The Free State department of health educates on a variety of health issues in its yearly calendar
The burden of mental illness is felt not only through the primary presentations of mental disorders, but through its high co-morbidity with other illnesses
The relationship between poverty and mental ill-health has been described as a “vicious cycle”: people living in poverty are at increased risk of developing mental disorders through the stress of living in poverty, increased obstetric risks, lack of social support, increased exposure to violence and worse physical health, said Nomsa Leshotho, manager for mental health and substance abuse for the Free State Province.
On the other hand, those who live with mental illness are at increased risk of sliding into (or remaining in) poverty, as a result of increased health expenditure, lost income, reduced productivity, lost employment and social exclusion due to stigma.
Youth risk survey (2003) found that Free State had the highest rate of suicidal behavior compared to other provinces.
Apart from this, Xhariep District has been identified as the region with the highest rate of foetal alcohol syndrome in the country.
Homemade alcohol made with ingredients only known to brewer, can include ARVs, powder from batteries and other shocking ingredients. One drink can be fatal.
Leshotho says that a study has revealed that in the South African context, the relationship between HIV/Aids and mental illness is particularly pertinent.
Research in South Africa shows that, with high prevalence in both, mental illness and HIV coexist in a complex relationship. Mental health impacts on and is exacerbated by the HIV/Aids epidemic, both being mutually reinforcing risk factors. Mental health problems are common in HIV disease, cause considerable morbidity, and are often not detected by physicians.
The message is to break down the stigma around mental illness, and accept that it exists and needs urgent attention.
There is good news. Mental health and substance abuse have been receiving increased attention in the Free State since the implementation of the National Mental Health Policy Framework and Strategic Plan 2013 -2020.
The catalyst was political will that singled it out as [being] a special area of focus through Dr Aaron Motsoledi, the National Minister of Health, who has been quite vocal about it,” said Leshotho.
“There are four burdens of disease and the Free State is putting admirable attention towards recognition that mental health is the fifth burden of disease and needs budget, personnel and infrastructure to add to the three all-service centres related to mental illnesses.
“Ignorance levels and stigma around mental illness is exactly the same as for TB and HIV, as is the level of intolerance and violence.”
According to Leshotho, apart from such issues as road rage and flagrant law-breaking, there is a level of violence in families linked to mental disorders. “Gangsters and gangsterism [is] affecting children, which in turn erodes the moral fibre of our society. We can never divorce mental disorders or the use of substances to cope from losing a mother or the father due to HIV.
“These children need care to function normally. As a result of mental disorders, such people become prone to rape and unprotected sexual behaviour, which ends up with them becoming susceptible to HIV infection.
“Greater advocacy is needed to raise awareness. We need to nip it the bud and cap the scourge, which is on the increase now and without wider studies, we simply do not know how deep the story is. “We need to deal with this from an early age, and through adherence. You want people to adhere to their medication? Prepare them psychologically first, attend to their mental state first.
“If they are not mentally prepared, they will rather opt to use other coping mechanisms, i.e. use of substances.”
“We are not painting a picture of doom and gloom, but rather raising awareness as a catalyst towards zero infection and improved adherence,” concluded Leshotho.