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By limiting access to treatment, poverty exacerbates mental illness

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Mental illnesses, such as depression and anxiety, can affect anyone. Approximately about 4.5 million South Africans suffer from depression. Research has also shown that approximately 30.3% of South Africans will suffer from a mental disorder at some point in their lives. According to the Mental Health and Poverty Project at the department of psychiatry and mental illness at the University of Cape Town (UCT), 17% of children and adolescents suffer from mental disorders. The project also discovered that people who live in township and rural areas suffer the most from mental disorders. 

Dr Crick Lund, a public mental health professor at UCT, said in an interview with The Daily Vox that the lack of mental health care resource and poor resource allocation in peri-urban and rural areas is an issue in the public sector, especially for young people.

“There’s no routinely available counselling services at primary care clinics, there is no routine screening or detection for picking up mental health problems in young people. So young people are really left in their own basically… there are very few options for them,” he said. The integration of mental health in primary care and into community-based health services, which was adopted by the National Department of Health in 2013, is being weakly implemented, he said.

“There was an audit done in 2016, following the whole Life Esidimeni [case], by the national department of health on the provincial department of health to find out how much they’ve gone about implementing the 2013 policy, and in fact there was little implemented by the provincial department of health,” he said.

According to Dr Jason Bantjies and Professor Lesilie Swartz from the Stellenbosch University’s psychology department, there were only 13 000 psychologists servicing more than 50 million South Africans in 2017. Bantjies and Swartz both argue that there needs to be an improvement in the allocation of mental health resources, especially in the public healthcare sector. Social deprivation, living in poverty, and exposure to crime and violence are strongly linked to mental illness. According to Dr Jan Chabalala, a chief psychiatrist at One Military Hospital, this is because people from rural and township areas who live in these conditions perceive mental illnesses as a Western illness.

“There is some acceptance but there is still a lot of that needs to be done to change the perception that stereotype,” he said in an interview with The Daily Vox. Dr Chabalala said the problem lies in the lack of education in these communities about the seriousness of mental illnesses. “I think to that extent, what could be better is [having] peer educators,” he added. Chabalala said we cannot look at poverty as inseparable from mental illness. “ Poverty is linked with everything that is negative; depression, anxiety, antisocial behaviours from people simply because they need to find ways to feed themselves,” he said.

Zamo Mbele, a clinical psychologist at Tara Hospital and the Wits Donald Gordon Hospital said we need to understand how the link between poverty and mental illness affects young people in terms the psychological distress and the difficulty of treating psychological distress and psychiatric conditions when they find themselves in poverty.
“When a person finds themselves in poverty, it often contributes to a feeling of hopelessness and helplessness or despondency and all the way through the thoughts of suicide. It can also cause a worry of the future and the present, which can kind of look like anxiety, where a person is worried about their future,” he said.

Mbele said the lack of medical resources to access help in rural and township areas can hinder treating psychological distress. “ We know that in our peri-urban and rural areas, there are a few psychiatrists, psychologists, social workers or counsellors. So when a person is struggling… they, unfortunately, do not have the access to the help that they would need, he said.
He further said that mental illness is an issue that needs immediate from the government, civil society and those affected by mental illnesses. “We situations, people who are struggling and suffering and…this affects their everyday life such as going to work or going to school… and their performances at school and their performances at work” he added. Mbele said that in most cases, young people with mental illnesses often leave their illnesses untreated and this has majorly contributed to the high suicide rate amongst young people.

“We know our suicide rates are South Africa is incredibly high and are on the rise, but the more difficult thing we know is that young people are attempting suicide at a younger age. So there are more suicide attempts and more successful suicides, so we really need to take this very seriously,” he concluded.

According to the South African Depression and Anxiety Group (SADAG), suicide is the second-leading and fasted growing cause of death amongst young people between the ages of 15-24

Featured Image via Pixnio

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