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As South Africa moves closer to the end of Covid-19 restrictions, experts say the country recorded a surge in the number of patients seeking mental health services in the past year because of the lockdown.
According psychiatrists and doctors, this was compounded by the long waiting lists in both private and state mental health facilities and a lack of beds for mental health patients across the country. The people in dire need of mental healthcare were not only adults but children and adolescents as well.
A report by Unicef SA found that 65% of young people who had mental health-related issues did not seek help.
Dr Alicia Porter, a member of SA Society of Psychiatrists (Sasop), said a number of mental health patients defaulted on their appointments and treatments during the lockdown.
“In South Africa there was a decrease in mental health visits during the lockdown period, and we saw a higher than usual number of patients who defaulted on appointments and treatment during the initial [hard] lockdown,” Porter said.
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She said some people avoided mental healthcare facilities because “of fear and anxiety about contracting the virus, fears of infecting loved ones, change in financial status due to unemployment and retrenchments and transport difficulties”.
Porter said the huge disparities in accessing mental healthcare were bound to be visible during or after the global health crisis due to the limited number of psychiatrists in the country. Porter said:
Another aggravating factor was the lack of funds at national level. “Mental health is allocated 5% of the national health budget, while only 50% of public hospitals offering mental health services have a psychiatrist and about 30% do not have a clinical psychologist [as at October 2019],” she added.
According to Porter, the common psychiatric conditions which increased during the pandemic were “depression, anxiety and post-traumatic stress, in children and adolescents”.
She added that there had been an exponential increase in depression, anxiety and eating disorder admissions.
Sadag mental health statistics
The SA Society of Depression and Anxiety Group (Sadag) presented the statistics below on the impact of Covid-19 on individuals.
Prior to the lockdown in 2020, 46% of the country’s population suffered from depression, 36% had generalised anxiety and 12% were bipolar. A fact sheet compiled by Sadag in 2020 revealed that depression was the leading cause of disability worldwide and one in three South Africans would or had mental health issues.
It also stated that only one in 10 South Africans accessed mental healthcare. “Four times more men die of suicide than women and 30.6% of students have had thoughts of suicide in the last 12 months,” said the fact sheet.
The Sadag said the main challenges experienced during the lockdown were:
- 55% anxiety and panic;
- 46% financial stress and pressure;
- 40% depression;
- 30% poor family relations; and
- 6% substance abuse.
The overall impact of Covid-19 to the general public
Psychologist Chris Kemp said the strict lockdown regulations that were meant to curb the spread of Covid-19 might have resulted in people suffering from complicated bereavement after losing their loved ones.
“Covid’s impact on our ability to visit family members in hospital, arrange funerals and engage in our own personal rituals dealing with loss may have resulted in a lot of people struggling with closure and complicated bereavement, compounding the already significant emotional distress of losing loved ones,” Kemp said.
He said the mental health situation in South Africa was “an epidemic.”
Kemp said:
Between January and September last year, Sadag recorded 466 407 calls – an increase of 47.75% from 2020. Its Suicide Helpline Centre received 85 516 calls and 105 390 online requests for help.
Cassey Chambers, Sadag’s operations director, said the organisation “has noted an increasing demand for mental health treatment. More callers are needing to see mental health professionals and access medication or treatment through hospitals”.
Chambers added that this was a cause for concern as there were not enough resources available in communities.
Going digital overnight
“We thought we were busy before Covid-19, then the lockdown happened and our call volumes doubled overnight. We had to adapt really quickly and ensure that there was no disruption in our services as so many people were reaching out who needed help,” she said.
Sadag had to close “our centre and move the entire helpline switchboard to an app and set-up our more than 180 volunteers to work remotely”.
“For the first time in 26 years, we had to close the call centre and we had only three days to do that. So we literally went digital overnight. It has been a difficult year as we navigate the new normal, learn to try work remotely, find new ways to connect with our counsellors and our team, working harder and longer than ever before.”
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While there was no research yet or evidence that suicides had increased, Chambers believed there had been an increase.
“We know that suicide is a major issue [in the country] throughout the year. What we do know is that due to Covid-19, we got more calls from people who feel lonely, are experiencing grief or loss, are anxious and depressed."
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