The Covid-19 global pandemic brought the world to a screeching halt while compounding the mental health crisis in South Africa, with many reported cases of Depression, Generalised Anxiety Disorder, Panic Attacks, Suicide Ideation and Trauma during the lockdown.
By: Thanduxolo “Thandz” Buti
Main image: Mwangi Gatheca – unsplash
The state of mental health care in South Africa has always been a paradox and the government has yet to make any drastic step to curb this growing and largely misunderstood epidemic. Ordinary people still lack access to simple mental education, access to mental facilities and treatment, resulting in further stigmatisation, or even worse, death. Many still associate mental illness with the upper and middle-class population, due to the expensive and highly inaccessible mental care resources.
According to research data, “1 in 3 South Africans will or do suffer from mental illness at some point in their lifetime.” And fewer than 1 in 10 people living with mental illness have access to mental care.
According to Psychiatrist and Chairperson of the SA Mental Health Alliance, Dr Mvuyiso Talatala, the little investment that the government injects into mental health care is not enough to cover the local mental health system. “Less than 5% of the national budget is spent on mental health care, and the majority of that budget is allocated to inpatient hospital care,” he says. “There isn’t nearly enough budget and resources allocated for outpatient programmes to help patients once they leave hospitals, and there isn’t enough money invested in community mental health systems.
“The only way to change the system is to advocate for more investment into mental health by appealing to governments – both provincially and nationally – to prioritize Mental Health, not just on paper but in the budgets too.”
Covid-19 Impact on Mental Health
The Covid-19 pandemic further exposed the inadequacy in the mental health system, as the lockdown further aggravated mental illnesses. According to Cassey Chambers, the Operations Director at SADAG (South African Depression And Anxiety Group), the volume of their helpline calls doubled in the last six months “with people feeling overwhelmed with depression, financial problems, anxiety and stress.” There were estimated 1000 – 1400 calls a day, over a 100 Whatsapp messages a day, 30 -50 patient emails and 5000 – 16 000 people logged in to Online Facebook expert chats.
Dr Frans August Korb, a Clinical Psychologist & Psychiatrist, says that during the early stages of the Covid-19, it appeared that the focus was more on physical symptoms and the management of the virus than on the psychological impact. However, along the way the focus slightly shifted towards the mental health effects of the virus – especially in reports, research and journals.
“Some of the main things that were highlighted in some of the research were that there had been a steep increase in psychiatric problems – depression, anxiety and suicide, with a dramatic increase in suicides. There were reports of new cases of depression, anxiety, stress and other psychiatric disorders.
“(There are people) who had controlled their depression, psychosis and substance abuse (which is one of the biggest ones reported), especially with people who had been in remission with their substance abuse, going out of control. Also, there were new cases, re-aggravation and relapsing on pre-existing psychiatric cases.
“I still believe that for a while we are still going to see this fallout with the psychiatric problems, especially in the next coming months. There is also the stigma for people who have had Covid-19, which is almost similar to the mental illness stigma. People who have had the virus and made a recovery are still being treated with suspicion and still not being included due to the fear that they might still infect other people. We definitely need to think about the stigma.”
Telehealth – Remote Consultations
With the world shifting fully towards digital connections during the lockdown, in order to adhere to social distancing regulations, this saw the utilisation of Telehealth, the use of technology (phones, computers, tablets etc.) for various healthcare activities, such as diagnosis, treatment, prevention and health education.
According to data from an online survey by SADAG of 200 patients and 109 mental healthcare professionals to explore the experience of the virtual telehealth sessions during Covid-19, reported cases from both patients and mental health professional were Depression, Generalised Anxiety Disorder, Panic Attacks, Suicide Ideation and Trauma.
Many made use of Zoom, Whatsapp, Skype and MS Teams for online consultations, with Zoom being the most used platform with 58% of patients and 81% of health professionals using it.
77% of mental healthcare professionals also revealed that through technology they were able to reach new clients, and a further 65% of mental care professionals added that through tele-counselling they could also reach clients in underprivileged areas in outlying and rural areas.
Over 58% of the patients who utilised tele-counselling during the lockdown stated that they would prefer to continue with the remote mental health support post-lockdown, while 48% still preferred face-to-face sessions over virtual consultations. 87% of mental health professionals indicated that they preferred to proceed with virtual counselling.
Chambers says that going forward it is imperative for us as a country to keep the conversation going around mental health, as it is needed now more than ever. “We had a mental health crisis before Covid-19, and we know this through the Life Esidemeni tragedy, and may we never have another Life Esidimeni. But if we don’t do anything quickly, and invest in mental health, we are going to be dealing with a Tsunami of Mental Health issues in an already strained mental healthcare system.
“If we can encourage people to get help, maybe we can prevent families from losing loved ones or from being devastated by suicide. Or just prevent patients from suffering in silence and scared to open up and to connect.
“With all these stats, we need to also remember that there are real people behind these numbers – people with family and friends, with lives and stories. We have to do everything we can to provide them with support.”
For more info and support, go to: sadag.org