Coping with the rise in mental illness
IS SOUTH Africa in the grip of a mental health crisis? This was the question when a group of journalists were presented with the latest stats at a mental health summit held in Joburg recently.
According to a global study, mental disorders have increased by 22.7%. In South Africa, 30% report a lifetime prevalence of psychiatric disorders, while 1 in 3 will be affected by a mental illness in their lifetime.
The figures don’t bode well for a nation where depression contributes to over 40% of mental health conditions. It puts a strain on the health care system, as pointed out by Dr Johanthan Broomberg, chief executive of Discovery Health.
“There’s profound fragmentation in private health care delivery,” he notes when referring to Discovery Health claims for last year. The private medical aid provider paid out R2bn in claims last year.
But he also alluded to the poor quality of care and high costs: “We need to change the structure of delivery by creating teams who work together.”
Broomberg suggests taking a holistic approach when treating mental illnesses by enlisting a group of specialists to treat a patient. The model has already been successfully implemented in the UK.
Experts believe the rise in mental health conditions is due to our change in lifestyle which includes less sleep, more stress and trauma.
With recent advancements made in the digital field, the use of apps were also found to help reduce depression.
Apps like Big White Wall, which provide advice to people with anxiety, debt, stress, or work problems, have reached over 35 000 users and seen a 20% improvement rate.
Broomberg says the strides made in the technological realm is creating new opportunities for those who are not able to consult a professional, but he also adds that “apps are no substitute for medication or consultation”.
So if apps aren’t a substitute for treating mental illness and patients don’t have access to medical aid, what then? Mental health disorders affect 10% of the global population – 20% are children, and 80% come from low income communities. Where does this leave the majority of SA’s population affected by mental illness?
Professor Gabriel Ivbijaro, president of the World Federation for Mental Health (WFMH) thinks he may have the answer. Ivbijaro says that mental health deserves more. “There’s something about mental health that you no longer exist, but it is coming out of the shadows,” he notes.
Ivbijaro’s plan is to transform primary healthcare by integrating mental health into the primary structure.
But will it work in SA where access to health care facilities are few and far between?
Dr Mvuyiso Talatala believes it is possible. The former president of the South African Society of Psychiatrists (Sasio), Talatala says that there are challenges facing mental health, including our reliance on big state facilities to treat psychiatric patients. These are: medical students not being exposed to psychiatry; no mental health directorates in all our provinces and no beds for admissions for involuntary care in state hospitals.
Dr Lesley Robertson, a state psychiatrist and national convener of Sasop’s public sector group, is an advocate for community psychiatry and community mental health. According to her, the government has a framework in place in the form of the National Mental Health Policy (2013-2020).
The plan is to implement community-based care for the mentally ill and provide long stay specialised services in the public health sector. “SA is trying to develop primary health care services with an integrated mental health plan,” states Robertson.
On paper, plans for integrated mental health care seem like a lifesaver for those who really need it. Putting it into action is another story altogether.
Professor Gabriel Ivbijaro wants to transform primary healthcare