The tragic story of mental illness in South Africa

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This image is part of series of photographs, published in a book called Condemned by photographer Robin Hammond. This government-run facility in the Niger Delta town of Eket, Nigeria, is meant to be a psychiatric hospital. In reality it is a merely a place of incarceration for people with mental disability. October 2012 photo by Robin Hammond/Panos

I’ve found some recent mental health statistics for South Africa (where I live) and the figures are scary – not because of the number of people who have mental illness but because the majority of people will never get the help they need.

The article was published on timeslive.co.za – take a look at these stats:

  • One in three South Africans suffer from mental illness and 75% of them won’t get any help.
  • Juvenile mental patients who do receive treatment in state institutions risk being raped and housed in prison-like conditions.
  • More than 17 million people in South Africa are dealing with depression, substance abuse, anxiety, bipolar disorder and schizophrenia – illnesses that round out the top five mental health diagnoses, according to the Mental Health Federation of South Africa.
  • 48% of new mothers suffer from postnatal depression.

The South African Depression and Anxiety Group, and NGO which is doing such good work in South Africa around mental illness, was quoted in the article saying that mental illness is “the orphan” of our healthcare system. The article says that the Department of Health in South Africa spends only 4% – or R9.3-billion – of its budget to address the country’s mental health crisis. The head of the government’s mental health services ascribes the meagre national health budget allocation to there being health problems that are more urgent, such as HIV/Aids – 43% of whom also have a mental disorder.

I am fortunate that I can afford private health care, but even if your medical aid plan covers in-patient treatment in a private psychiatric clinic, it doesn’t cover the cost of seeing a psychologist or psychiatrist regularly. Some people have a savings allocation as part of their medical aid, but often this runs out very quickly if you are also paying for medication every month.

 

Under-resourced state facilities make it is close to impossible for people to get the treatment they need. I think one of the reasons why the budget allocation is so low is because there is a lack of understanding about mental illness. It isn’t viewed as a chronic condition that needs treatment. And then there’s the stigma and the appalling treatment of people who have mental illness – no wonder no one wants to talk about it and seek help. This is also a problem in many private health care facilities (but this is story for another blog post).

Dr Melvyn Freeman, head of non-communicable diseases at the Department of Health, was quoted in the article saying: “We know we have a problem, but we have to take it in the context of South Africa, which has many problems. We have to look at the priority list.

Why isn’t mental illness a priority?

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In honour of my therapist

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therapy

 

I owe a great deal to my psychologist and psychiatrist. They are amazing people and although I know I pay them to help me, that’s not the point for me. I once read something about how important it is to honour the people in your life who believed in you and gave you confidence when you needed it most – and that is how I feel about them. I actually know I wouldn’t be alive if I wasn’t for them. They helped me realise that my story isn’t over yet. They showed me how to feel emotion again. Because of them I realised that my life is valuable. And that comfort of having someone really listen to your story – the really honest version with no edits. Such a relief and so much freedom.

 

 

I’m fine and other lies

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I’m fine.

How often have you found yourself saying that? I think people who struggle with depression are professionals at this. I know I am.

It just seems so difficult to tell someone how you really are – and it is risky.  How do you explain it? How do you tell people that you’ve reached your breaking point? I didn’t tell most people because I was worried that they might delegitimize my feelings and then I wondered if would they really even care.

I also didn’t want to risk someone telling me that I should just pull myself together, that I should snap out of it and that there are lots of people worse off than me (by the way – these are three of the worst things you can say to someone who has depression).

Sometimes it just seemed easier to hide the pain and despair. But actually – it’s not. Doing this is exhausting. And when I do it, I’m just lying to myself. It takes a lot of energy to pretend that you are happy.

Eventually I realised that I need people in my life who I don’t always have to be fine with. People who don’t have to see the cleaned-up version of me.

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I saw this quote the other day and it got me thinking:

“Everybody is always so fu***ng “fine. But we are not. Sometimes we are hurt and bruised and nearly completely shattered and this, sir, is not what one calls fine.”

So I wondered why I feel the need to be so guarded? I hide my emotions to protect myself and because I’m scared of making myself vulnerable. But there is actually nothing more freeing than being real and telling someone how you feel, what you’ve been through and what you are experiencing now.

I treasure the people in my life who stood by me when I was at my lowest point. These people helped me to find the things I had lost – hope, courage and the will to live. They helped me to stay close to the things I love and make me happy to be alive.

So what do I do these days?

My psychologist doesn’t allow me to walk into her room and tell her “I’m okay” or “I’m fine”. I have to explain how I’m feeling. Properly. This irritated me so much in the beginning, but now I’m learning to label my emotions and express them. The word “depressed” isn’t an emotion. Now I rather work out if I’m feeling fear, despair, hopelessness, anger, betrayal or sadness.

I’m realizing that emotions are messages delivered by my subconscious mind and I owe it to myself to listen to that message.  And I also take time to document that feeling in my journal.

What I also find helpful is making a list of all the emotions I feel – positive and negative. It might sound stupid but if, like me, you struggle with these things it is a very useful exercise. And if you struggle to find the emotion – just Google it!

I don’t always get it right – I still struggle with identifying and dealing with my emotions because it wasn’t something that I was encouraged to do as a child. My default mode is to push my emotions away as quickly as I can.

But now, when I’m starting to feel that my mind is a race track of thoughts and emotions, I make a point of calming myself down and I take just a few minutes to figure out what I’m feeling. This is something that’s really worked for me.

And in the process I’m learning to be gentle with myself. I’m not a project to be completed flawlessly and I don’t always have to get it right – this is one of the biggest life lessons I’m learning all the time.