For decades, Cape Mental Health - a community-based non-profit working throughout the Western Cape - has championed the rights and well-being of society's most vulnerable, particularly people with intellectual disabilities. Central to its approach is a simple but powerful conviction: that these individuals are not passive recipients of care, but rights holders who deserve dignity, protection, and full inclusion in their communities.
As part of this work is its Access to Justice Programme, a critical intervention helping survivors of abuse, particularly sexual violence, navigate a system that often excludes them, offering psychological and legal support, court preparation, and close collaboration with caregivers and law enforcement.
Cape Mental Health is not only challenging stigma but bridging a life-or-death gap between health, social support, and justice systems that too often fail those they are meant to protect.
For many survivors of sexual violence with intellectual disabilities, justice does not begin in a courtroom. It begins in fear.
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"They are easily intimidated," says Keamogetse Mokgadi, the Access to Justice Manager at Cape Mental Health. "Someone threatens them, shifts the blame, tells them it will be their fault and they believe it."
In some cases, survivors cannot identify their abuser . In others, they cannot describe what happened in ways the justice system expects. Sometimes, the abuse only comes to light months later through pregnancy, through a witness, or by accident. And sometimes, it never comes to light at all.
Across communities, perpetrators take advantage of this vulnerability. They know who is less likely to be believed. They know who has been taught to obey adults without question. They know who the system is least prepared to protect.
"There is still this idea that people with intellectual disabilities don't have feelings, or that they make things up. So people take these cases lightly," says Mokgadi.
It is this dangerous combination of stigma, silence and systemic failure that the Access to Justice Programme was built to destroy.
Before the 1990s, survivors with intellectual disabilities faced near-impossible odds in South Africa's courts . Cases were often withdrawn before trial. Police struggled to take statements. Prosecutors doubted the testimony. Courts dismissed survivors as unreliable.
"They were seen as suggestible," Mokgadi explains. "As not competent to testify."
The turning point came when a prosecutor from Wynberg Sexual Offences Court took a chance, asking a psychologist at Cape Mental Health to assess a complainant with intellectual disability who, despite barriers, might be able to testify. The case led to a successful prosecution.
"That was the breakthrough," Mokgadi says. "It set up the programme during that time."
From that moment, the Access to Justice Programme began to take shape, transforming how the legal system engages with survivors with intellectual disabilities.
Today, the programme works at the intersection of psychology and law, translating vulnerability into evidence the courts can understand.
Cases come in through the police , prosecutors or care centres when there are signs that a survivor may have an intellectual disability. From there, a rigorous process begins, including psychosocial assessments, clinical evaluations, court preparation, and expert reports.
But the work goes deeper than paperwork. It is about rethinking what justice looks like.
"If someone cannot tell you the days of the week, or their date of birth," Mokgadi explains, "you cannot ask them what day the incident happened."
If a survivor cannot describe colours, you cannot expect them to identify what a perpetrator was wearing. If they struggle with communication, questions must be simplified. If they are anxious, they should not face their abuser in open court.
The programme assesses three critical areas, a survivor's level of intellectual functioning, their ability to consent, and their competence as a witness. It also recommends accommodations, such as intermediaries who can translate complex legal language into accessible communication.
People with severe intellectual disabilities may not even understand that what happened to them was abuse. Many cannot report it. Many cannot describe it.
"They are the biggest silent victims," Mokgadi says.
Even when cases are reported, justice moves slowly. Months stretch into years. And behind the scenes, the programme itself is under strain. In a week, Mokgadi says, they may receive up to 15 referrals. A psychologist can only complete two assessments in that time.
The result is a growing backlog, delayed reports, and postponed trials.
"We need more capacity," she says. "More psychologists. More social workers. More resources - financial resources."
Language barriers add another layer of difficulty, with a shortage of professionals able to work in indigenous languages. Meanwhile, social workers carry the emotional weight of supporting survivors and families through long, complex legal journeys.
Among the many cases Mokgadi has encountered, one still lingers. A survivor, displaced after abuse, spoke not of justice but of escape. "They just wanted to leave," Mokgadi recalls. "To go somewhere far. To start over."
Home was no longer safe. Family offered no refuge. Survival meant distance. What stayed with Mokgadi was not just the trauma but the awareness. "They were aware that this is not how people should normally live," she says. "They knew there were better ways to live life compared to their current state at that point in time."
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Despite the challenges, there are signs of change.
Courts are becoming more responsive. Survivor support is improving. There are efforts to make systems more accessible from simplified communication to dedicated waiting rooms for survivors of gender-based violence.
For Mokgadi, real change would mean something simple, yet transformative, a system that people with intellectual disabilities can understand and trust.
"Information must be easy to read. Visual. Accessible to everyone," she says. "Only then can people truly exercise their rights."
In a country grappling with one of the highest rates of gender-based violence in the world, the Access to Justice Programme is more than a service; it is a lifeline, says Mokgadi.
It ensures that survivors who have long been ignored are finally seen. The voices once dismissed are finally heard. That justice, however delayed, is still possible.
But its future and its potential to scale nationally depend on something beyond dedication. It depends on investment. With the right support, this model could be expanded across provinces, transforming how entire justice systems respond to vulnerability. Without it, the risk is clear: growing silence, unpunished wrongdoing, and more lives lived in the shadows.
