Maverick Citizen Op-Ed
The government is failing its people on mental health
Our government was never ready for the mental health fallout from Covid-19.
In early May, the South African Anxiety and Depression Group (Sadag) sent out a release about the influx of calls it had been getting since the start of lockdown in late March.
“Many callers are stressed about a combination of issues including the spread of Covid-19, finances, relationship problems, job security, grief, gender based violence and trauma,” said the organisation.
As a mentally ill person myself, I knew immediately that this was going to take a toll on us all. This seemed like an obvious connection to make. Put people in isolation, take away their privileges and freedom, add the fact that there’s an invisible virus out there trying to kill them and the people they love; there is going to be an emotional and mental reaction.
Speak to anyone you know, whether they were diagnosed with a mental illness before lockdown or not, they will tell you they were, and quite possibly still are, struggling.
Initially, I was proud of the measures the government was taking to protect our people. Stringent lockdown measures. Setting up various methods of communication so that people could reach out in case they had been exposed. But absolutely nothing was done about the mental health effects this pandemic would have on all of us.
The Covid-19 online resource and health portal set up by the government has a section about mental health and well-being that only began being populated on 8 June. They’re basically sponsored posts from Discovery Vitality. While some of the more recent ones deal with the fallout of Covid-19 directly, there is no tangible advice or a link to resources to help those in need.
This should come as no surprise as, to use my generation’s vernacular, the government has been doing the least when it comes to mental health in this country. Which is shocking considering that we’re a developing nation still healing from hundreds of years of oppression, slavery and trauma, plus the complications of gender-based violence, poverty, homophobia and diseases like HIV/AIDS.
According to a City Press article from February 2019, a total of 3% of the healthcare budget is dedicated to mental health in South Africa. That’s less than R100 per person in our entire country; which is even less than the 5% budgeted in 2016/2017, according to this Oxford Academic study.
According to SACAP, an estimated 17% of our population has anxiety, depression or substance-use problems, while up to six million South Africans could suffer from post-traumatic stress disorder (PTSD). These are all crude estimates because mental health reports are severely neglected. Less than 16% of the mentally ill are actually being treated and 85% of that number has to rely on state-funded care, which is under such enormous strain. Those who are even accepting of being mentally ill often have to sit in their local clinic for hours to see a psychiatrist for 10 minutes and then wait even longer to have medication dispensed.
This is a big ask of those in poorer, disadvantaged communities as time spent in the clinic means they’re not being paid. This means mental health is often put on the backburner because putting food on the table is more important.
The average therapy session costs upwards of R900 and that’s if you’re on medical aid, which most of our country is not. However, this does not even take into account the fact that there are only 1.52 psychiatrists and 0.08 child psychiatrists per 100,000 people in our population.
The cost of medication varies, but it can also be quite costly depending on the severity of your condition.
A National Mental Health Policy Framework and Strategic Plan 2013-2020 was developed with the aim of integrating mental health into general health services, thus reducing the burden of untreated mental health conditions on the current healthcare system. But this does not seem to have been implemented, at least not effectively; the horror of the Life Esidimeni case in 2017 was evidence of this.
Sadag, several universities, organisations and private mental healthcare professionals have offered their services in aid of failing mental health during these times, but our actual government? Nothing.
No services have been made available for essential service workers or teachers by the government either. Our president has thanked these frontline heroes several times in his speeches, but not once has it been announced that a special hotline will be opened for them or that they will be given access to psychiatric services. A pat on the back and a “good job!” is what these people get when they stare the possibility of death from Covid-19 in the face every day.
It’s bad enough that we live in a society that shames the mentally ill, but even now, when the entire country, even cognitively normal people are feeling the effects of anxiety and depression first-hand, nothing is being done by our government to support us because it takes a backburner to actual active Covid-19 cases. There’s not even counselling for those who have lost family and friends to the virus.
Suicide already accounts for 17% of all deaths in South Africa and while this Psychology Today article talks about US numbers, it’s not implausible to say there will be an increase in the number of suicides in South Africa as well, with our massive inequality problem and an estimated three million possible job losses.
There are many things our government has got right and many things that are up for debate, but this is not one of them. The mental healthcare system in South Africa was mediocre at best before, but now, under the weight of a pandemic? It’s absolutely horrifying. DM/MC
Carmen Williams is a freelance writer.
If you need help for feelings of anxiety and depression, use these resources: Sadag 24-hour helpline 0800 456 789 (Please donate to them during this time if you can)
Sadag suicidal emergency 0800 567 567
Also, this article shares details of the various resources they have made available.
Childline 08 000 55 555
Lifeline 0861 322 322
University of Cape Town – 0800 24 25 26
University of Pretoria – 0800 747 747
University of the Western Cape – 0800 222 333
Tshwane University of Technology – 0800 68 78 88
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