Persons living with mental illness face major challenges accessing disability grant

“I went to Sassa nine times last month to renew my disability grant and only on the ninth time was it approved,” says 30-year-old Howard (name changed) who was diagnosed with Schizoaffective disorder in 2018. He is among hundreds of people with disabling mental health illnesses like schizophrenia, bipolar disorder and depression who have complained about the difficulties applying for the grant.

There are currently just over a million people across the country who receive the grant, mostly for a six or 12-month period. The South African Social Security Agency (Sassa) provides a list of eligibility criteria which includes a medical assessment from one of only 360 state-approved doctors. Unlike a physical disability, assessing a person with a disabling mental illness can be tricky for overburdened practitioners and staff who sometimes have little understanding of why the full or reduced disability grant is critical to the applicant’s wellbeing.

Dr Sean Baumann, who was a psychiatrist for 25 years at Valkenberg Hospital, said the shortage of specialists in the public sector making these assessments is a problem. “There’s a lack of understanding of how enormously stressful these people’s lives can be. The problem with mental illness is that a lot of our colleagues tend to be working in an overcrowded community clinic, mostly seeing people with diabetes, HIV and TB,” he said.

“The disability grant is an intrinsic part of the package of care in a way. The struggles that come with economic hardship from a person’s inability to access the grant could cause a relapse or hospitalisation,” he explained. “So it really is intrinsic to their management and to ensure they can take their medication.”

For beneficiaries like Howard, having to repeat this process every six to 12 months is nerve-wracking. Howard currently lives at a residence owned by Cape Mental Health — a community-based mental health service organisation — in Observatory, Cape Town and relies on the grant to subsidise his stay there among other things.

Howard said he was formally diagnosed with Schizoaffective disorder four years ago. He has been in and out of hospital. Symptoms of this illness include hallucinations or delusions, and depression or manic periods. He will have to take medication to manage his symptoms for the rest of his life.

Howard said he and his family only discovered that he could apply for the grant after he joined one of Cape Mental Health’s programmes. “I went to Sassa with my ID and clinic card. They gave me a date to visit a Sassa doctor at the Day Hospital in Mitchells Plain with my medical documents and an affidavit to confirm my living situation. I had never seen this doctor before and the line at the clinic was so long that I knew I would have to wait almost all day,” he said.

The first time he applied, his application was granted for a six-month period. After that he had his grant renewed annually but not without hiccups. “I don’t really understand why, because my mental health condition is a permanent one. It’s not like I’ll wake up tomorrow and no longer have schizoaffective disorder. I suppose if during the assessment you appear to be more confident and engage well then they may think you no longer need it as much.”

Though familiar with the process, Howard said it took him nine visits to reapply for his grant at the Sassa offices in Cape Town. “People sleep outside from the previous day, so if you’re not in the first 70 people, then you have to go come back and try the next day. My next grant will be paid in June but I’ll only be back paid for three months even though I have been trying to reapply for longer than that,” he said.

“My advice to new applicants is to have lots and lots of patience and try their best to have all the required documents in order when they apply,” he said.

Common complaints

• Applicants have to arrive at Sassa offices before dawn and wait hours to be helped in long queues, often without shelter in bad weather.


• A limited number of people are helped at offices per day which means many people have to return more than once at their own expense to apply or merely to submit an outstanding document.


• Frequently malfunctioning computer systems also hamper the number of people helped per day.


• Grant recipients can also be exploited if their grant is paid to a third party.

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