“Monopoly on Madness?”: Private Long-Term Mental Institutions in South Africa, 1963–1989
The government and those in its employ continued to focus on protecting white men from the “evils” of black insurgence and international maladies. One means of ensuring this was to disallow most Africans permanent settlement status within white cities by creating African “homelands” and the tricameral system. Yet despite the government’s intentions to move health care responsibility for blacks to homelands, it was never successful. It still needed to deal with potentially “dangerous” black individuals. In 1962, the South African government contracted long-term mental health care-particularly care of long-term black patients-to the private company Smith, Mitchell & Co. Because of the discriminate application of community psychiatric programs, the numbers of patients placed in Smith Mitchell’s mainly rural institutions increased signiﬁ cantly so that by the mid-1980s, Smith Mitchell provided over forty percent of all mental health care beds in the country. Only about six percent of the beds were reserved for whites.1 Charges of the government’s misuse of these institutions to detain political detainees and mistreat black patients were widespread in the 1970s. Investigations by the Church of Scientology’s Citizens Commission of Human Rights (CCHR), the International Committee of the Red Cross (ICRC), the World Health Organization (WHO), the Royal College of Psychiatrists, the American Psychiatric Association (APA), and an American psychiatrist, Dr. Stanley Platman and his nurse-practitioner wife Vera Thomas, substantiated these claims.