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Saturday, January 19 2019 @ 04:56 pm UTC

'Eden has highest suicide rate in SA'


A former health worker at a clinic in George, Juanita Nel, has walked her own difficult road with major depression and is now motivating others in her position to get help.

GARDEN ROUTE NEWS - Juanita Nel suffered from the "blues" during her years at college.

She started hearing voices after the birth of her first baby, and it was dismissed as postnatal stress. She became delusional after her second child and only then received the help she desperately needed.

Nel, as with many other patients, had a difficult time explaining to her family how she felt. She was ultimately diagnosed with major depression.

Through the support of her family, community and professional help, Nel is now able to enjoy life. A former health worker at Conville Clinic in George, Nel does motivational speaking at the clinic with the hope of motivating others to seek help.

“I am not ashamed to admit that I have a mental illness. Neither should anyone else,” she said.

Read More >>> July is annually acknowledged as Mental Illness Awareness Month, now referred to as Psychosocial Disability Awareness Month.

The Western Cape health department has identified mental health as one of its priority programmes and is working towards improving access to mental health services by integrating mental healthcare with general healthcare.

Start at primary level
The Eden District acknowledges that access to mental healthcare should start at a primary healthcare level and has therefore implemented projects to train generalist health providers to deliver mental health services.

According to the Diagnostic and Statistical Manual of Mental Disorders, edited by American Psychiatric Association, a mental illness or a mental disorder is a major disturbance in an individual’s thinking, feelings and behaviour that causes distress and a reduced ability to function as expected.

“Such a major disturbance reflects that the brain or parts of the brain is no longer working well or working in the wrong way,” explained Dr Lynnie Boon, head of psychiatry at George hospital.

The World Health Organisation (WHO) defines mental health as a state of wellbeing in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

According to Eden and Central Karoo districts health spokesperson Nadia Ferreira, the following statistics apply to the Eden District:

Mental health in Eden

• Highest suicide rate in South Africa.

• Highest rate of incidents of driving under the influence and the second highest rate of drug-related crimes in the Western Cape.

• In the Western Cape, 1 in 3 people suffer from a common mental disorder during their lifetime. The most frequent disorders include anxiety, depression and substance abuse. These are also the top three mental disorders seen in the Eden District outpatient services.

• Common mental disorders (depression and anxiety) frequently occur together with other chronic diseases. “Recent research showed that as many as 50% patients with diabetes, hypertension or HIV in Eden may have comorbid depression.

The possible reasons for the high suicide rate in Eden, says Ferreira, can be inferred from available data as follows:

• High prevalence of depression and substance abuse. This is influenced by Eden having significant rates of risk factors that increase the risk for mental illness, eg. poverty, unemployment, inadequate education, violence against women.

• Low levels of treatment. This could be ascribed to low levels of mental health literacy/awareness and high levels of stigma.

• Suicide is often the unfortunate outcome of an underlying mental illness.

Seek help
In South Africa, only 25% of people with any mental disorder receive treatment. This is due to people not seeking help, disorders not being adequately identified and limited available resources to deal with the need.

Psychotic disorders such as schizophrenia and bipolar disorder occur in 1% of the population. Psychosis is a set of symptoms that make it very hard or impossible for a person to know what is real, to think and communicate clearly and relate with others, and to feel normal emotions. Although psychosis is rare, it is a severe condition and the top reason for inpatient admissions.

Available services

• Clinics and district hospital outpatient departments: screening, assessment, diagnosis, medication, counselling and psychotherapy.

• District hospitals: inpatient admission for uncomplicated, but more severe disorders.

• Specialists (mental health nurses, psychiatrists and psychologists) visit clinics and district hospitals on a regular basis to consult complex cases and support primary health practitioners.

• George hospital psychiatric unit (GPU): the 10-bed inpatient unit receives referrals from district hospitals of patients who have been certified under the Mental Health Care Act of 2002 or have complex mental illness. It is an acute-admission unit offering inpatient care for limited periods. Transfers can be accepted within a week from referral.

• Specialist outpatient clinics: consult and manage complex cases.

• Nelspoort psychiatric unit, situated 60km outside Beaufort West. Ten beds are available for medium-term (three to six months) care. Waiting list for admission is four to 12 weeks, and referrals are only accepted from other specialist services.

• Tertiary psychiatric hospitals: only about 20% to 30% of cases need to be managed specifically by specialists or in psychiatric hospitals.

•Valkenberg hospital: accepts referrals from GPU for adults requiring a longer period of inpatient care. Transfers are accepted within a week of referral.

• Stikland hospital: accepts referrals from GPU for elderly patients requiring a longer period of inpatient care. Waiting list for admission is long and transfers can often only be accepted within three to four weeks.

• Tygerberg hospital: accepts referrals from GPU for adolescents requiring a longer period of inpatient care. Waiting list for admission is long and transfers can often only be accepted within three to four weeks.

• Super-specialist programmes, eg. for children, eating disorders or forensic problems, have long waiting lists of three to six months, but provide telephonic support readily to general specialists to assist in managing patients during the waiting period.

Where to go

• If there is a suspicion of a possible mental illness, the person, family or friend should report his or her concerns to a nurse or general medical doctor at their nearest clinic.

• If a person behaves in a manner that could harm themselves or someone else and there is a suspicion that the behaviour may be caused by a mental illness, the family or friend of the person should report this to the emergency unit at their nearest hospital.

• A person who experiences mental health problems due to alcohol or drug use/abuse, should first seek assistance from a local social worker (available at the Department of Social Development or an organisation like the SA National Council on Alcoholism and Drug Dependence (Sanca). Should detoxification be required, the social worker will refer the individual to a local clinic or hospital.

Specialists can see referrals from primary healthcare practitioners (nurse or general medical doctor) within hours or maximum four weeks, depending on the urgency of the matter. Telephonic specialist support for primary healthcare practitioners is available 24 hours daily.
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