The South African Mental Health Advocacy Movement (SAMHAM) was established by the SA Federation for Mental Health (SAFMH) in 2007 in recognition of the importance of giving persons with psychosocial and intellectual disabilities a voice, and further recognising that they are ultimately the experts in mental health and should thus always be key partners among all stakeholders within the mental health sector. Outside of the mental health field and within communities, persons with psychosocial and intellectual disabilities must be empowered to participate at all levels of their lives. Prevalence rates of stigma attached to these disabilities are very high (not just in SA, but worldwide), which creates barriers in accessing and enjoying all rights enshrined in the South African Constitution’s Bill of Rights and other relevant policies and legislation such as the UN Convention on the Rights of Persons with Disabilities. Persons affected by these “invisible” disabilities however play a crucial role in breaking down these barriers through being empowered and actively engaging with the public and private sectors, and expressing their concerns, needs, challenges and working together to overcome these. Because of their personal experiences, these individuals are also a key source of awareness on mental health, with direct access to and in-depth knowledge about specific communties across South Africa.
People with psychosocial and intellectual disabilities themselves are however yet to effectively communicate and raise awareness of their needs and to self-advocate on all public platforms for their rights to be implemented and their challenges to be addressed. The lack of a strong national self-advocacy movement results in continued social isolation and marginalisation of these individuals. In this way, human rights violations continue unmonitored and ignored, which result in unequal and limited access to resources and protection. These conditions impact directly on the material and lived reality of persons with psychosocial and intellectual disabilities.
The Dept of Health’s National Mental Health Policy Framework and Strategic Action Plan for 2013-2020 emphasises (in point 7.5 on Advocacy) that there is a commitment from the Dept of Health to (4) “give exposure to positive images of mental health advocates, prominent user role models and well-known and influential champions for mental health in order to change discriminatory attitudes toward mental disability. This work will be framed within the provisions of the UN Convention of the Rights of Disabled Persons and the human rights based framework of South African law, as well as advocacy guidelines from the WHO” and further states (5) “Emphasis will be placed on ensuring representation of people with mental disability on the broader disability agenda, and developing capacity to place mental health user concerns on the political, development and public health agenda”. The goals listed under point 7.5 are set to be achieved by 2015, and it is therefore critical that this be prioritised and that persons with psychosocial and intellectual disabilities are empowered and able to fully participate within the ambit of these activities and to successfully achieve these goals.
Thus far, advocacy groups have been established in some provinces, functioning at different levels. However, they very often still lack sufficient capacity to be strong, united and representative voices for persons with psychosocial and intellectual disabilities at a national level. This is where SAMHAM is of vital importance, as it has an extremely important role to play in the strengthening of existing advocacy groups, supporting the establishment of advocacy groups in parts of the country where such groups are still lacking, whilst at the same time also identifying individuals with leadership potential and developing them into leaders for the mental health movement around which ongoing advocacy and awareness activities can be built.
SAFMH recognises that it has an important part to play in the empowerment of persons with psychosocial and intellectual disabilities in South Africa. At the same time, SAFMH also recognises that, as an NGO with limited resouces, it is important for the organisation to find its niche in the field of awareness. SAFMH has over the years trialled several different approaches to national awareness; however, with ongoing resource contraints, it is important for the organisation to rationalise what it can realistically achieve within the parameters of its infrastructure and services. Further to this, SAFMH recognises that, as advocates for mental health, with empowerment at its heart, the organisation is in a position to utilise SAMHAM as a vehicle not only for advocacy and empowerment, but also for awareness.
Based on this, SAFMH has developed an intensive 4-year strategy for the period 2015/2016 - 2018/2019, to support the establishment of mental health care user advocacy groups in all 9 provinces of South Africa, with the aim of creating a well-coordinated, effective national advocacy movement through which mental health care users can be empowered:
The provinces have been selected based on the scale of work needed to help develop effective advocacy work in the provinces, taking into consideration the sizes of the provinces and what has already been done (or not). Provinces with the highest need are prioritised first, leading to provinces with more established advocacy groups, which might just be in need of some degree of coordination, or assessing areas not currently covered by the Mental Health Societies.
At the centre of the awareness agenda is the need to address stigma and discrimination, and SAMHAM provides an excellent vehicle for doing so. In the report on the 5th International Stigma Conference, which took place in Canada in June 2012, a number of key messages emerged, which highlighted many of the issues within the international study of stigma and discrimination that needed to be taken forward, amongst others stating that it is important to:
Against this backdrop, SAMHAM provides SAFMH (and South Africa) with the perfect structure to build a responsive mental health advocacy and awareness structure.
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