Robben Island is located in Table Bay 6.9 km from the vibrant port city of Cape Town, South Africa. Made famous by Nelson Mandela – student activist – political prisoner number 466 – South Africa’s first post-apartheid president – 1993 Nobel Peace prize recipient – it is now a UNESCO World Heritage Site. It is a “must-see” for visitors to Cape Town so as we neared the end of our Global Mental Health Program of workshops and scientific meetings this past week, our group of researchers, clinicians, fellows, and advisory board members from around the world headed to the Victoria & Albert Waterfront to board the 9 AM ferry last Sunday.
That morning, I learned that Robben Island served as home not only to political prisoners as far back at the 17th century, but also to generations of lepers and lunatics.
1. In 1847, the British colonial government established the Robben Island Insane Asylum as part of a general infirmary for lepers, lunatics and the chronically ill. Misguided by notions of danger and contagion, government officials, doctors and Robben Island chaplains required that both lepers and lunatics be segregated from the general population. They also agreed that the needs of black and white lunatics were such that residents needed to be segregated from each other based on race as well.
2. In the wake of the early 20th century reform movement of psychiatry, new institutions were erected on the mainland, and the Robben Island Asylum fell into disrepair until it was resurrected in 1961 as a maximum security prison for political troublemakers. Nelson Mandela arrived in 1964 and spent 17 of his 28 years imprisoned there.
3. Treating individuals with mental illness in the same way that we treat prisoners continues to this day. In parts of Africa, chaining and shackling the mentally ill is common practice. In the US, prisons and jails have become our new asylums; with an estimated 10 times as many people with mental illness behind bars as compared to the number being treated in our psychiatric state hospitals.
4. “Robben Island is a symbol of the triumph of the human spirit over adversity” is proudly painted in big letters over the doorway for all visitors to read as they enter the queue for the ferry. “Nice idea, but is it true?” I wondered. A few hours later, I knew it was at least one of the truths of the island. As Ntsoelengoe Kgot so, fellow inmate of Nelson Mandela and current guide on Robben Island, pointed out Mandela’s cell and described their rations and routines, I asked him what matters most to him about his being a guide as opposed to a prisoner today. Without missing a beat, he replied with a focus on his mental health, “I have peace of mind. My mind is no longer tormented. I have my dignity.”
5. “… that we may have the strength to listen to the whispers of the abandoned, the pleas of those afraid, and the anguish of those without hope.” These were the words of Archbishop Desmond Tutu as he bowed his head and opened the first session of the Truth and Reconciliation Commission, which was set up to deal with what happened under apartheid. What would such an effort look like for those with mental illness?
We are 67 in all from around the world, united by the pledge that forty years hence the landscape of mental health will be transformed for the better – a gathering of spirits, a meeting of friends, a sharing of dreams.