An “Open Letter”

In volume 4, number 3 of the Journal of Child Psychotherapy, Elizabeth Holder expressed her profound distaste for the abuse of psychiatry for political purposes in the U.S.S.R. and Eastern Europe. She argued that child psychotherapists should become involved when “… a professional discipline akin to our own and founded on the same humanistic principals is being blatantly misapplied”. She suggested that a policy of non-involvement in what psychiatrists were apparently doing in another country could be described as complicity in such circumstances.

As a result of a suggestion from a child therapist friend, I now write to draw attention to another issue. I refer to ethical problems arising from the publication of the W.H.O. Secretariat's Preliminary Review “Apartheid and Mental Health Care” — prepared for the U.N. Special Committee Against Apartheid (Published in Geneva on the 22nd March 1977). The report summarises four types of allegations about privately provided mental health care for African patients — some 8,000 to 9,000 in number.

1. The Institutions run by a private enterprise known as the Smith-Mitchell Company, keep in custody an exceedingly large number of Africans, admitted on an involuntary basis through a perfunctory legal and medical procedure.

2. The standards of care provided and the living conditions of the patients in these institutions are extremely poor and degrading, not only in comparison with the standards of a mental health care ensured for the white population, but also in relation to the most elementary and essential human needs and rights.

3. There is a collusion of interest between the private companies and the State, in the sense that the companies are making a profit, using Government subsidies, while the Government is spending through this arrangement less than it would have to, if mental health care for Africans were to be provided entirely by the State Services.

4. The chain of private institutions for mentally ill black Africans is a tool for human ri