World Mental Health Day: Poverty should not determine quality of care

On 10 October every year, the World Health Organisation observes World Mental Health Day. The theme for 2021 was “mental health in an unequal world”.

I was overcome by a cocktail of paradoxical emotions related to this day. I know full well that many people who live with mental illness will not tangibly gain from this commemoration; therefore, it holds no real meaning for them. Simultaneously, I was filled with joy, because I have noticed a visible increase in mental health activism and advocacy.

In discussing inequalities related to mental health, it is my belief that our country’s health system stigmatises and, therefore, fails people living with mental illness who desperately need and rely on its services. But mental health services are grossly underprioritised and people living with mental illness are undermined by a system that should care for and protect them.

The Life Esidimeni atrocity dehumanised people living with mentally illness and left affected families traumatised, as well as those of us who have empathy towards human suffering and vulnerability. As someone living with mental illness, I was heavily triggered:  the Life Esidimeni tragedy sobered me up to the realisation that I could have easily been cast adrift by stigma and rights violations had it not been for my socioeconomic standing. 

Our unequal world further victimises people living with mental illness through poverty, which compounds their suffering. Our health system is struggling, specifically mental health services. Mental healthcare workers are overwhelmed by a pressured system that is often unco-operative; there is a limited supply and access to medication and services, which does not meet the demand.

The inequality that exists between public and private healthcare throws what the state offers into sharp relief. This results in a portrayal of private healthcare services as superior. This, then, incorrectly renders mental healthcare as a luxury for the privileged to be enjoyed and undermines the importance of this speciality in our already traumatised society. I feel sadness at how poverty is a major determinant of the quality of care one receives, when this is a basic human right.

I write this article in honour of those people whose human rights were violated through the Life Esidimeni tragedy, as well as those who might never access mental health services in their lifetime in this unequal world. 

My passion for mental health advocacy is fuelled by the urgency I feel on behalf of those people who are unable to articulate their plight.

May the theme for World Mental Health Day translate to reflections that inspire proactivity and produce visible change.

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Samke Ngcobo
Dr Samke J. Ngcobo is a medical doctor working toward the day when mental illness is treated with the same respect as physical illness.She is the founder of thenon-profit organisation Sisters For Mental Health and Vocal Mentality

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