Expanding access to mental health services
MULTIPLE losses, anxieties and complications in the grieving process are affecting mental wellbeing worldwide as the coronavirus pandemic continues.
Globally, awareness of mental illhealth has become more prevalent, and there is a better understanding of what it entails and the effect it has on individuals and societies.
However, the understanding and conceptualisation of mental health and ill-health are generally deeply rooted in Western culture.
As a result, the intersectionality of race, culture, gender and class from less economically developed countries (the Global South) is often ignored.
According to Dr Suman Fernando, an expert on transcultural mental health approaches and an honorary professor at London Metropolitan University, the prioritisation of Western biomedicine and the way the richest and most industrialised countries inform how mental health and ill-health are perceived in the rest of the world are remnants of colonial power relations.
Indigenous interventions and ways of healing have not been developed.
Such methods, for which social and cultural aspects are just as important as medical aspects in the understanding and treatment of illhealth, may be the most accessible to people in the Global South.
Since the onset of the Covid-19 pandemic, our mental health has been compromised by uncertainty, insecurity and a series of losses – of income, social connections, health, dignity, status, possessions, activities and loved ones.
The World Health Organization is clear that mental health is not merely the absence of a mental disorder or disability, but a state of well-being, comprising a realisation of one’s abilities and the capacity to cope with typical stresses, work productively and contribute to one’s community.
Complications in death-related loss during the Covid-19 pandemic – losing several family members in a short period, financial constraints, potential child-headed households, not being able to say goodbye to an infected relative in person, not being able to hold a traditional funeral
– can have lasting effects that can potentially turn into mental health issues such as depression, or complex and prolonged grief.
Mental ill-health impacts not only the individual, but communities and societies too.
It is estimated that 80% of people in under-developed or developing countries who are suffering from depression are not formally diagnosed or treated, compared to 50% in developed countries.
Even before Covid-19, Trevor Pols of the South African Medical and Education Foundation, highlighted statistics showing that 16.5% of South Africans experience common mental health problems, one in six have lived with anxiety, depression, or substance use problems, and a depressive disorder would be experienced by 20% of South Africans in their lifetime.
The stigma of mental health remains a problem. While awareness is growing, much more needs to be done to ensure that people who are mentally ill are supported, not humiliated.
With the added stresses of the pandemic and the lockdown, the need to expand the provision of mental health-care services is greater than ever.
Holistic, dual therapy and treatment, encompassing mainstream medicine and indigenous mental health interventions, would allow for a greater spread and enhanced quality of care, benefiting individuals and society as a whole.
Regulatory bodies could potentially play a role in initiating this form of therapy, and in training and development to meaningfully increase South Africa’s mental health-care capacity.