In addition, many psychiatric patients are at higher risk for Covid-19 due to co-morbid diseases and difficulties in following preventative measures such as mask-wearing and social distancing. In a statement released on June 15, the South African Society of Psychiatrists (SASOP) urged public and private healthcare providers to maintain the availability of beds for psychiatric patients as they work to build a large hospital bed network to cope with the disease outbreak.

Dr Kagisho Maaroganye, a SASOP board member and public sector national convenor, said that against a background of a chronic psychiatric bed shortage and lack of psychiatric medication in the district health system to treat, manage or contain relapsed or new patients, there is no adequate plan in place to support mental health patients during the pandemic.

“The twin peaks of an increased rate of Covid-19 among psychiatric patients and increased incidence of relapses and new psychiatric cases is bound to have these two distinct groups of patients arriving at psychiatric facilities at the same time, and possibly in large numbers,” he said.

Dr Maaroganye warned that accommodating Covid-19-positive psychiatric patients in the same ward as psychiatric patients not suspected of having Covid-19 would be “unacceptable, for both ethical and humanitarian reasons”.

This would be contrary to the National Department of Health’s Covid-19 Infection Prevention and Control Guidelines (Version 2 issued May 21), which state that “Confirmed or suspected patients with Covid-19 not requiring ICU care should be accommodated either in a single room or in cohort isolation.”
He argued that the long-standing critical situation in state mental health hospitals is exacerbating the crisis, while psychiatric patients are far more at risk of contracting Covid-19 than the general population due to their high levels of co-morbidities.

“The lifestyle of those suffering from mental illness increases their risk and the most frequent co-morbidities include diabetes, hypertension, obesity, smoking, and addiction. These medical conditions not only escalate the risk of contracting Covid-19, but also the risk of mortality once infected. Psychiatric patients have for many years suffered from a minimal allocation of national healthcare resources to meet their needs and now, at a time that they are most vulnerable, they cannot once again be denied the rights afforded to medical and surgical patients for whom such mixing of patients would hardly be considered.”

Dr Maaroganye said mental healthcare services were already burdened by crowded living conditions in psychiatric hospitals with shared dining and bathroom spaces, and are poorly-equipped especially when it comes to protective equipment.

SASOP has urged the National Department of Health, provincial departments of health and private hospital groups not to use psychiatric beds for non-psychiatric Covid-19 patients in their drive to build a stronger hospital bed network, due to an already acute shortage of psychiatric beds.

The correct assumption that anyone could have Covid-19 even without symptoms should not negate or diminish the sound ethical and legal basis for this stance by the National Department of Health.

If you need help, phone any of these numbers:

Adcock Ingram Depression and Anxiety Helpline: 0800 70 80 90;

Suicide Crisis Line: 0800 567 567; SADAG Mental Health Line: 011 234 4837;

Akeso Psychiatric Response Unit 24 Hour: 0861 435 787

or the Cipla Whatsapp Chat Line on 076 882 2775.