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The 26th of May is Bipolar Disorder Awareness Day. This offers an opportunity to look back at the past, examine the present and envisage the future we want for those affected by this mental health condition. To this effect SAFMH has composed a press release on the issue. Read it below:

 According to the World Health Organisation (WHO), Bipolar Disorder is a prevalent mental health condition, affecting 60 million people worldwide. Harddon, Hayes, Blackburn et al (2013) cite it as a serious mental illness. However, this is not to say that people with this mental health condition cannot lead happy and fulfilling lives.

According to the WHO (2014), mental health is defined as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” As the South African Federation for Mental health (SAFMH), we believe that everyone can live life in a good state of mental health, if only a conducive climate is created for them to do so. Bipolar Disorder need not be a life sentence. For 2019’s Bipolar Awareness Day on the 26th of May, this is what we aim to illustrate.

Bipolar Awareness Day is an opportunity to look back at the past, examine the present and consider what kind of future we want for people with this mental health condition. Such individuals have been prolifically discriminated against and relegated to a class of the incapable and infirm, their talents and capabilities chronically overlooked. The stigma surrounding this condition has led to poor rates of employment, institutionalisation and poor measures to accommodate such individuals in learning environments.

In reality, this is wholly unnecessary and places undue limitations on the exercise of the rights of individuals so-situated. This is not only a moral affront but is entirely unconstitutional- something society rarely thinks of in the way they treat such individuals.

Sifiso Mkhasibe, a Project Leader at SAFMH, refers to himself as a “survivor of Bipolar Disorder.” Mkhasibe struggled with the disorder for years- at times hospitalised and isolated- until he was provided with the right treatment regimen and proper assistance. Today he is confident and successful, having taken control of his life: 

“Days, weeks, months went by, until I realised enough is enough. I had to take ownership of Bipolar Mood Disorder. I educated myself about the symptoms I had experienced when I was diagnosed…once I had learned how to manage my Bipolar Mood Disorder, life started to become clearer, I knew what I had to do and how to do it. I was no longer a victim of my Bipolar Mood Disorder. I stopped defining myself as a person with Bipolar Mood Disorder, now I just say I had those symptoms when I was diagnosed. I am on medical treatment and I do not present those symptoms any longer.”

There are different support structures that, if put in place and available to those needing it, can aid in the recovery of people with Bipolar Disorder. According to the South African Depression and Anxiety Group (SADAG) (no date) treatment can take the form of the provision of medication, psychotherapy, family support groups or periodic hospitalisation as a last resort. Authors like Mkize (2003) highlight that assistance from traditional healers is also one of the options available to people with mental illness. A further mechanism which can be used to support such individuals is reasonable accommodation in the workplace, as contained in the Basic Conditions of Employment Act 75 of 1997. There are thus many mechanisms that can be employed to enable people with Bipolar Disorder to have a good quality of life.

Unfortunately, state structures frequently fail those with this mental health condition. An example of this is the inadequate number of trained professionals to care for such individuals                                                and lack of information concerning lay counsellors who render services to people with mental health conditions. According to the WHO’s Mental Health Atlas (2019), South Africa has only 1.52 psychiatrists per 100 000 people. The same document indicates that there are only 16.56 beds available in psychiatric hospitals per 100 000 people. There is no evidence surrounding how many support groups there are. In addition, only R99.47 is budgeted per person for mental health services on an annual basis. What is perhaps the most problematic of all is the fact that, in many instances, there is simply no data available on the state of mental health in South Africa, with the Atlas indicating in many places that there is no information or that no information has been reported on various items such as community-based organisations (which the United Nations (2018) has acknowledged as something that needs to be developed and recognised) or length of stay in inpatient facilities. Another example of how the state is not supporting mental health adequately is the failure to employ adequate numbers of people with disabilities (this includes people with mental health conditions), - let alone take steps to reasonably accommodate them. According to the Commission for Employment Equity Annual Report (2017/2018), only 1.3% of the workforce were people with disabilities, in comparison with the employment equity target for employment of such individuals which is 2%.

SAFMH is a non-governmental organisation seeking to protect and uphold the rights of people with mental health conditions. We wish to issue calls to action first to society and then to government:

We urge members of the public, friends and families of people with Bipolar Disorder and people with the disorder themselves to become educated about this mental health condition so that the stigma surrounding it can be diminished. This will enable people with the condition to live in their communities, to work and to obtain an education.

We call upon the state as the primary duty-bearer to take steps to realise the rights of people with Bipolar Disorder and to ensure that basic services improve. The state must also take steps to provide human rights education to the public.

Bipolar Disorder can be disabling, but it need not be the governing force in a person’s life. With proper intervention and care, people with this mental health condition can flourish and thrive, if only they are given the chance to do so. It’s time to #takeyourplace in ensuring the needs of people with Bipolar Disorder are met.

ENDS

Contact Details

Nicole Breen

Project Leader: Information and Awareness

South African Federation for Mental Health

011 781 1852

072 2577 938

This email address is being protected from spambots. You need JavaScript enabled to view it.

The South African Federation for Mental Health attended the presidential inauguration of Cyril Ramaphosa. Thousands of South Africans filled Loftus Stadium on Saturday 25th May 2019. The festivities ranged from cultural performances by the Tshwane Gospel Choir and the South African National Defence Force’s (SANDF’s) marching band. The atmosphere throughout the day was that of excitement as many gathered to witness this momentous occasion.

On the 19th of May 2019, a global mental health campaign entitled Speak Your Mind was launched at the World Health Assembly. The campaign is an initiative of United for Global Mental Health, a UK-based NGO, in collaboration with civil society organisations from numerous countries from across the world, and is intended to catalyse positive and concrete changes in the lives of mental health care users within countries of various income levels.

United for Global Mental Health (UGMH) was founded to create a united global effort to bring about greater action on global mental health through a strong demand for action on mental health, more financing, and better global frameworks to deliver it. The campaign will target and hold governments accountable and responsible for providing access and funding for mental health. It is a nationally driven, globally united campaign involving civil society from 15 countries- with many of these bodies including individuals with mental health conditions The campaign gives people with lived experience the megaphone and serves to bring their voices to the fore.

The campaign has a South African Country Team, led by the South African Federation for Mental Health (SAFMH) in partnership with the South African Depression and Anxiety Group (SADAG) and the Regional Psychosocial Support Initiative (REPSSI). This campaign will seek to hold governments around the world accountable for their actions and inactions towards mental health care users and is intended to accelerate the rights of people with mental disabilities coming to fruition. The South African Country Team will work to domesticate this objective for the local context in South Africa.

The primary objectives of the campaign are to do no harm, to enable others to speak their minds and to get the messages surrounding mental health conditions out there. The secondary objectives of the campaign are to promote increased funding, to promote the need to create inclusive mental health systems and the need for government-led change in awareness on mental health.

The vision of the campaign is “mental health for all.” It’s ask to the public is to “end the silence, fight for action and speak your mind.” The ask to government is to invest, empower and educate to lead us into a future where mental health is valued now for the future we need for people with mental health conditions. The challenge with which we are faced is the chronic neglect of mental health, and the campaign aims to combat this.

The reality is that mental health conditions are on the rise in every country in the world. Some key statistics to note are the fact that depression is the leading cause of disability worldwide, that suicide is the leading cause of death among 15-29 year olds and that mental health conditions could cost the global economy US$ 16 trillion from 2010-2030 (United for Global Mental Health 2018). The problem with the current response is that governments have failed to act, limiting our potential today and depriving us of opportunities tomorrow. This is reflected in areas such as schools and the workplace.

The campaign has a set of 10 key objectives:

  1. All governments must have a national policy/plan and law for mental health. This must be in line with international law and policy, such as the United Nations Convention on the Rights of persons with Disabilities. Governments must implement these properly and efficiently.

 

  1. Governments and relevant stakeholders must uphold all people’s rights (including persons of all ages) to access the right care at the right time, as set out in the United Nations Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities.

 

  1. All governments should commit to increase the amount they spend on mental health in order to place spending on mental health on par with spending on other health areas.

 

  1. Global aid for mental health should increase to at least US$1 billion p.a by 2023.

 

  1. Governments and relevant stakeholders should work together to deliver the United Nations Sustainable Development Goals (SDGs), including the promotion of mental health and wellbeing. This must be comprehensively monitored globally, nationally and locally and must look at aspects such as reducing the rate of suicide, increasing the coverage and treatment rates for alcohol and other substance use disorders, and achieving universal health coverage by 2030.

 

  1. Mental health services should be community-based and integrated across primary health care, specialised care, and social care housing. Mental health has recently been recognised as a non-communicable disease and must thus be included in efforts to reduce chances of death due to both communicable and non-communicable diseases, bearing in mind that people with severe mental health conditions have a considerably reduced lifespan due largely to poor physical care.

 

  1. Governments and relevant stakeholders must ensure persons with mental health conditions are at the centre of the steps taken to address mental health issues and must be involved in decision-making processes that are focussed on person-centred and recovery approaches. These services must reflect the wishes of those who make use of mental health care services and must be culturally appropriate.

 

  1. All stakeholders – including governments, the private sector, civil society organisations, and persons with mental health conditions and their carers - should work together to reduce stigma and discrimination and increase knowledge and understanding of mental health. This is critical to inform better policy making, prevention and service delivery, and research.

 

  1. Governments and other stakeholders need to rapidly scale up high-quality services to those affected by conflict and humanitarian crises, invest in mental health care, and must ensure that sustainable mental health services are available after emergencies.

 

  1. Governments and other funders of mental health research should increase their investments in research and innovation, making use of innovative approaches from a wide range of disciplines such as genomics, neuroscience, health services research, clinical sciences, behavioural sciences and social sciences, both for discovery and implementation research. Stakeholders should explore the use of innovative technology for delivery of mental health interventions, especially to be accessible by those most vulnerable, at-risk and “left behind.”

 

The need for a nation to be in a good state of mental health affects us all, and it is vital that duty-bearers take action to ensure that mental well-being is prioritised. Mental health in South Africa is in a crisis situation, as evidenced by the Life Esidimeni tragedy and the human rights violations against people with mental health conditions that crop up continuously.This has gone unnoticed for too long. This campaign will work towards ensuring that law and policy reflect the needs of persons with mental health conditions and that government takes proactive steps to ensure that the struggles of people with mental health conditions are alleviated.

 

To follow the international campaign which will include community activations, media campaigns, social media and advocacy, please follow @GoSpeakYourMind or visit www.gospeakyourmind.org and follow #SpeakYourMind and #TimeToAct.

In order for a population to be able to be in a good state of mental health (and good health in general), government – as the primary duty-bearer – must create a climate necessary for people to achieve these states. Positive conditions for growth and development must be fostered and people must have faith that their needs are being met. Unfortunately many of the actions of government leave a lot wanting in this regard. Personal circumstances can lead to a person having difficulty coping with the challenges with which they are faced or not being able to contribute in the manner in which they would otherwise be able. Add to this government failing to provide for and protect its people, thus placing everyone in a precarious position and condemning them to a state of unhappiness and dissatisfaction, and a bleak picture starts to emerge.

According to the 7th World Happiness Report released this year, South Africa has been ranked one of the unhappiest nations in the world- something shocking in a country meant to embrace concepts such as the spirit of Ubuntu. One example of how South Africans are disempowered and sometimes plunged into a state of despair at a large scale is the failure of State-Owned Enterprises (SOEs).

Eskom is a poignant example. Day after day and night after night, people in South Africa are left without electricity, unable to work or function at school during the day and then plunged into darkness in the evenings, unable to prepare food, charge appliances or engage in other forms of activities for themselves and their families. The threat of national blackouts looms large for all those living in South Africa and people are bewildered, confused and angered by this state of affairs. This lost productivity prevents people from making contributions to their full potential, which can lead to an immense sense of anxiety and often a sense that one is failing their employer or their loved ones. This in turn could diminish their mental health.

According to Stats SA, 55.5% of people lived in poverty in South Africa in 2015, up from 53,2% in 2011, indicating that poverty is on the rise. It is difficult for impoverished members of society to escape the poverty traps in which they find themselves. We are all too familiar with hearing about worsening unemployment and poor education, but until South Africa gets out of this economic rut it becomes difficult to create jobs and to provide opportunities for people to gain qualifications- least of all in the face of an ill-managed public purse. A measurement called the Gini-Coefficient demonstrates income inequality. South Africa’s stood at a high 0.69 as reported by Stats SA in 2017. Lack of scope for growth on a personal and professional level leads to loss of confidence and hope, and a diminution of the idea that a person can create a better life for their children or make a positive contribution to society. Financial freedom is empowering. Absence of this freedom leads to disenfranchisement and feelings of worthlessness. This is also a catalyst for poor mental health, given the sense of insecurity it creates.

Corruption within government also leads to a loss of trust in the state. Mismanagement of funds and criminal charges being brought against high-level politicians leads to a loss of faith in those responsible for the running of the country. With phenomena such as state capture emerging it sometimes seems as if all hope is lost. It is nearly impossible to envisage how people can be expected to be in a good state of mental health amid such chaos, and possibly why we have been ranked as such an unhappy nation.

The general elections are upon us. Ultimately, many feel that the party they will choose to vote for in the May elections will be the “best of a bad bunch”. While all political parties promise positive changes in their own ways, a large number of people have simply lost their faith in the promises of political parties. According to a poll released by the Institute for Race Relations in 2018, there is likely to be a lower voter turnout in comparison to the 2014 elections due to factors such as high levels of voter discontent, which leads to voter apathy. The fact that people are not even willing to vote is both telling and concerning.

All that can be done at this point is to issue a reminder and a caution. The people of South Africa must remember that we have a Constitution guaranteeing a full complement of rights, and contains a careful construction of rights and responsibilities of government. It provides for the clear separation of powers of the three branches of government, striving to guarantee good governance. We have a comprehensive legal and policy framework, which prioritises human dignity, equality and freedom and a society which has largely embraced constitutional democracy. Political parties claim to want the best for their constituents. In all of the manifestos is a clear desire to undertake what they feel will better the lives of their voter base. Not everyone will agree with all of their views, but then one does not have to vote for them. That is the beauty of democracy. We caution these parties, however, about making promises they can’t keep and betraying those who vote for them.

The problems with SOEs have to be addressed, a decrease in poverty must urgently occur, and corruption must be rooted out.

Finally, the public must hold those serving them accountable. Advocacy and self-advocacy- doing things that empower those around you as well as yourself-surrounding the aforesaid issues are key to realising the Constitutional prescripts of Democracy. Democracy has not failed as some would have us believe. The overwhelming majority of us want to get along and co-exist peacefully. For this reason we must band together in ensuring that our common goals- a good life, where services are delivered properly and where the state is honest, open and transparent- come to fruition.

South Africans must take opportunities to voice their outrage with a view to secure redress. They must make use of the courts system and stage peaceful protests when something objectionable happens, must seek to obtain and provide civic education to remain informed and to place themselves in a position where they can proliferate knowledge, take political stances on important issues, and make use of the country’s vibrant civil society services such as law clinics, advocacy groups or those organisations providing direct services.

Through these endeavours, collective disempowerment can be transformed into collective empowerment- something that is good for morale and will boost the mental health of the people of South Africa.

Our country is presently in a precarious state and the mental health of its people is suffering as a result.

Poor mental health, as a result of collective disempowerment, could lead to large-scale negativity, mental illnesses, apathy, lawlessness, civic unrest and stress if it is not addressed.

Let us improve the state of our country and in turn our mental health.

On the 25th of March 2019, the Director of the South African Federation for Mental Health, Bharti Patel, took part in the Little Eden CEO Wheelchair Challenge. The aim of this initiative was to raise awareness for people who are wheelchair users through having those at the apex of an organisation spend a work day in a wheelchair. This was done with a view to raise funds as well as for those who took part to gain a sense of understanding as to what it is like to be a wheelchair user. We caught up with Bharti after the experience and did a brief interview with her to ascertain her thoughts on the experience and for her to describe what she had learnt as a result. An account of the interview appears below:

Please give us an overview of your experience:

I had to adjust to remaining seated for the entire day, and I found it difficult to perform tasks such as fetching documents from the printer. I was extremely conscious of moving about the office as I realised I would be blocking the entire passageway and I was conscious of the fact that I had to ask for assistance moving across the boardroom. This experience has been a real eye opener and has given me a new perspective on what it is like to be a wheelchair user.

What were the highlights of the day?

The concept of mindfulness of what it is like to be in a wheelchair dawned on me- I was able to see things in a new light. As the day progressed, it was no longer about the wheelchair, it was about getting things done using resources around me. I was motivated to go beyond the wheelchair and get things done and was able to appreciate how it was all very possible despite the challenges that had been so apparent to me at first, however I do realise that those with mental health challenges who also have physical disabilities face even more challenges.

How did people treat you?

Initially it drew a great deal of attention to me. People saw the wheelchair first and me second. People were accommodating but also almost apologetic. I almost felt like a victim at the start of the day. This dissipated as the hours went by.

What were your three biggest challenges?

In terms of context, I must say that I felt like someone who got into a wheelchair just subsequent to a traumatic accident- it felt sudden and confusing. I had to quickly adapt to being bound for the first time. I had to learn how to move around and my office had to be repositioned to allow me to get behind the desk. There were some doors I struggled to get through and it was difficult to pass by furniture and in passageways without being assisted.

Why do you respect wheelchair users more?

I appreciate the fact that people who use wheelchairs are able to go beyond the construct of them having a disability. Using a wheelchair also requires physical exertion and strength. People in wheelchairs are thus more resourceful in both mind and body.

Thank you Bharti for both your participation and taking the time to do this interview.

 

The right to basic education is a rudimentary entitlement extending to everyone, as set forth in section 29 of the Constitution. People with intellectual disabilities have long since been denied this right and it is vital that this change. Inclusive education is an area that has been chronically neglected and this is an affront to the rights of learners so-situated. Similarly, the right to employment is an entitlement in international law. Like education, the rights of people with intellectual disabilities have been neglected in this regard, with very capable individuals being unable to enter into the labour market. Poor education is directly linked to unemployment and is massively problematic in our society. People with intellectual disabilities have also suffered from a lack of support in communities and proper community-based care. With a human rights approach required by government in the White Paper on the Rights of People with Disabilities, this picture should be completely different. To this effect the South African Federation for Mental Health has drafted 3 policy briefs setting our how such individuals are situated and possible ways forward. Click on the links to read them.

https://www.polity.org.za/print-version/safmh-intellectual-disability-awareness-month-2019-and-policy-brief-2019-02-27