Situated almost 150 kilometres from Johannesburg, Mogwase Prison was the first prison to become involved in the South African Depression and Anxiety Support Group’s Outreach project, aimed at providing education and information in those areas where there is a noticeable lack of support for mental health problems. As a result of overcrowding and lack of funds, conditions in many of South Africa’s prisons are dire, with high incidents of anxiety and depression among prison inmates.
Outreach co-ordinator, Therry Nhlapo, was accompanied by an experienced and dedicated psychiatrist Dr. Seape to the prison, where a talk was presented to over 20 professionals at the prison, including doctors, psychiatric nurses, social workers and guidance teachers. After a formal introduction by the Area manager of the Prison Department, Dr. Seape presented a talk covering anxiety disorders which also explained the five disorders falling under the umbrella of Mood Disorders. Difficulties in diagnosing Panic Disorder were also pointed out since the disease mimics a myriad of symptoms and syndromes ranging from heart attacks, gastrointestinal problems to neurological problems. Important psychosocial implications of Anxiety Disorders such as marital discord, job loss and associated financial difficulty, as well as drug and alcohol dependency were also discussed.
The programme was ended with a question-and-answer session which elicited many queries from the audience, who were interested in knowing how they could best help the prisoners in the absence of psychiatrists and psychologists. The prison doctor, Dr. Joe Kabugujjo was particularly interested in side effects and medication, and asked the group to try and influence the South African government to bring about a change in the curriculum at medical schools to include more training for general practitioners on psychiatric illnesses. A difficult question raised was that of how to differentiate genuine cases of depression from feigned illness attempts by attention seeking malingerers, especially in view of the fact that the symptoms of depression are rife in South African prisons. Therry Nhlapo explained the role that the support group plays in helping to identify these disorders, and how the different nationwide campaigns undertaken by the group educate people about these disorders. The enthusiasm of all the professionals working within the prison was most impressive, and groundwork was laid for the establishment of a support group within the prison, with constant input and support from the Depression and Anxiety Support Group’s Johannesburg headquarters.
Contact was allowed with 20 prison inmates who suspected that they might be suffering from anxiety or depression illnesses. The formation and the activities of the support group was discussed, and a brief overview of the five anxiety disorders was presented in the Sotho language. Inmates questioned whether the justice system is obliged by law to supply them with psychologists - they mentioned the lack of help available for psychological disorders in the prison. The formation of a prison support group with assistance by way of video and audio tapes, reading material and educational aids was proposed as an interim measure.
The Correctional Services department was pleased with the outcome of the initial meeting. A second pilot meeting is being planned with a view to expanding the group’s direct involvement in prisons to include all prisons by end-1999.