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If the looming shadow pandemic of mental health problems is not addressed timeously, the country will have very few human resources left to rebuild after the pandemic, according to experts.
Isolation, the prohibition on visiting loved ones, and uncertainty around the economy and job security are all factors which have contributed to stress, depression and anxiety among South Africans since the lockdown.
According to research by the South African Depression and Anxiety Group, the main mental challenges experienced during the lockdown included anxiety and panic, financial stress and pressure, depression, poor family relations, suicidal thoughts, and substance abuse. But the lockdown has also worsened other mental issues and re-awakened previous traumas, says psychologist and director of Centre for the Study of Violence and Reconciliation (CSVR) Nomfundo Mogapi.
“We find that, according to South Africans who struggled with mental health issues before lockdown, it has made them feel worse. Others had previous traumas. Some of them say the presence of police in townships reminded them of previous traumas. Anxiety issues have increased a lot, fueled by the uncertainty of the future and what is going to happen about this unknown enemy,” she says.
Depression and sad feelings due to loss were also common among those who have lost their jobs and loved ones due to the pandemic.
But it is not only ordinary citizens feeling psychological pressures during this time, as government leaders and healthcare workers feel the pressure of having to make “moral decisions” when it comes to treating their patients.
Leigh-Anne Snyman, a nurse in the Doctors Without Borders team in Khayelitsha, found her role shifting when working with the Khayelitsha and Cape Town health facilities, when she realised that staff needed mental health support. What healthcare workers required was to feel prepared, protected and supported, she said.
“My role was to ensure everything that related to staff safety, preparedness, and support was displayed, forums to allow staff to voice their concerns were implemented, and there was a psychologist that staff could call for confidential counselling and support, if needed.”
But there were also mental health issues at leadership levels in healthcare sectors and private companies as they could experience high levels of burnout due to sudden changes in their organisations, Mogapi explained.
Graphic: Costa Mokola
“They find themselves conflicted on having to make hard moral decisions, like who gets ventilators and who doesn’t, other leaders on who lose their jobs or have to be to retrenched. High moral decisions have to be made and they lead to burnout and lead to moral injuries. We can see the coronavirus has attacked our mental health in various ways.”
The pandemic has also placed additional stress and anxiety on victims of gender-based violence, said Yolanda Hanning, a psychologist working at MSF’s Sexual Violence Project in Rustenburg.
She said they experienced common health issues such as acute stress disorders, mood disorders such as depression and bipolar disorder, panic disorders, like anxiety and phobias, post-traumatic stress disorder, psychosis, and sleep disorders.
“The trauma of being a victim in and of itself has a severe impact on the mental health of the patients over both the short term and the long term.”
It is, however, the increased stress that contributed to violence and emotional abuse, Mogapi added.
“Even the people that are usually amicable could end up perpetuating violence because of the increased stress. What we find is an increase of emotional abuse. Women have said when these men went to work or to the bar to drink, it gave them an opportunity to design an escape plan or consult friends, but now they can’t escape or pick up the phone to call. Covid-19 has taken off the psychological skin that protects us from stress,” she said.
“Government has brought all sorts of responses, which have been focusing a lot on health and the economy. But mental health is becoming a looming crisis, if not another shadow pandemic. If we don’t address it, we will wake up and realise we don’t have any human force to rebuild our society post the Covid-19 pandemic,” said Mogapi.
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