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INTERVIEW WITH THE SOUTH AFRICAN FEDERATION FOR MENTAL HEALTH

To commemorate the month of Mental Health Awareness, we decided to get in contact with professionals in the industry, and ask them a few important questions to help in raising awareness about this often misunderstood, underestimated topic. Although often a hushed subject, we decided to bring some vital information to light. A huge thank you goes out to The South African Federation for Mental Health (SAFMH) ﹘ we hope to inspire more questions, interest, and of course, answers!

  1. What defines mental health?

Mental health can be described as a state of wellbeing in which an individual realises their own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community. (World Health Organisation (WHO), 2020)

Mental health is essential to our overall well-being and as important as physical health. Mental health is vital to our functioning as human beings. It is important to invest, promote, protect and restore our mental health. When we feel mentally well, we can work productively, enjoy our free time, and contribute actively to our communities (WHO, 2020).  

Your mental health needs to be maintained, just like we maintain our physical health. It is also important to note that Mental health is NOT mental health disorders.

We talk about mental health disorders when they have been clinically diagnosed by a mental health care professional, like a clinical psychologist, clinical social worker or psychiatrist. It is important to note that mental health disorders can affect anyone regardless of race, age, sex or social status, and there is no shame in being diagnosed with a mental health disorder.

  1. Can one cure or prevent mental health problems?  

At a population level, we know that we are able to reduce the incidence of mental health disorders with evidence-based, culturally appropriate interventions bolstered by good political support. This is only possible through successful collaboration between the multiple partners involved in research, policy and practice, including community leaders and consumers. We also know that, at a population level, when people have access to the required therapy, medication, and community-based support services, people can manage their mental health problems in such a way that it does not impede on their quality of life. Further efforts are needed to expand the spectrum of effective and cost-effective preventive interventions, particularly in South Africa.

At an individual level, you have to assess every person on a case-by-case basis. Based on the complex interaction between their genetics and life experience, every individual will respond differently to different care and prevention efforts.

However, it’s important to emphasise that everyone experiences mental health challenges and mental health disorders are treatable. Dealing with mental health disorders are also not about “curing” them per se. It is about recovery. The Mental Health Foundation (2021) provides the following useful guidance on how the concept of recovery related to mental illnesses should be understood:

‘When it comes to mental illness, recovery can mean different things. For some people, it will mean no longer having symptoms of their mental health condition. For others, it will mean managing their symptoms, regaining control of their life and learning new ways to live the life they want. 

Recovery is often described as a process, meaning it isn’t always straightforward. You might have days (or weeks, or months) where you feel well and times when your symptoms return. If you’ve discovered techniques and treatments that work for you, you’re likely to feel more confident and less overwhelmed by your symptoms. When it comes to your recovery, think about what’s important for you and what a meaningful life would look like.” 

Please remember to always consult your local qualified health professional if you require additional support. There is no shame in recognising that and being responsible enough to reach out for help.

According to WHO, approximately 450 million people live with mental and behavioural disorders around the world with psychiatric conditions leading to 5/10 causes of disability and premature death. Addressing mental health disorders is burdensome and a huge task. The WHO argues that due to current limitations, a sustainable method of reducing this task is prevention.

  1. What causes mental health problems, what are some possible triggers?

Mental health problems can have a wide range of causes. It’s likely that for many people there is a complicated combination of factors – although different people may be more deeply affected by certain things than others. For example, the following factors could potentially result in a period of poor mental health:

  • childhood abuse, trauma, or neglect
  • social isolation or loneliness  
  • experiencing discrimination and stigma  
  • social disadvantage, poverty or debt  
  • bereavement (losing someone close to you)  
  •  severe or long-term stress  
  • having a long-term physical health condition  
  • unemployment or losing your job  
  • homelessness or poor housing  
  • being a long-term carer for someone  
  • drug and alcohol misuse  
  • domestic violence, bullying or other abuse as an adult  
  • significant trauma as an adult, such as military combat, being involved in a serious incident in which you feared for your life, or being the victim of a violent crime  
  • physical causes – for example, a head injury or a neurological condition such as epilepsy can have an impact on your behaviour and mood. (It’s important to rule out potential physical causes before seeking further treatment for a mental health problem).  

It’s important to remember that just because we may not know exactly what causes someone to experience a mental health problem, this doesn’t mean that it is any less serious than any other illness, any less deserving of recognition and treatment, or any easier to recover from. (Source: Mind UK)

  1. How can one improve their mental health?  

On World Mental Health Day on 10 Oct, the world had been grappling with the pandemic for over 18 months. This is a really long time to be in constant distress. The most important thing to note however, is that help is available.

For anyone who is feeling hopeless, having suicidal thoughts and/or unsure how to help someone in need, please call the SADAG Suicide Crisis Line on 0800 567 567 or SMS 31393. These numbers are free and counselling is available in all 11 official languages. Remember, there is nothing shameful about feeling alone or hopeless. You are not the only one feeling this way.

Some other steps one can take to improve their mental health include: making a concerted effort to prioritise your mental well-being. You can do this by taking up or doing more behaviours which are meaningful to you and bring you joy. For example, that could be going for walks or jogs, keeping in touch with loved ones, reading a book. Similarly, try and avoid behaviours which do not make you feel good, for example, ‘doom-scrolling’ and watching too much news. Remember what is considered to be ‘meaningful behaviours’ differs for every individual so be sure to take the time to try to find what brings meaning to you.

It is really important for us to reiterate that safeguarding mental health is essential, not just for persons with existing mental health conditions, but for EVERYONE because –being healthy, means being mentally healthy.

  1. Why is there such a stigma attached to mental health issues; and how can we go about dispelling this stigma? 

Stigma and discrimination are among the biggest barriers that persons living with mental health problems face not just in South Africa but globally.

Stigma can prevent people from seeking the help they need. Before COVID-19, sharing mental health struggles was often seen as a shameful thing and linked to having a mental illness. This is not true. We all have mental health, just like we have physical health. Just like with physical health, some days we feel better than others, but this doesn’t mean we have an illness. The past 18 months has created a safer space for more people to share their fears and anxieties. This has been really encouraging, but we still have a long way to go with regards to ending the stigma attached to speaking about mental health.

The government must endeavour to provide guidance on how stigma should be addressed, specifically the implementation of evidence-based, anti-stigma programmes at a national and provincial level. These programmes must be culturally-relevant for the communities where they will be implemented. The inclusion of mental health in our national curricula could be another avenue to promote comfortability in speaking about mental health and reducing stigma. Here, young people can learn the vocabulary to speak out when they are struggling with their mental wellbeing, strategies to promote mental wellness, and normalise speaking about their mental health.

  1. What are some examples of mental illness, and perhaps a couple of examples of the less obvious ones?

Depression Bipolar Disorder Eating Disorders Anxiety Disorder

Schizophrenia Disorder 

Postpartum depression 

You can read summaries of various mental disorders on our website: https://www.safmh.org/  

  1. Can someone suffer from multiple mental illnesses simultaneously?  

Yes, people do live with multiple mental illnesses at the same time. For example, someone might have major depression and anxiety at the same time.

  1. Is there a certain age group or demographic that is at higher risk?

Depending on the mental health disorder and the country, different groups are more likely to be at risk. For example, we know that in South Africa men are four times more likely to die by suicide compared to women. While there are factors that can happen throughout the life course (including when a baby is in utero) that can place a person at higher risk for developing a mental health condition, it is also important to note that mental health disorders can affect anyone regardless of race, age, sex or social status, however, this impact is not proportional.

  1. What should one avoid when dealing with mental health issues? And what should one avoid saying/doing when dealing with somebody who is suffering from mental health issues?

First and foremost, refrain from using terms like people “suffering” from mental health issues. Suffering has a negative implication and mental health advocates will often correct these types of statements, stating that they are not “suffering” but are merely living with, or are simply A PERSON with a mental illness. Treat these individuals like you would treat everyone else – with dignity, empathy and respect, and challenge those who might use stigmatising language. And do not speak down to them. Having a mental illness does not mean that there is anything wrong with the person’s intellectual functioning.

When dealing with a mental health problem, it is always advisable to get support from a qualified health or mental health professional. Avoid self-diagnosis through using Google; always go for the professional avenue of support instead.  If you would like more advice, please feel free to reach out to our Help Desk which is dedicated to assisting mental health care users, their families and members of the public in need of information about mental health services.

  1. How has the Covid-19 pandemic affected the status of mental health in South Africa?  

COVID-19 has impacted on mental health in various complex and wide-ranging ways, leaving no part of any population or society untouched. It’s important to note that the pandemic has only exacerbated the struggles and obstacles that those living with existing mental health disorders experience.

COVID-19 has had a major impact, and not just on those living with pre-existing mental health conditions.

A study conducted by the Human Sciences Research Council (2020) reported that 33% of South Africans were depressed, while 45% were fearful, and 29% were experiencing loneliness during the first lockdown period.

At SAFMH we run a mental health information desk, through which we facilitate referrals to mental health and legal resources for persons with mental disabilities and their families, along with assisting these individuals with information on residential facilities, how to access treatment and support, and with information on mental health processes and procedures in South Africa – And during the July to August period of this year we were inundated with enquiries from people reaching out to obtain mental health support – so that just gives you an idea of how many people were and still are struggling during the pandemic.

COVID has also impacted mental health services. The country’s struggling health and social systems were further exposed as the country struggled to address the demands of the pandemic. The mental health societies that we work with reported instances of not seeing anybody coming to their offices. Workshops had to stop, counselling moved online or via phone which is very different to how these services were accessed before the pandemic.

That being said – the pandemic offered an opportunity for mental health organisations to shift, reinvent and reorganise the way in which they work. A great example of this was the way in which Cape Mental Health, based in Cape Town, provided mental health care in the form of facility, home, and face- to-face counselling as well as virtual interventions to retain contact, reduce isolation, and enhance mental wellness to over 6000 beneficiaries.

As much as the pandemic has been overwhelming for our mental wellness, it has in some ways and for us in working in the mental health space, it has really helped with tackling the stigma so often associated with mental health. That is why we are encouraging everyone, at all levels of society, to raise awareness, to fight to make more resources and services available for those who are living with or struggling with mental health illness.

  1. Why do you think that mental health has become a more openly discussed topic in recent years? (Would that be a fair statement?)  

This is a fair statement and we have seen more progress when it comes to having open conversations regarding mental health. This can be attributed to the great advocacy efforts of families and those with lived experience. As mentioned above, the pandemic has also helped to normalise the idea of openly expressing stress, fear and anxiety being felt right now.

  1. What do I do if I’m worried about my mental health? Who can I contact if I am worried about my own mental health, or the mental health of someone close to me? 

At SAFMH we work with 17 community-based mental health NGOs across the country to raise awareness of mental health and human rights and to advocate for improved resourcing of mental health. These organisations deliver essential frontline mental health services to communities.

If you are interested in connecting with the organisation in your province, feel free to reach out to us via our enquiries Help Desk. Our Help Desk also facilitates referrals to mental health and legal resources for persons with mental disabilities and their families, how to access treatment and support, and with information on mental health processes and procedures. Reach out here: https://www.safmh.org/help-desk/

For those who are looking for guidance, you can head to our website and check out our Information Library: https://www.safmh.org/information-library/Also, just a reminder if you or your loved one is feeling hopeless and/or having suicidal thoughts, please call the SADAG Suicide Crisis Line on 0800 567 567 or SMS 31393. These numbers are free and counselling is available in all 11 official languages.

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