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Speculation in the early days of the Covid-19 pandemic suggested that the illness was going to be a sort of “great equaliser”; an indiscriminate killer that took the lives of rich and poor alike. But, like many diseases for which there is no cure or prevention, only treatment, its death rates soon showed it to be another symptom of inequality: those who were in good health when the disease hit, as wealthier people were likely to be, had a better chance of surviving their bout of Covid-19. They were statistically more likely to catch it, too: those working in service industry jobs did not have the option of working remotely. Those who could afford access to the treatment that ameliorated its effects were, similarly, safer — not entirely safeguarded, to be sure, but more likely to receive the care that would allow them to survive.

This suggests that poorer populations in South Africa are going to feel the effects of Covid-19 to a deeper extent than their rich counterparts, even if one focuses only on lives lost and neglects to consider the disproportionate economic losses suffered by those who were already living near to or below the poverty line: the trauma of being unable to help a sick loved one, and the terror of being ill with tenuous access to necessary care.


It also works as a more immediate, more visible example of the ways in which disparate access to quality healthcare can shape the way in which different populations experience the same dangerous illness. For those suffering from a mental illness, be it mild or severe, treatment is expensive and hard to reach.

Lockdown has changed the way that many of us receive mental health help. Therapy apps and online therapy sessions are not new, but have long been seen as second best to an in-person consultation with a psychologist or psychiatrist. During the various levels of lockdowns implemented in countries around the world, even the most expensive therapy sessions had to happen online, and the gap between an in-person session and one held online has narrowed.

Online therapy is still not free, but a number of considerations make it considerably more affordable and accessible. “Shopping around” for the right therapist is quicker and easier when the options available to a prospective patient extend beyond those within easy travelling distance. And when easy travelling distance is a concern, wealth is a significant factor: those constrained to a short lunch break without the option of flexible hours or time off don’t get to travel as far. Those using public transport quite simply have fewer options when it comes to the number of therapists available to “try out”. And it might be argued that these are the people who need to find the ideal match in their therapist: those suffering from the effects of a specific gender-based, racially influenced or socioeconomic concern can undoubtedly benefit from the help of a mental health professional who is easily able to understand their circumstances.

For those who’d still prefer in-person counselling, there are options worth exploring. The Counselling Hub offers an invaluable service: quality counselling and mental health resources to the community in group and one-on-one counselling sessions at affordable rates, while LifeLine Johannesburg offers counselling in person, over the phone and via WhatsApp. For those on a medical aid scheme, it’s worth investigating whether your plan allows for mental healthcare: even a hospital plan allows for a number of sessions of therapy as an outpatient treatment for depression and anxiety.

Like so many of the results of the Covid-19 pandemic, we’re faced with a crisis that can be turned into a golden opportunity if we act quickly and decisively.

At a time when trauma, grief and heartache are so widespread that they seem to be emotions we all hold in common, we need to talk about them. Perhaps by doing so, whether on social media, with trusted friends or with a professional, we can start to chip away at the stigma surrounding our negative feelings.

It may be too much to imagine that mental health support is about to become widely accessible or even acceptable, but it’s time for an inclusive conversation about how new options can be open to all. — Cayleigh Bright

If you’re experiencing a mental health emergency, don’t hesitate to seek help.

Call the SADAG toll-free hotline on 0800 4567 789

or WhatsApp 076 88 22 775.

For a suicidal emergency, call 0800 567 567.

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