A visit to a pri­vate psy­chol­o­gist or coun­sel­lor can be costly but there are more af­ford­able op­tions for those need­ing help


FEEL­ING stressed and over­whelmed can be a lonely road to travel, es­pe­cially if you don’t know where to turn for help. If these feel­ings have per­sisted for a while, chances are you may be suf­fer­ing from clin­i­cal de­pres­sion, a con­di­tion that re­quires treat­ment. And you’re def­i­nitely not alone. More than 300 mil­lion peo­ple world­wide suf­fer from de­pres­sion, ac­cord­ing to a re­port re­leased by the World Health Or­gan­i­sa­tion in 2015, and a fur­ther 264 mil­lion are af­fected by anx­i­ety dis­or­ders.

De­cid­ing to see a men­tal health pro­fes­sional is a brave step in the right di­rec­tion but it doesn’t come cheap and fig­ur­ing out how to pay for coun­selling can be a huge chal­lenge.

Most med­i­cal aids won’t cover on­go­ing ther­apy and ac­cord­ing to Meryl Da Costa

of the South African De­pres­sion and Anx­i­ety Group ( Sadag) face- to- face ther­apy can cost any­thing from R600 to R1 200 per ses­sion.

The good news is there are a range of other op­tions avail­able that don’t cost an arm and a leg.

A new low-cost men­tal health cen­tre that of­fers coun­selling for R50 a ses­sion re­cently opened its doors in Cape Town and is set to pro­vide help for peo­ple who of­ten fall through the cracks of South Africa’s health­care sys­tem.

The Coun­selling Hub is the brain­child of the SA Col­lege of Ap­plied Psy­chol­ogy Foun­da­tion ( Sa­cap) and the Ka­plan Kush­lik Ed­u­ca­tional Trust. It of­fers oneon-one ses­sions as well as free group work­shops, al­low­ing peo­ple with lower in­comes to seek pro­fes­sional sup­port.

But this new out­fit isn’t the only al­ter­na­tive for those of us un­able to fork out money when in need of a ther­a­pist.


How it works Fa­cil­i­ties like The Coun­selling Hub of­fer ther­apy or coun­selling at dis­counted rates or for free, although many NPOs have wait­ing pe­ri­ods due to high de­mand.

If you don’t know where to start, your best op­tion is to con­tact Sadag so it can point you in the right di­rec­tion.

“Once you get on the line with one of our lay coun­sel­lors they’ll as­sess your si­t­u­a­tion and, if need be, put you in touch with a coun­sel­lor, psy­chi­a­trist or psy­chol­o­gist,” says spokesper­son Kayla Phillips.

“If you’re on med­i­cal aid we’ll put you in touch with some­one in the pri­vate sec­tor. If not, we’ll re­fer you to your near­est NPO.

“Should your men­tal health cri­sis be an emer­gency our coun­sel­lors will alert your fam­ily and get an am­bu­lance sent to your home.”

The ex­pert says Even though South Africa faces an in­creas­ing men­tal health bur­den – wors­ened by drug use, vi­o­lence and un­healthy life­styles – 80% of psy­chol­o­gists work in the pri­vate sec­tor, ac­cord­ing to Shifra Ja­cob­son, co­or­di­na­tor and su­per­vi­sor of The Coun­selling Hub. This is why fa­cil­i­ties like the Hub are so im­por­tant.

“In the public sec­tor there’s such a lim­ited num­ber of men­tal health work­ers em­ployed by the state that it’s dif­fi­cult to do the ev­ery­day coun­selling many of us need to flour­ish,” Ja­cob­son says.

Is it for you? The Coun­selling Hub isn’t only for those who don’t have ac­cess to med­i­cal aid but also for peo­ple on med­i­cal aid af­ter they run out of funds, ac­cord­ing to co-founder Romi Ka­plan. The cen­tre has ac­cess to lay-coun­sel­lors, qual­i­fied psy­chol­o­gists and stu­dents (who all work vol­un­tar­ily) and pro­vides short-term coun­selling of no more than six ses­sions to help peo­ple get back on their feet dur­ing a cri­sis.

Cost The Coun­selling Hub charges R50 per ses­sion. Many NPOs of­fer their ser­vices for free.


How it works Many uni­ver­si­ties run coun­selling clin­ics where trainee psy­chol­o­gists pro­vide out­pa­tient ser­vices to the com­mu­nity sur­round­ing the univer­sity as part of their course­work.

The ex­pert says Coun­selling ser­vices are pro­vided by three kinds of trainees, ex­plains Pro­fes­sor Greg Howcroft, di­rec­tor at Nel­son Man­dela Univer­sity’s Psy­chol­ogy Clinic (UCLIN). “Ser­vices are of­fered either by in­tern psy­chol­o­gists in their fi­nal year of train­ing, reg­is­tered psy­chol­o­gists in their fourth year of train­ing or mas­ters’ stu­dents in their fifth year.”

Is it for you? Although UCLIN caters to the com­mu­nity sur­round­ing the univer­sity, it aims to serve mainly lower in­come ci­ti­zens who can’t af­ford ther­apy.

Cost UCLIN has two cam­puses in Port El­iz­a­beth, one in Sum­mer­strand and one in Mis­sion­vale, and rates range from R220-R500 for in­di­vid­ual ses­sions and be­tween R60 and R100 for group ses­sions. Clients who aren’t on med­i­cal aid are charged R70 per ses­sion but the fa­cil­ity also con­sid­ers fee re­duc­tions if a client is des­ti­tute. SUP­PORT GROUPS How they work Sup­port groups are net­works of peo­ple who vol­un­tar­ily get to­gether, either in per­son or on­line, be­cause they face sim­i­lar prob­lems, such as strug­gling with in­fer­til­ity, di­vorce, be­reave­ment, sub­stance abuse, anx­i­ety or de­pres­sion. Dur­ing their ses­sions they find so­lace, in­sight and sup­port from one an­other.

The ben­e­fits of join­ing a sup­port group in­clude feel­ing less lonely, iso­lated or judged.

Group mem­bers gain a sense of em­pow­er­ment and con­trol, and im­prove their cop­ing and ad­just­ment skills.

They get the op­por­tu­nity to talk openly and hon­estly about their feel­ings, share prac­ti­cal ad­vice and com­pare notes on re­sources.

Fam­ily mem­bers of those suf­fer­ing with cer­tain con­di­tions also form groups.

The ex­pert says While ac­knowl­edg­ing the many ben­e­fits of sup­port groups, Cape Town-based spe­cial­ist psy­chi­a­trist Dr Bavi Vythilingu­m warns that a group shouldn’t be seen as a com­plete re­place­ment for ther­apy.

“Sup­port groups don’t deal with a spe­cific set of prob­lems the way ther­apy does and won’t look at the rea­sons you be­came ill. If the fa­cil­i­ta­tor is poor, at­tend­ing group ses­sions could worsen your ill­ness or even has­ten a break­down by not pro­vid­ing a safe space.”

Is it for you? “Talk­ing to peo­ple who have been through the same ex­pe­ri­ence will make you feel safe, know­ing you will not be judged,” Dr Vythilingu­m says, adding that you can learn from their ex­pe­ri­ence and feel re­as­sured that you aren’t alone. “Once you get bet­ter, a sup­port group can also en­able you to give back to fel­low suf­fer­ers, some­thing that’s very re­ward­ing and may help you com­plete the heal­ing process.”

Cost Many sup­port groups cost noth­ing. To find a sup­port group suited to your needs, call Sadag’s men­tal health line (see be­low). “One of our lay-coun­sel­lors will as­sess your si­t­u­a­tion and try to lo­cate a sup­port group in your area,” Phillips says. EX­TRA SOURCES: SADAG.ORG, WHO.INT

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