Mental Health in South Africa
While a 2019 report from the South African College of Applied Psychology painted a bleak portrait of mental health in South Africa, the country has recently seen promising innovations in telehealth, offering South Africans struggling with mental health new avenues for accessing vital resources and support.

Telehealth is Expanding Access to Mental Health Care

A severe shortage of mental health professionals creates a bottleneck to receiving psychiatric care in South Africa – currently, the country has only one psychiatrist for every 100,000 people. Where South Africa is experiencing a shortage of mental health workers, a report by the U.S. Health Resources and Services administration (NHRS) outlines the ability of telehealth services to increase patient access to healthcare professionals. By allowing providers the ability to deliver care from anywhere, the report said, telemental health is able to significantly expand the capacity of existing staff.

In South Africa’s rural areas, the large obstacles to care that patients currently face include the cost of transport and long distances. According to the NHRS’s report, telemental health addresses both of these obstacles, promising to reduce the cost of delivery both for the provider and the patient, both of whom stand to benefit financially from time saved and from no longer needing to pay for travel.

The South Africa Depression Anxiety Group (SADAG)

One telehealth technology, implemented by the country’s largest mental health support and advocacy group – the South Africa Depression Anxiety Group (SADAG) –  allows patients to speak or instant message directly with mental health professionals via a mobile phone or landline. When South Africa’s COVID-19 lockdown first began, SADAG saw calls to its helpline double. In September 2020, the organization was still receiving around 1,400 calls a day, an increase in the volume of 53% from the previous year.

To handle this influx of patients, SADAG has set up WhatsApp support groups, moderated by the organization’s counselors, and moved all of its day-to-day operations online. With 96% of South Africans now able to access either a landline or mobile phone, SADAG’s decision to shift its services to the digital sphere offers an alternative to in-person care for South Africans coping with mental illness.

SADAG has also recently launched a toll-free mental health hotline that gives nonprofit workers 24-hour access to mental health services, citing the need to provide “psychological first aid” to nonprofit workers who have experienced  “unprecedented strain and burden” during the pandemic.

The MEGA Project

The MEGA Project, a consortium of nine universities spread across Europe and Africa, is another organization focused on using technology and the internet to expand access to mental health services in South Africa. Through a mobile application, the project aims to offer primary care providers a screening tool to monitor children and adolescents for early warning signs of mental illness, hoping to increase the mental health literacy of these providers in the process. This technology, though still in its early stages of development, is one of the many innovations offering the potential to increase the capacity of South Africa’s overburdened mental health care sector.

Breaking Down Barriers of Geography and Stigma

Telepsychiatry not only helps patients overcome geographical barriers to receiving care but also breaks down the barriers that stigma creates. In South Africa, family, friends and health care workers often perpetuate stigma and misunderstandings around mental health. By giving access to mental health resources outside of a socioculturally insulated community, one study suggests that telepsychiatry can also overcome these stigma-related barriers in offering South Africans the possibility to interact with non-stigmatizing perspectives. According to the same study, telemental health services also mitigate stigmas that exist around older adults attending in-person sessions.

Professors Call for Increased Government Attention

In an op-ed penned alongside two University of Ghana public health professors and published in eNCA, one of the most popular news networks in South Africa, professor of global mental health and development at the University of Cape Town Crick Lund has called for increased attention by governments to the issue of mental health in African countries, and particularly in South Africa.

Pointing out that only 15% of South Africans with mental health conditions ever receive treatment, Lund called on governments to invest in mental health surveys as well as treatment and argued that this investment in mental health not only would improve health outcomes but would pay economic dividends.

Technology “must… be used to deliver mental health services in times of public health emergencies,” the op-ed argues. The professors added that investment in these technological innovations offers governments the opportunity to make “training for and practice of mental healthcare attractive and relevant.

“Underpinning all our recommendations is sufficient and timely mental health financing,” the professors wrote. “This requires a multi-sectoral strategy that shows the health and economic benefits of investing in mental health in Africa.”

– Coalter Palmer
Photo: Wikipedia Commons