Mental health services crucial for South Africa’s township residents

Mental health issues in South Africa are on the rise, with many communities being faced with escalating levels of poverty, violence and substance abuse.

These issues are particularly pronounced in the country’s many townships and rural areas. An upsurge in conditions such as anxiety and depression amongst township-dwellers represents an important call to action for healthcare providers.

Understanding the issues

Currently, at least 30% of individuals residing in South African townships exhibit symptoms of depression, while around 25% are affected by anxiety disorders. Similarly, post-traumatic stress disorder (PTSD) rates are estimated to be around 15% - 20%, with substance abuse disorders impacting roughly 10% - 15% of this segment of the population.

The underlying causes of these worsening conditions are closely linked to the unique socioeconomic challenges faced by people living in these communities. Some of these causes can be attributed to the alarmingly high level of unemployment, which currently stands at just under 33%.

High levels of crime can also be linked to the deterioration of mental health – South Africa currently has a crime index of 75.4, which; despite its decrease in recent years, is still the highest crime index on the continent. Due to vast levels of underservicing, the rise of gangsterism and increasing levels of violence, crime conditions in townships are particularly acute.

These major social issues play a crucial role in shaping the overall well-being and mental health struggles experienced by people who live in townships. To this point, The South African Human Rights Commission has established a direct link between poverty and child and adolescent mental health, with this producing far-reaching effects into adulthood. Conversely, living with untreated mental health issues has in turn been linked to an increased risk of falling into or staying in poverty – an indicator of a vicious and perpetual cycle.

Commenting on this is Dr Thabo Mogotlane, Specialist Psychiatrist at Mediclinic Legae, which houses the first specialist unit to provide mental healthcare treatments for communities in Mabopane, Soshanguve and Ga-Rankuwa.

As he explains: “Residing in areas with limited infrastructure and substandard living conditions can trigger emotions of isolation, despair, and helplessness. This is exacerbated by inequalities in education and healthcare. Lack of access to these services can evoke feelings of hopelessness and low self-worth, all of which can negatively impact mental health.

Lessons from Legae: start with access

For this reason, addressing these social issues strategically and systematically is imperative to the general health and wellbeing of the entire nation, given the high volumes of South Africans who make up our township communities. By offering access to resources, support services, and opportunities for personal growth and development, communities can strive towards tackling the root causes of mental health disorders and fostering psychological wellness.

Improving access to mental health services in under-serviced and under-resourced locations is arguably the primary objective that needs to be addressed, according to Mogotlane. This objective is at the centre of the work being done by Mediclinic Legae, which provides community members with access to two full-time and two part-time psychiatrists who are based in formal practices at the facility. Historically, access to these kinds of services have been very limited.

Enhance community support

Other strategies that Mogotlane believes to be critical in providing better access and quality mental health treatment include raising awareness about mental health concerns in a bid to diminish stigma through educational initiatives and outreach. The stigmatization of people with mental health issues is in fact one of the major hurdles that patients in townships face in their journey to long-term recovery.

“It is vital for healthcare providers to tackle mental health issues directly but also indirectly by combating stigma. We need to facilitate open dialogues between patients, their families and their communities. It’s also important that that this work is enhanced by support groups and counselling that is culturally sensitive and language appropriate. For this reason, we’ve ensured that our team includes social workers who work with patients’ families to help them integrate into the community after treatment and reduce the risk of a relapse. 

Prioritise quality care

Another key issue is the need for patients in townships, to enjoy mental health services that are of the same quality and calibre of those offered in more resourced locations. The mental healthcare centre at Mediclinic Legae therefore plays an important role in providing patients in need with the opportunity to be admitted to conveniently located facilities offering the same level of treatment and care options available in large, urban areas.

Promote long-term recovery

“One of the messages we emphasise is that immediate treatment is just as important as ongoing treatment – we need to provide the space and resources to enable immediate interventions, but after-care support is just as important.

This why our occupational therapists and psychologists assess patients to determine whether they can cope with the demands of a work or family environment. Similarly, our psychiatrists collaborate with psychologists, because medication alone is effective for around 45% of patients, whereas the success rate is more than 80% when combined with psychotherapy.

In our work within these communities and our plans to expand and establish 4 more facilities in the short-term, we hope to provide a holistic support system that can take patients through their journey of recovery towards long-term wellbeing,” he concludes.