South African President Cyril Ramaphosa, in his COVID-19 update to the nation on 30 March 2020, reminded citizens why the government deemed a drastic 21 days lockdown on the country necessary. The South African Federation for Mental Health(SAFMH), like many organisations, fully support President Ramaphosa’s call for South Africans to practice social distancing by staying home to avoid getting infected with and spreading COVID-19, which has already infected some 740,000 people worldwide and resulted in more than 35,000 people losing their lives.
The president stressed that the lockdown is absolutely necessary to save the lives of thousands, even tens of thousands, of our people from the virus that in South Africa has already infected 1353 people, with the death toll standing at five on the 1st of April 2020. While it is important that people avoid going out at all cost, health care workers, security and emergency personnel, food suppliers, providers of medicine and basic goods, and other providers of essential services, as defined in the regulations, can go continue to go out to work. This means that people in urgent need of these services, including mental health care users seeking essential medical services, are allowed to go out to get the services they need.
During the next 16 days, we are all challenged to consider alternative options to managing our concerns, and in doing so, continue to ensure healthy and safe lifestyles for ourselves and our families. People with mental illness are some of the most vulnerable in our society, and more care is needed to ensure that they are not exposed to the COVID-19 virus. It is important for these people to continue taking and getting access to medication to ensure adherence to treatment, which is necessary to prevent relapses and maintain a balanced lifestyle, while at the same time ensuring minimum exposure to the virus.
Being consistent with regular routines will help people with mental health illness to maintain their mental health. This could include using phone technology through voice and video calls to keep psychologists or psychiatrists’ appointments, where possible. According to a study published in Conflict and Health (2013), mental health problems, especially anxiety and mood disorders, are common in humanitarian emergencies, both natural and man-made disasters. This study which looked at four programs by Médecins Sans Frontières, an organisation that provide mental health services during emergencies, found that mental health care services should be part of the standard response to humanitarian emergencies.
An international group of organisations representing people who are living with psychosocial disabilities who includes “users and ex-users of psychiatry, victims-survivors of psychiatric violence, mad people, voice-hearers, and people with psychosocial diversity” says people with mental illness may be at increased risk of contracting COVID-19. The group made of organisations such as the Pan African Network of Persons with Psychosocial Disabilities, Redesfera Latinoamericana de la Diversidad Psicosocial - LOcura Latina, Transforming communities for Inclusion of persons with psychosocial disabilities- Asia Pacific and European Network of (Ex-) Users among others, say people with mental illness could be at risk as a result of:
● Living in social care institutions, shelters, psychiatric wards, correctional facilities and other settings that deprive them of their will to exercise social distance.
● The conditions in such environments usually increase risks of infections because of overcrowding, sharing amenities and being ill-equipped.
● Inability to access relevant health information in languages they can understand.
● Socio-economic challenges that preventing them from in following recommended preventative hygiene measures where they live.
● “Mistreatment and abuse”.
● Inadequate social support and inclusive communities.
● The systemic discrimination against people with mental illness.
People with psychosocial and intellectual disabilities must be empowered to participate at all levels of their lives, so sharing important information on COVID-19 on a regular basis will reduce mental anxiety according to the World Health Organisation. In a media statement on 27 March 2020 the Deputy Minister of Social Development, Hendrietta Bogopane-Zulu, acknowledged that persons with disabilities are among those who are particularly vulnerable to the negative impact of COVID-19.
Ms Bogopane-Zulu stressed that during this period of national disaster and lockdown, people with disabilities should not be left behind. The Deputy Minister called for measures to ensure that persons with disabilities and their families continue to receive services during the lockdown, through residential facilities, including centre and community-based respite facilities, which will remain operational as they form part of the essential services.
Coldiron, M.E., Llosa, A.E., Roederer, T. et al (2013). Brief mental health interventions in conflict and emergency settings: an overview of four Médecins Sans Frontières – France programs. Accessed at https://conflictandhealth.biomedcentral.com/articles/10.1186/1752-1505-7-23#citeas
Pan African Network of Persons with Psychosocial Disabilities, Redesfera Latinoamericana de la Diversidad Psicosocial, Transforming communities for Inclusion of persons with psychosocial disabilities, Asia Pacific. et al (2020). COVID-19 and persons with psychosocial disabilities
Social Development (2020). Deputy Minister Hendrietta Bogopane-Zulu on measures and services available to persons with disabilities during Coronavirus COVID-19 lockdown. Accessed at https://www.gov.za/speeches/deputy-minister-bogopane-zulu-measures-and-services-available-persons-disabilities-during
The Daily Maverick (2020).Covid-19: Giving meaning to ‘social solidarity’ through mental health support. Accessed at https://www.dailymaverick.co.za/article/2020-03-26-covid-19-giving-meaning-to-social-solidarity-through-mental-health-support
The Presidency (2020). Message by President Cyril Ramaphosa on COVID-19 pandemic. Accessed at http://www.thepresidency.gov.za/speeches/message-president-cyril-ramaphosa-covid-19-pandemic
World Health Organisation (2020). Mental health and psychosocial considerations during COVID-19 outbreak.Retrieved from https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
(Project Leader – Info & Awareness, SAFMH)
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