Hundreds of state patients declared unfit to stand trial are being held in correctional facilities instead of receiving treatment in psychiatric hospitals, raising serious concerns about their human rights, mental health care, and the broader justice system.
Patients Stuck in Limbo
According to Dr. Dudu Shiba, Director for Mental Health at the National Health Department, 362 state patients are currently detained in correctional centers, despite being legally mandated to receive psychiatric care. This figure represents nearly 10% of the country’s 3,675 state patients.
While administrative processes typically require a 28- to 30-day waiting period before transfer, Dr. Shiba admitted that 80-90% of these patients have been waiting far longer, with the Eastern Cape and Mpumalanga provinces facing the worst backlogs.
Systemic Challenges and Human Rights Risks
Dr. Shiba acknowledged the crisis, linking it to high crime rates, poverty, and a surge in court-ordered mental health declarations. Despite efforts to expand infrastructure—including new psychiatric hospitals in Mpumalanga, KwaZulu-Natal, and the Free State—the system remains overwhelmed.
Key issues include:
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Delayed discharges: Even when doctors recommend releasing stabilized patients, judicial approvals lag.
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Ongoing influx: From January to April 2025, 118 new state patients were admitted, adding to the backlog.
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Safety concerns: Mentally ill individuals are left in prisons, where their well-being and that of other inmates may be at risk.
No Clear Timeline for Resolution
Pressed on when the 362 patients would be transferred, Dr. Shiba could not provide a definitive deadline, citing fluctuating numbers and systemic delays. However, she noted that 118 patients were moved in early 2025 and pledged continued efforts to reduce the backlog through interdepartmental collaboration.
Human Rights Implications
Advocates warn that detaining mentally ill individuals in prisons violates their right to adequate care. Dr. Shiba conceded that correctional facilities are not therapeutic environments but emphasized that health teams conduct prison visits to initiate treatment.
Calls for Urgent Action
Critics argue that the government must accelerate transfers and address judicial bottlenecks. “These patients shouldn’t be in prisons,” Dr. Shiba said, acknowledging the urgency. Yet, with no fixed timeline for resolution, hundreds remain in limbo—a stark reminder of the intersection between mental health, justice, and human rights in South Africa.