The Sunday Times’ recent article investigating the magnitude of the mental-health problem in South Africa, serves, once again, as a profound reminder that the range and depth of community mental-health needs is radically disproportionate to the capacity of health services to deliver on these needs.
In a post published on our blog late last year, entitled ‘Mental Health in South Africa: Whose problem is it?’ , we, too, highlighted some of the shocking statistics as regards the ‘sick’ state of country’s ‘mental health’. These include:
- As many as one in six South Africans suffers from anxiety, depression or substance-use problems (and this does not include conditions such as bipolar disorder or schizophrenia);
- Over 40% of people living with HIV in South Africa have a diagnosable mental health disorder;
- An overwhelming 48% of new mothers suffer from postnatal depression;
- When crime and motor-vehicle accidents are taken into consideration, up to 6 million South Africans could suffer from post-traumatic stress disorders;
Yet, despite the fact that we are clearly in the midst of a mental-health crisis, only 27% of South Africans reporting severe mental illness ever receive treatment, says the South African Depression and Anxiety Group (SADAG). One of the chief reasons for this is that the overwhelming majority of these people (SADAG puts the figure at 85%) are dependent on public health-sector services and, with only 18 beds for every 100 000 people available in such hospitals (and only 1% of these reserved for children and adolescents!), it’s easy to see why nearly three-quarters of sufferers are not accessing any form of mental-health care at all.
While there’s no denying that South Africa is clearly in dire need of registered counsellors, one of the stumbling blocks, according to Professor Gertie Pretorius, Vice Chairperson of the Health Professions Council of South Africa (HPCSA), is a general misunderstanding of the role of this category of mental health care professional. ‘Registered counsellors are not mini-psychologists who predominantly provide curative or therapeutic interventions on a one-on-one basis,’ she says. ‘Registered counsellors work mainly in group and community contexts, such as schools, children’s homes, prisons, police services and NGOs, to mention but a few.’
According to Dr Sharon Johnson, the former BPsych co-ordinator at SACAP, ‘Registered counsellors are professional practitioners who meet the needs of South Africa to make primary psychological services available in diverse community contexts, thereby enhancing the psychological wellbeing of the public. They work with individuals or in groups, focusing on prevention and primary intervention for psychological difficulties rather than on psycho-therapeutic interventions, which is more the realm of the psychologist.’
‘SACAP’s Bachelor of Psychology Degree (BPsych) equips students with theoretical knowledge to underpin practical roles they need to perform in communities, with on-site fieldwork experience (the practicum) to enable them to handle the realities of these contexts,’ says Dr Johnson. ‘From the first term of the first year of the course, subjects deal with the introduction to psychology, different theoretical counselling modalities and practical counselling skills in learning the fundamentals of a helping relationship. From this base, students’ knowledge is expanded to include subjects like community psychology, psychometrics and statistical analysis, including a basic introduction to languages such as Xhosa. A research report in their final year allows Bachelor of Psychology students to deepen their application of theory to practice.’
When correctly equipped, says Dr Johnson, ‘Registered Counsellors add great value to South African society, as well as to the profession of psychology. They provide a workforce to address problems in South African society, prevent mental-health problems, and enhance wellbeing and development.’
And in South Africa, this is clearly where such services are needed the most.