South African Psychiatry - November 2018

REPORT
FEEDBACK FROM THE ROYAL COLLEGE OF PSYCHIATRISTS
INTERNATIONAL CONFERENCE, JUNE 2018:
NEW
HORIZONS
Lesley Robertson
I
represented the South African Society of
Psychiatrists (SASOP) at the Royal College
of Psychiatrists (RCPsych) 2018 international
conference. A “tripartite” agreement exists
between the South African College of Psychiatrists,
the SASOP, and the RCPsych. Unlike South Africa,
where the College is responsible for conducting
national examinations and the SASOP furthers other
objectives of the profession, the RCPsych combines
both functions in one organisation. With its mission
statement of “Improving the lives of people with
mental illness”, the RCPsych is governed by a board
of ten trustees, which includes three lay people. At
present the lay trustees include a retired businessman,
a lawyer and a person with experience as a nonexecutive
director and strategic management. The
Board is supported and advised by the Council,
which has overall responsibility for education and
training, policy, professional practice, professional
standards, public engagement, quality improvement
and research. A far larger body, the Council includes
a patient and a carer representative as well as four
members of the Board, academic and divisional
representatives.
THE THEME OF THE CONGRESS WAS “NEW
HORIZONS”, AND THE FIRST NEW HORIZON
DISCUSSED WAS A NEW MENTAL HEALTH
ACT, TO BE ALIGNED WITH THE UNITED
NATIONS CONVENTION ON THE RIGHTS
OF PERSONS WITH DISABILITIES (CRPD).
Baroness Hale, the president
of the supreme court, outlined
the complexities around the
comment on article 12 of the
CRPD, legal capacity, involuntary
mental health care and insanity
defence. The difficulties she
raised were like those raised by
Freeman et al (2015), 1 and are
highly relevant to South Africa, Lesley Robertson
also signatory to the CRPD. I believe
we could gain by closely watching the processes
followed by the UK in drafting their new legislation.
In view of the Essential Medicines List, I opted to
attend presentations by the British Association
of Psychopharmacology (BAP), which publishes
evidence-informed treatment guidelines. They
presented on the management of the aggressive
patient, on schizophrenia, and on the use of
valproate.
THEIR APPROACH DIFFERS FROM THE
NICE GUIDELINES IN THEIR INCLUSION OF
OBSERVATIONAL STUDIES. OF NOTE, RCTS
MAY NOT RECRUIT SEVERELY ILL PEOPLE,
LEADING TO SMALL EFFECT SIZES AND A
LACK OF GENERALISABILITY.
So, to inform the BAP guidelines, observational
studies with hard, patient-oriented outcomes (e.g.
40 * SOUTH AFRICAN PSYCHIATRY ISSUE 17 2018