Headaches remain for mental healthcare

Before we move on to the main topic of this column, I just want to take the opportunity to thank the staff of Life Beacon Bay Hospital. I was admitted on Thursday morning for a nasty case of appendicitis and had to be rushed to surgery that night.

Throughout my three-day stay, the Life BB staff were professional, polite and took great care of me. So again, a big thank you to the doctors, nurses and general staff there.

This actually segues neatly into what I want to talk about this week.

October 10 is World Mental Health Day which, as the name suggests, is aimed at educating people about the reality of mental health issues and combating the negative stigma.

This day has some special significance for me as someone who has struggled with mental health issues for a long time. I won’t go into the details, but instead I want to discuss what I consider the three most important steps to treating mental illness and also look at how these they can often be out of reach for some people.

These three things are: access to therapy, medication and the ability to make necessary lifestyle changes.

The first thing – access to therapy, was probably the most important one since it is what led me on to the next two.

I was “lucky” enough to have my big breakdown when I was still a student at Rhodes University. Part of their student welfare services includes trained psychological assistance when required, free of charge.

After the first appointment, I was then able to meet my therapist once or twice a week. every week for nearly all the four years I remained at Rhodes.

In contrast, I tried to speak with a therapist here in East London. In addition to the hefty fee I would have to pay, I was also told that they’d only be able to see me in six months’ time.

Now if someone is currently undergoing a severe mental episode and needs help immediately, this sort of extreme delay can be fatal.

Now one could argue that a person in that situation can simply go to a hospital or a dedicated mental health facility.

This is a separate discussion all on its own, but for now, a Google search of “Life Esidimeni” will provide sufficient evidence that such facilities can end up doing more harm than good.
And besides, what if someone doesn’t want to be locked in a hospital for months on end because of a depressive episode? In such scenarios, just having a therapist to talk to is more than enough.

In addition to counselling, the varsity therapist was also able to guide me along an effective treatment path which brings us to item No2: number two, medication.

If you are put on a course of medication for a mental condition, there’s a chance that it’s going to be very long-term or even permanent.

In such a scenario, the biggest obstacle here is cost. Psychiatric medicine is not cheap and most basic medical aid insurance plans don’t cover it which means you’ll be forking out a hefty amount out of your own pocket each month.

There’s another problem in that psychiatric medicine is a very, shall we say, trial-and-error process.

While you can give a Panado to just about anyone on the street and have a good idea on what the outcome will be, you won’t have the same certainty here. In addition, you’ll often have to opt for combinations of medications which might also need a few attempts to get right.

Combine this with the cost and the fact that it can take a while for a medication to first take effect in the first place (in my experience, anyway), and you can end up shelling out thousands of rand over the course of one or two years before you actually find the correct brand, dosage and combination of medications that treats your particular condition.

Finally, the third component of effective psychiatric treatment involves making important changes to your lifestyle. Depending on your situation, these may be different but they’re generally just good healthy decisions in their own right – eat less junk food, exercise more, quit smoking, etc.

Trust me, when combined with the other two steps, they make a huge difference.

However, you can’t make the changes if you don’t know you should. A therapist would be able to guide you but you need to have access to one first.

The way we look at psychiatric medicine also means we usually think that going on to a regimen of pills is all we need. While medicine is indeed an important part of the treatment process, it won’t do much on its own without the other two.

Anyway, I guess the main point of this ramble is that treating mental health is a complex process that requires a number of important steps in order to be properly effective.
Unfortunately, two of these things can be out of reach for a lot of people simply due to cost.

Now our healthcare system needs reforms in plenty of areas, but even in more developed countries, mental healthcare is often stigmatised and sidelined in health policies. This leads to higher prices and fewer resources available for those who desperately need it.
That is why World Mental Health Day and other awareness campaigns are important.

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