Die andere pandemie: inzichten in en suggesties voor een betere public mental health (care)

That other pandemic: insights and suggestions for a better public mental health (care). Like Covid-19, mental health problems threaten to undermine our society and the personal well-being of many – perhaps more dormantly, but not less destructively. Many people suffer from mental health problems and high suicide rates, skyrocketing psychopharmaceutical use and endless waiting times suggest that the quality of care today – despite the efforts of dedicated professionals –is sub-optimal. These staggering figures make the rollout of a larger plan to prevent, early identify and promptly treat mental health problems an urgent matter. This article focuses on how we can intervene in the mental wellbeing of our population: what bottlenecks underlie the current situation, what societal changes need to be made, and what data can contribute in the matter.

COVID-19, psychosocial issues, politics, and public mental health care

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

Public mental health care in colonial Lesotho: themes emerging from archival material, 1918–35

This paper identifies some of the themes that emerge from a study of official archival records from 1918 to 1934 on the subject of mental health in colonial Lesotho. They include: difficulties experienced by colonial medical doctors in diagnosing and treating mental illnesses, given the state of medical knowledge in the nineteenth and early twentieth centuries; impact of shortage of financial and other resources on the establishment and operation of medical services, especially mental health care; convergence of social order, financial and medical concerns as influences on colonial approaches to mental health care; and the question of whether Basotho colonial society saw institutionalization of their relatives as ‘hospitalization’ or ‘imprisonment’. Two case studies are presented as preliminary explorations of some of the themes.

Scaling up public mental health care in Sub-Saharan Africa: insights from infectious disease

Introduction Models estimate that the disability burden from mental disorders in Sub-Saharan Africa (SSA) will more than double in the next 40 years. Similar to HIV, mental disorders are stigmatized in many SSA settings and addressing them requires community engagement and long-term treatment. Yet, in contrast to HIV, the public mental healthcare cascade has not been sustained, despite robust data on scalable strategies. We draw on findings from our International AIDS Society (IAS) 2020 virtual workshop and make recommendations for next steps in the scale up of the SSA public mental healthcare continuum. Discussion Early HIV surveillance and care cascade targets are discussed as important strategies for HIV response in SSA that should be adopted for mental health. Advocacy, including engagement with civil society, and targeted economic arguments to policymakers, are reviewed in the context of HIV success in SSA. Parallel opportunities for mental disorders are identified. Learning from HIV, communication of strategies that advance mental health care needs in SSA must be prioritized for broad global audiences. Conclusions The COVID-19 pandemic is setting off a colossal escalation of global mental health care needs, well-publicized across scientific, media, policymaker, and civil society domains. The pandemic highlights disparities in healthcare access and reinvigorates the push for universal coverage. Learning from HIV strategies, we must seize this historical moment to improve the public mental health care cascade in SSA and capitalize on the powerful alliances ready to be forged. As noted by Ambassador Goosby in our AIDS 2020 workshop, ‘The time is now’.

From darkness to light: Barriers and facilitators to mental health recovery in the South African context

Background: South Africa is a low and middle income country facing many challenges in public mental health care and implementation of recovery. Aims: To contribute to what barriers and facilitators to recovery might be for service users in South Africa, from the perspective of service users, carers and service providers from three psychiatric hospitals in the Western Cape province. Method: Interviews and focus groups were conducted with service users, carers and service providers. Interviews and focus groups were transcribed and analysed using atlas.ti software and reflexive thematic analysis, from the bottom up. Results: The barriers, environment, family, public mental health services, stigma and service users’ attitude or behaviour generated, were found to be the most salient. The facilitators to recovery generated were support, family or friends, service providers, structure and empowerment. The need for support was identified as an underlying component to all these themes. Conclusion: Barriers and facilitators to recovery seemed to have both intrapersonal and external sources that intersect at times. Recovery needs to be supported at an individual level, especially through an under-utilised resource such as peer support work, but in conjunction with the development of recovery-enabling environments in services and communities in South Africa.

Challenges Faced by Mental Health Nurse Specialists in North West, South Africa

This article reports on a study that sought to explore and describe the challenges faced by mental health nurse specialists in North West (NW), South Africa, using a qualitative research design. The study population comprised all mental health nurse specialists working in public mental health care institutions in NW. A non-probability expert sampling method was used to identify mental health nurse specialists for voluntary participation. The sample size was determined when data saturation was reached after interviewing seven mental health nurse specialists working in the province. Data analysis was done independently by both the researcher and the co-coder. Credibility, transferability, dependability and confirmability were observed to ensure trustworthiness. Three themes emerged from the study, namely: (1) challenges affecting mental health nurse specialists directly; (2) challenges directly influenced by the government; as well as (3) suggestions to support mental health nurse specialists. Recommendations were derived and proffered to support mental health nurse specialists in NW.

MENTAL HEALTH IN THE PANDEMIC TIMES

The primary aim of this paper is an attempt at the analysis of the prospective direct and indirect, short- and long-term consequences of COVID-19 pandemic for the individuals’ mental health. The secondary aim is to deconstruct the binarity of categories of “mental health” and “mental disorder” in the context of the global critical situation. The pandemic and its consequences such as isolation requirements as well as uncertainty in diverse aspects of life burden the individuals with the stress that results in the increase of anxiety and depressiveness, which challenges the public mental health care systems. Since the anxiety and depressive states are the reactions to a hazardous outside situation, the categories of “mental health” and “mental disorder” needs reconsideration. The theoretical framework of present analyses is determined by the theory of social (cultural) trauma. The method used for the present study is a meta-analysis of theoretical literature, the results of empirical research on COVID-19 pandemic published so far (mostly in medical journals), studies on psychosocial aspects of the previous pandemics (SARS and Ebola), and press publications selected on the basis of their content on mental health issues in the context of the coronavirus pandemic.