For many people, the banning of social gatherings has ‘disrupted their social networks and that is a huge loss for people,’ says Edith Kamaru Kwobah, the head of psychiatry at Moi Teaching and Referral Hospital in Kenya. (Photo: Unsplash / Camila Quintero) Mental healthcare in South Africa and Kenya is often last on the government’s priorities but with many people’s social lives being disrupted by the spread of Covid-19, now is the best time to prioritise mental healthcare, said Bonga Chiliza, the head of psychiatry at the University of KwaZulu-Natal and Edith Kamaru Kwobah, the head of psychiatry at Moi Teaching and Referral Hospital in Kenya.
“The effects of the lockdown are numerous. In our cultures, we attend weddings and funerals. We’ve seen people who are really traumatised because they were not able to attend the funerals of the people that they love,” said Kwobah on a webinar on mental health during Covid-19.
For many people, Kwobah says, the banning of social gatherings has “disrupted their social networks and that is a huge loss for people”.
While residents are urged to stay at home and conduct meetings with their psychologists using technology, Chiliza points out that the digital divide means that not everyone has equal access to technology.
“Even with the middle class, there are people who have never used Zoom before or they don’t have good quality phones. In the United States, psychologists have opted to use audio rather than video sessions,” said Chiliza.
The lack of technology or unfamiliarity has resulted in a number of patients missing their sessions with their psychologists.
“A lot of our colleagues are saying that many patients are relapsing and when they’re asked why they said that they were reluctant to use the technology or simply didn’t have the means to use it,” said Chiliza.
The price of data in South Africa excludes many people in a country where the majority of the population earns below the minimum wage. In December 2019 the Competition Commission found that Vodacom and MTN data prices were “anti-poor” and recommended that they are reduced by 30%-50%.
Added to this is South Africa’s “quadruple burden” of HIV/AIDS, tuberculosis, violence and non-communicable diseases, says Chiliza.
South Africa also doesn’t have enough psychologists. The country has 1,800 psychologists.
“Most of the psychiatrists and psychologists [in South Africa] are white and female. Most of them work in the private sector and are often based in big cities. We’re struggling with human resources for mental healthcare so we should be looking at how to deal with mental healthcare with limited resources,” said Chiliza.
Kwobah says the mental healthcare sector in Kenya also has limited human resources. A 2015 report found that Kenya had 92 psychiatrists and 327 psychiatrist nurses
According to Kwobah, Kenya has developed national guidelines on how to treat patients with mental health illnesses who test positive for Covid-19.
“Kenya also developed public psychological messaging so that people can understand that they will be anxious but that help is available,” said Kwobah.
A challenge for psychiatrists could be instructing severely mentally ill patients who have tested positive for Covid-19 to adhere to physical distancing, especially since there have been a number of complaints regarding a lack of personal protective equipment (PPE), said Chiliza.
But what we need to keep doing is emphasising that mental health is not less important than physical health, said Kwobah. DM