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 care and aiding mental health 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 not only 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

Mental Health in South AfricaThe South African Depression and Anxiety Group (SADAG) conducted a study that revealed the shocking state of mental health in the country. In fact, one-third of South Africans have a mental illness. However, 75 percent of them will not get any kind of help.

This is where SADAG comes in. SADAG is Africa’s largest mental health support and advocacy group. It is made up of experts who take calls from South Africans about their mental health questions and concerns. The group has a 16-line “counseling-and-referral” call center and work in “urban, peri-urban and the most rural communities across South Africa.”

SADAG is comprised of a network of over 200 mental health treatment facilities and support groups throughout the country. Its focus is on areas lacking widespread community health resources. The organization believes access to this type of treatment is fundamental to improving mental health in South Africa. Additionally, SADAG believes it can improve the overall quality of life while simultaneously influencing socio-economic issues in a positive way.

SADAG and Language

Since South Africa has 11 different official languages, SADAG offers workshops and training programs tailored to these languages for individual members. In fact, the programs also are tailored to corporate businesses, healers, doctors, care workers, correctional facilities, schools and churches.

Workshops and Campaigns

These workshops focus on how to openly and productively talk about illnesses such as depression, panic disorders, bipolar disorder, PTSD and suicide prevention. Furthermore, the workshop explores healthy ways to deal with stress in an attempt to reduce the stigma surrounding mental health.

SADAG is also working to disseminate mental health awareness beyond just those member organizations within the group. They have created media campaigns with a message of de-stigmatization of mental illness that runs on TV and radio. Additionally, the campaign runs via print and electronic press releases.

Finally, SADAG has been working especially hard with HIV and AIDS patients on coping skills to conquer depression and other mental illnesses that accompany a diagnosis. This is pivotal in the country where the leading cause of death is HIV/AIDS.

There are several other organizations located in the nine different provinces doing important work to improve mental health in South Africa.

  1. Care Haven Psychiatric Centre: This center provides residential accommodation and an arts and crafts area. The main purpose is to provide therapeutic care for those with mental illnesses who have been discharged from psychiatric hospitals, and who struggle to function independently in society.
  2. Port Elizabeth Mental Health: Located in Port Elizabeth, this organization provides social work intervention services, skills training and prevention towards better mental health. It also promotes neighborhood unities for children with disabilities who cannot access special daycare centers. Finally, the organization offers youth skills development centers.
  3. Bloemcare Psychiatric Hospital: This is a private psychiatric hospital in Bloemfontein in the Free State. It offers psychiatric programs and nursing care. Its programs help develop coping skills and group therapy environments to connect with others. Furthermore, the hospital has recreational facilities and dietitians to help promote the balance between physical and mental health.
  4. SA Federation for Mental Health: This is the largest mental health organization in South Africa located in Randburg, South Africa. They work to implement national awareness campaigns, empower mental health care users and organizations, advocate for human rights of mental health care users and conduct mental health research.
  5. Ekupholeni Mental Health and Trauma Centre: Located in Katlehong, South Africa, this center provides HIV/AIDS support and a bereavement program to counsel infected children, youth and adults.
  6. PsySSA: The Psychological Society of South Africa works to negotiate with the government and other legislative bodies to create programs that focus on mental health awareness development. Specifically, these programs focus on the unique circumstances of a post-Apartheid society.
  7. Durban & Coastal Mental Health Society: In addition to standard psychiatric care, this organization offers protective training workshops that promote self-worth, dignity and self-reliance for those with mental illnesses. The organization does this through job creation initiatives that encourage block making projects, gardening projects and supported employment.
  8. NICRO: This organization focuses on social crime prevention, juvenile justice and the reintegration of criminals into society during a tough transition.
  9. Mpumalanga Mental Health Society: Located in Secunda, South Africa, this organization advocates for the rights of the disabled, trains caregivers and provides social work services to those dealing with substance abuse.
  10. Careline Clinic: The goal of this clinic is to provide care while upholding human dignity. It provides psychotherapy and crisis resolution skills to encourage empathy for patients going through emotional trauma.
  11. MSF Rustenburg: This international NGO provides medical services and support, initiated by Doctors Without Borders. It focuses on providing support to domestic violence and sexual assault survivors. It is located in Rustenburg, South Africa.
  12. Bendiga House: Bendiga House is a facility helping those in recovery from trauma and those suffering from mental illness. It teaches independent living through lessons. For example, lessons are offered on budgeting, shopping and chores. It also provides group and music therapy, life skills training, exercise programs and supervised leisure and entertainment.

These great initiatives are tackling inter-sectional and systemic barriers that prevent adequate care for many marginalized communities. Overall, mental health in South Africa is improving via these organizations and initiatives.

– Meredith Breda
Photo: Flickr