Involuntary treatment of psychiatric patients in South Africa : review

Society deems that mentally ill patients who lack insight and judgement may be treated involuntarily in institutions as a way of protecting them and the society around them. The ethical principle of 'paternalism' supersedes the principle of 'autonomy'. In South Africa, the new Mental Health Care Act (MHCA), No 17, 2002 has raised the issues and profile of mental health and serves as an advocate for mental health care users. In accordance with this MHCA, a mental health care user may be treated involuntarily at a health establishment on an inpatient basis under very specific regulations that serve to protect the users' rights as much as possible. However, the implementation of involuntary treatment whilst upholding users' rights within a health care service, which is plagued by human resource and infrastructure constraints, is extremely difficult and likely to infringe on these rights. The understanding of the regulations and principles governing involuntary treatment is important as it is a means of helping users' who despite needing it, refuse such treatment. If it is done sensitively, respectfully and conservatively, we can both protect the users' and societies' interests whilst at the same time are compliant with the principles of the MHCA.