What mental health patients should do during lockdown

The South African Society of Psychiatrists (SASOP), which represents the psychiatric profession, has recently urged mental healthcare communities to be aware of early relapse signs.

They encourage patients to continue with prescribed medication and to keep therapy appointments.

According to SASOP, stress, anxiety and a sense of isolation amid the global Covid-19 pandemic and South Africa’s current lockdown can add to psychological distress for those already struggling with mental health disorders.

SASOP assured patients that public and private health sector mental health services remain open for both scheduled appointments and emergencies.

“Where possible some practitioners have shifted to online consultations,” said Prof Renata Schoeman, board member of the Psychiatry Management Group (PsychMG).

“Mental well-being is vital in this time of crisis, whether or not one is suffering from a mental illness,” said Schoeman.

“Lockdown can aggravate feelings of isolation, even more so for those already struggling with mental health issues. Now is the time to re-focus one’s energy on improving your mental health and resilience.”

The professor said it is crucial to stay socially connected while practising physical distancing.

“People can stay informed via credible sources of information, and to keep to generally healthy habits.

“A strong individual and communal mental health status are key to remaining physically strong and socially cohesive during this crisis,” she said.

For those with mental health conditions, she said, it was vital to remain well and stable by keeping up with treatment.

Read: Mental health care is vital during lockdown

“Avoid the need for hospitalisation when healthcare resources are already stretched by the impact of Covid-19. Remember, medications such as mood stabilisers and antipsychotics cannot easily be continued should they require admission to ICU and especially should they require ventilation,” she said.

Dr Kagisho Maaroganye, SASOP board member and public sector national convener, said as an essential service, mental healthcare providers including psychiatrists, psychologists, mental health nurses and occupational therapists are on duty.

Pharmacies, depots and suppliers are also open to ensure continued availability of medication.

“Hospitals and clinics will be available throughout this period to assist mental healthcare users in case they have an emergency or crisis during the lockdown and beyond.

“Both private and public hospitals along with clinics are taking well-considered, best practice measures to ensure that mental healthcare is delivered in the safest possible way during this public health crisis,” said Maaroganye.

Some practitioners have switched to telehealth as a contingency plan during lockdown, offering remote consultations via telephone or online platforms such as Zoom.

This is in line with guidelines issued by the Health Professions Council of South Africa, according to SASOP.

“Tele- or video-consulting is a means of delivering high-quality treatment to vulnerable patients while protecting both them and clinicians from unnecessary risk of exposure to the virus,” said Schoeman.

Mental healthcare users should be aware of early relapse signs like lack of sleep or irritability.

SASOP advised patients to get advice by phone from doctors or clinic nurses on what steps to take to manage their vulnerability and fears around the risks of Covid-19 and isolation.

Maaroganye said, “Avoid self-medicating or trying to heal yourselves with alcohol, illicit drugs or taking your medication in a manner not advised by your psychiatrists or general practitioners.

“It is important that we can manage any potential relapse early on, to avoid hospitalisation.”

The doctor said the public at large may also experience emergencies or crises due to steadily increasing mental distress or illness and they can contact community healthcare workers, social workers and doctors, nurses or psychologists at clinics for assistance.

SASOP urges the public to remain both physically and mentally healthy by exercising at home, eating healthy foods, including fresh fruit and vegetables as far as possible, getting enough sleep, and avoiding alcohol abuse and illicit substances.

“SASOP members are available to offer support to mental healthcare users and their families who may be feeling overwhelmed during this time.”

“At the same time, we will continue to offer our members our total support so that they can feel enabled to continue delivering the high quality of psychiatric management to mental health care users that they have been for many years,” said Maaroganye.

SASOP advised all South Africans to use the communication means they have available to stay connected with families and loved ones and to be aware of those in the community who may be more vulnerable in isolation, such as single parents, the elderly and those with mental health disorders.

Maaroganye said staying informed is important by accessing credible information sources, such as government’s SA coronavirus website and the World Health Organisation.

“Also do not look for constant updates but rather twice a day to avoid feeling overwhelmed and heightening anxiety,” Maaroganye said.

Schoeman added, “Although this challenge is enormous, it is important to have faith and hope that you and the country will overcome Covid-19. Being without hope can add extra burden on one’s mental health to a point that one’s mental condition can relapse or worsen.”

Where to get help and information:

• SA Depression Anxiety Group (Sadag): 0800 21 22 23 or 0800 70 80 90
• Sadag WhatsApp support (9am-4 pm): 076 882 2775 or SMS 31393 or 32312 (counsellor will call back)
• Lifeline South Africa: 0861 322 322
• Department of Health: 060 012 3456 (WhatsApp “hi” for access to comprehensive Covid-19 information)
• National Institute for Communicable Diseases toll-free Covid-19 hotline: 0800 0299 299
• Visit www.sacoronavirus.co.za

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