusional and allegedly tried to attack other mentally ill inmates with a toothbrush. They responded by attacking him. The inmate was left sitting against the wall of the cell where he was found dead the next morning by officials.
DCS spokesperson Singabakho Nxumalo said he would not comment on the cases. “Every unnatural death [is] recorded ... [And] receives attention and must be investigated ... As a result, I will not want to comment on the information provided by JICS.”
Cupido said there are currently 1,212 incarcerated mentally ill state patients in 81 facilities inspected by the organisation.
According to an annual report released on October 11, there were 82 unnatural deaths reported in 2017/18, with suicides accounting for 27 (38%).
The report looked into the living conditions of prisoners at 81 of the country’s 243 correctional centres.
Disturbed by what it had found, JICS held the seminar last week to outline its concern about the plight of mentally ill inmates and state patients and to try to find solutions. The inspectorate said it investigated many incidents where mentally ill inmates and state patients were victimised and assaulted.
They believe state prisons are being used as care facilities for the mentally ill.
Cupido said JICS was also concerned about the lack of staff, such as psychologists and psychiatrists, trained to deal with mental health inmates.
Nxumalo agreed that the DCS lacked skilled staff. “We do have challenges ... [The] majority of our facilities are old and they were constructed solely for incarceration purposes and this presents us with limited space to accommodate inmates with special needs. Further to this ... adequately skilled professionals are not easily available and sadly, some do not stay long with us.”
The DCS had proposed the designation of certain correctional facilities to house only mentally ill patients, and had increased the support available to vulnerable offenders, “especially during the first 24 hours in custody”.
“It is in the spirit of respect for human rights and treatment of people as equal that we call for mental institutions to treat inmates as patients seeking help and not be viewed as a different category. “Our view ... is that mental health care management and services must be prioritised by the country. And mental health care must be de-institutionalised so that community-based care can be set up in a systematic way. By doing so, this would entail first strengthening and then expanding community-based care. “We will continue to take the mental health of inmates extremely seriously,” Nxumalo said.