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Silence around mental health a barrier to accessing treatment

Time to embrace that it's okay not to be okay

Research shows since the outbreak of Covid-19, 67% of people are reporting higher stress and anxiety levels, while 53% say they feel more emotionally drained and exhausted.
Research shows since the outbreak of Covid-19, 67% of people are reporting higher stress and anxiety levels, while 53% say they feel more emotionally drained and exhausted. 

As a mental healthcare provider, I approach the end of every year with some trepidation. As soon as the August winds start to blow in Bloemfontein, we tend to see a distinct increase in our community’s psychological distress. The year 2020 has not spared us this increased burden of suffering.

This year has presented humanity with extreme challenges and our university community has felt this to our core. The latest research indicates that the SA population has been affected by the Covid-19 pandemic in various ways and on various levels, but none less severe than our psychological health. One in three South Africans will present with a psychological disorder during our lifetime, and the effects of the pandemic have caused a significant rise in depression, anxiety and trauma symptoms among South Africans.

We are experiencing exceptionally high levels of financial stress due to the impact of the disease and lockdown on our economy. We have endured months of social distancing, fears surrounding our own health and the well-being of our loved ones, our financial safety, managing our children’s home-schooling, adapting to distance-learning and concerns about the academic year being salvaged.

We have had to experience loss after loss. We mourn loved ones, colleagues and acquaintances that have become ill or passed away due to the pandemic. We have mourned the loss of our normal lives. The hugs, handshakes, casually touching someone’s arm, the shows, sporting events, weddings, graduations and braais we took for granted.

World Mental Health Awareness Day on October 10 could not have arrived at a better time. This year the World Health Organisation is encouraging investment into mental healthcare across the globe. While this is an essential step in increasing access to mental healthcare services, it is also only one aspect in the use of psychological treatment resources.

One of our most important barriers to providing mental healthcare often lies within us. Mental illness remains one of the most stigmatised conditions in society. Some of the common problematic and erroneous beliefs society holds about people who struggle with mental illness is that they are somehow deviant, dangerous, weak or even faking it.

Unfortunately, our healthcare workers are not immune to such prejudicial attitudes and neither are their patients. Self-stigmatisation occurs when we internalise these discriminatory generalisations and fail to access mental healthcare because we believe that we should be stronger, or just pull ourselves together or worry about the impact of receiving a psychiatric diagnosis on our career or our relationships. 

Perhaps one of the most tragic aspects of this is that almost all would sit in utter shock recalling how their loved one had seemed fine. How this came out of the blue. How he or she had never told anyone how difficult life had become for them. They were silent in their suffering because of fear of stigma, judgment, rejection or being viewed as a burden. 

Receiving psychological treatment is becoming as normal a part of well-being as going for a run, or eating healthily or spending time with our social support system. And this is what is going to save lives. The more we normalise the use of psychological services, the less stigma and silencing we will be subjected to.

There is no shame in owning our vulnerability and reaching out for assistance in order to make meaningful and even enjoyable the few journeys around the sun that we have left.

So this October should be the month when we start the conversation about our mental health. And by doing so we permit those around us to do the same. We have survived a pandemic that changed the world and our daily lives. It's okay not to be okay.

• Angie Vorster is a clinical psychologist in the school of clinical medicine, University of the Free State.                                                

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