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Mental Health Matters Journal for Psychiatrists & GP's

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Literacy is a luxury that many of us take for granted.  We depend on written communication for information, guidance, and access to heath care information That is why SADAG created SPEAKING BOOKS and revolutionized the way information is delivered to low literacy communities. It's exactly what it sounds like.a book that talks to the reader in his or her local  language, delivering critical information in an interactive, and educational way.

The customizable 16-page book, accompanied by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood..

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 30 titles, such as TB, Malaria, Polio, Vaccines for over 30 countries.

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Two well-known psychiatrists – Dr. Charl Els from Bloemfontein, and Professor Mkhize from Umtata – have recently launched their own support groups in their respective areas. We interviewed them to find why they decided to initiate these groups, and to see how the groups are progressing.

Professor Mkhize (Head of Department of Psychiatry, University of Transkei)

Q: What prompted you to initiate a support group in Umtata?

A: I started a support group in my area for two main reasons. Firstly, I see a lot of depression and anxiety in my practice and we just don’t have enough manpower to deal with the demand. Secondly, I believe it is essential that we make people aware of the symptoms and information surrounding the disorder.

Q: Tell us a bit about your support group.

A: I work with a core of psychiatric nurses who are very enthusiastic about the project. We opened our first Umtata group fairly recently. For the occasion, Therry Nhlapo (Outreach Co-ordinator for the Depression and Anxiety Support Group) and Dr. Fred de Beer (Advisory Board Member for the group) traveled down to Umtata. Therry spoke at the public meeting and both she and Dr. de Beer addressed the doctors’ meeting.

Q: How many people did the meetings attract?

A: The turnout was good – we had 48 people at the public meeting and 30 doctors and 10 psychiatric nurses at the doctors’ meeting.

Q: How do these kind of support groups empower the sufferer?

A: By knowing and understanding your disorder you are halfway along the road to recovery – I attach a lot of importance to psycho-education. Once the sufferers are in the group, they also learn to take responsibility for their own recovery. Furthermore, support groups can result in early diagnosis of disorders.

Q: What have you learnt from dealing with anxiety and depression sufferers in a more intimate group setting?

A: It has reinforced the fact that my patients and the community need to acquire tremendous knowledge concerning these disorders. For a long time depression has been thought not to exist in and around Africans.

Q: Why do you think this is?

A: I believe that African depression/anxiety sufferers go to their doctors complaining of psychosomatic problems and the GPs are too busy to explore the symptoms further. GPs need to listen to their patients carefully and be made more aware of the disorders. The Depression and Anxiety Support Group is tackling this area very effectively with their doctors talks.

Q: What are the future goals for your support group?

A: Once our central Umtata group is running smoothly, we intend opening up groups in the smaller surrounding towns such as Mt. Frere, Butterworth and Tsolo. I believe it is important that we continue educating our community and supplying the mentally ill with regular support.

Dr. Charl Els (Advisory Board Member of the Depression and Anxiety Support Group)

Q: What prompted you to get involved in a support group in Bloemfontein?

A: Traditionally there has been a stigma attached to psychiatry which meant that patients who could really benefit from treatment were reluctant to contact a psychiatrist. By being part of a support group, needy patients are bought into contact with those that can help them. This programme is available to anyone and not just those that can afford first world care and, thus, I feel I am giving something back to the community. I also believe that I am getting Bloemfontein in line with happenings on a national level.

Q: Tell us a bit more about your group.

A: The support group is open to both anxiety and depression sufferers. We are currently meeting once a week and have a committed core of about 30 people.

Q: What enlightenment’s have you had from working with the patients in a group setting?

A: With a gentle nudge in the right direction, patients are willing to take responsibility not only for their own treatment, but also for those around them. It is so rewarding seeing people with their own problems willing to put them aside to assist those who are less fortunate. For a sufferer, realising that they are not alone in this and that there are other people who have been through it and gotten better makes a real difference. The group also encourages the involvement of families and friends which further builds a very strong support system for the patients. My involvement has proved greatly satisfying personally.

Q: How does psycho-education empower the sufferer?

A: There is a distinct lack of knowledge readily available to the general public, and what is available is not always easily accessible. The Depression and Anxiety Support Group plays a valuable role in supplying the public with information on conditions, medication and additional therapies. Insight and knowledge about a disorder gives the sufferer power over it, and constitutes the first important step in the healing process.

Q: What is your personal perspective on dealing with a group?

A: For the maximum benefit patients should be exposed to all available additional therapies (e.g.: coping techniques, CBT, alternative medications). Holistic approaches in treatment can prove to be very effective. The support group provides a neutral forum for these issues to be discussed, questions to be answered and fears to be allayed.

Q: Do you have a future vision for your support group?

A: At the moment, Bloemfontein remains under serviced in terms of mental health care and support. My personal aim is that this support group will grow up to the point where it is able to fulfil the deep need that exists in our area concerning anxiety and depressive disorders.

The Chairman of the Advisory Board for the Depression and Anxiety Support Group, Prof. Michael Berk said that Depression and Anxiety remain poorly recognised and treated illnesses. It is now well established that they have a neurochemical core as highly responsive to appropriate therapy. Nevertheless, poor recognition and treatment and high prevalence rates ensure that they are a frequent and serious cause of morbidity and disability in the population. In developed countries, the WHO ranks depression as the single largest cause of disability, and predicts that by 2020, depression will have a similar impact in developing countries.

The role of the Depression and Anxiety Support Group is to educate professionals and the public about the illnesses, to de-stigmatise them, to increase awareness about anxiety and depression and to lobby government and medical insurers for equitable treatment of patients with mental illnesses. Projects like those initiated by Prof. Mkhize and Dr. Els should be applauded by the whole community. They are performing an invaluable service to mental health.


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