The aim of this study was to document the safeguards inherent in the Mental Health Act (MHA) of 1973, and to examine the extent " to which these are observed in practice. The research was conducted at Lentegeur Hospital in Mitchells Plain, Cape Town. The population consisted of 726 certified patients who were admitted involuntarily (i.e. under sections 9 and 12 of the MHA) from 01 January 1990 to 31 December 1990. Data for each of these patients was collected from the admission register, clinical files, administrative files, and the certified post book. In addition, the official hospital statistics were examined. Measurements obtained included demographic data, the validity of the document contents, the validity of the certification process, and an overall measure of the validity of each of t he certifications taking into account both document contents and observance of the time strictures set out in the MHA. Twenty nine patients (4,0%) were admitted by Urgency (Section 12), and 697 (96,0%) on Reception Order (Section 9). The study focused mainly on the Section 9 patients, because of the small sample size for Urgency admissions. It was found that 609 (87,4%) of the 697 admissions were legally flawed in terms of document contents criteria and the time limits in the certification process. Document content criteria were not fulfilled in: 3,0% of the Applications for Reception Order; 32,1% of Medical Certificates; 20,1% of Reception Orders; and 3,6% of Reports to the Attorney-General. In 40,0% of certifications the Report to the Attorney-General (G2/28) could not be traced. Examination of temporal safeguards revealed that the least satisfactory aspect was the delay in the completion of the post-admission Report to the Attorney-General. It was found that 32,3% of these Reports were not submitted on time. Reasons for the discrepancy ("gap") between legal standards and actual practice are discussed. Recommendations are made which could help minimise or eradicate this "gap". These include suggestions for changes in the document format, for the use of a certification booklet, for stricter control of late and inadequate documentation, and for inservice training of all those involved in the certification process. / Thesis (M.Med.)-University of Natal, Durban, 1993.

This study examined, within the South African context, the prevalence of mental retardation in a forensic observation setting, and the impediments of and successes to forensic rehabilitation. The results of the study indicated that a significant amount of forensic observation patients (25.16%) are ultimately diagnosed as being mentally retarded, with 39.24 percent of such offenders being found unfit to plead. Further 32.91 percent of the same sample was found to be not responsible for their actions. A link was also drawn between the mentally retarded offender and violent offenses. The advantages and disadvantages of a current rehabilitative process are discussed in light of alternate community-based forms of rehabilitation that are being implemented in other countries, for example the United States of America, with a view towards investigated their usefulness and adaptability to South African circumstances. The findings of the study have implications for mental health professionals working within forensic settings concerning the future management of mentally retarded offenders, particularly within the rehabilitative process .

This dissertation deals with the comparative analysis of mental illness as a defence in criminal law. The mental illness / insanity defence is deemed applicable when the accused does not have mens rea or lacks criminal responsibility or is afflicted by the inability to appreciate the wrongfulness of his act and act accordingly, at the time of the commission of the offence due to a pathological disturbance of the mental faculties. A review of the law in South Africa, English Law and United States of America law was done with regard to their approach in connection with the matter. The legal systems of South Africa, English Law and the United States of America were compared and analyzed because English Law and United States of America are developed countries and I decided to compare their approach to insanity defence with reference to South Africa, which is a developing country. Similarities were drawn between South Africa and English Law and this could be attributed to the fact that South African law emanated from English law. This is an important research topic on comparative analysis of mental illness as a defence in criminal law. The law applicable today in South Africa in respect of the defence of mental illness is combined in the provisions of the Criminal Procedure Act 51 of 1977, which replaced the criteria as set out in the M’Naghten rules and the irresistible impulse test. In all the three countries law that were compared the burden of proof has always been on the accused to prove his case on a balance of probabilities but in South Africa the position now is he who alleges must prove because of the legislative amendments. United States of America law allows for the forcible medication with drugs of the mentally ill defendants who are charged with crimes so that they can be fit to stand trial. This is the only country in the ones that were analyzed, which practices such a barbaric and inhuman acts. In the USA , the defendant has the burden of proving the defence of insanity by clear and convincing evidence, and the finding in not guilty by reason of insanity, English law, South African law has the same finding in insanity cases. The most common diagnosis used in support of a defence of insanity continues to be schizophrenia in South Africa and in English law system. In the English law system, the Home Secretary has the power to order defendant to be detained in a hospital on the basis of reports from at least two medical practitioners that the defendant is suffering from mental illness, if the minister is of the opinion that it is in the public interest to do so. In South Africa, the accused will be detained in a psychiatric hospital or a prison pending the decision of a judge in chambers. The detention of those found not guilty by reason of insanity could be challenged under the Human Rights Act in English law because the legal definition of insanity is far wider than the medical concept of mental disorder. The Drs under English Law have to use the legal, not the medical understanding of the mental disorder. The placing of a burden of proof on the defendant may be challengeable under European Convention of Human Rights as contrary to the presumption of innocence that is protected under convention. Finally this is a controversial subject on mental illness but the position in South Africa has been clear for a long time, and I did not come across any deficiencies in our law. I submit that South African law position on mental illness is good.

No abstract available.

No abstract available.

The purpose of this thesis is to develop a comprehensive process for identifying and addressing primarily constitutional, medico-legal and liability issues, and in addition ethical, social and scientific issues related to the psychiatric and psychology professions in South Africa. In fulfilling this purpose, a comprehensive search is conducted of relevant historical, ethical, philosophical and clinical aspects pertaining to psychiatry and psychology, as well as an evaluation of the current juridical framework regarding the legal liability of the psychiatrist and psychologist balanced against the constitutional rights of the mentally disordered patient in South Africa. Recommendations are made for the establishment of any new controls needed to mitigate and prevent the exposure of mentally disordered patients, further attempting to provide specific remedies to adapt the current juridical framework in South Africa. The examination is conducted within the framework of the South African and United Kingdom's legal systems. Focus is placed on aspects of medical law, human rights law (as envisaged in the Bill of Rights in the Constitution of the Republic of South Africa, 1996), criminal law and the law of delict and, to a lesser extent, administrative law and the law of evidence. / Law / LL.D.

The purpose of this thesis is to develop a comprehensive process for identifying and addressing primarily constitutional, medico-legal and liability issues, and in addition ethical, social and scientific issues related to the psychiatric and psychology professions in South Africa. In fulfilling this purpose, a comprehensive search is conducted of relevant historical, ethical, philosophical and clinical aspects pertaining to psychiatry and psychology, as well as an evaluation of the current juridical framework regarding the legal liability of the psychiatrist and psychologist balanced against the constitutional rights of the mentally disordered patient in South Africa. Recommendations are made for the establishment of any new controls needed to mitigate and prevent the exposure of mentally disordered patients, further attempting to provide specific remedies to adapt the current juridical framework in South Africa. The examination is conducted within the framework of the South African and United Kingdom's legal systems. Focus is placed on aspects of medical law, human rights law (as envisaged in the Bill of Rights in the Constitution of the Republic of South Africa, 1996), criminal law and the law of delict and, to a lesser extent, administrative law and the law of evidence. / Law / LL.D.

Mental illness remains one of the most devastating condition affecting the social functioning of individuals and families. The affected individuals and their caregivers expressed dissatisfaction in mental health service delivery. The mental health system is medically oriented and does not involve caregivers as partners in the provision of mental health services. Although the developmental approach has been adopted to guide the provision of services recognising human rights and social justice, the medical model remains a challenge in the provision of comprehensive mental health services. This is compounded by the Mental Health Care Act (Act No. 17 of 2002) that is silent on the role of families in the mental health system. Additionally, social workers are unable to provide adequate services due to lack of resources. A qualitative study using the exploratory, descriptive and contextual designs was undertaken. Purposive sampling was used to select 28 participants from three groups, namely ten MHCUs, nine caregivers and nine social workers. The goals of the study were to understand the experiences of MHCUs, caregivers and social workers in mental health service delivery; and to proffer guidelines for social work practice to enhance partnership between the family and mental health care providers. Data was gathered through semi-structured interviews and analysed according to Tesch’s (in Creswell, 2009:186; 2014) framework. Data verification was guided by Lincoln and Guba’s (in Krefting, 1991:214-222) model to enhance trustworthiness. The findings suggest that MHCUs and caregivers received inadequate psychosocial support which is attributed to lack of involvement in service delivery. Furthermore, social workers lack adequate training to provide effective mental health care. As a result, guidelines were developed for the establishment and enhancement of partnership between families and mental health service providers to offer comprehensive and sustainable mental health services. Future exploration of the role of the family in mental health services is required. / Social Work / D. Phil. (Social Work)