In the current situation of South African Mental Health, there is a great need to increase the general awareness of depression and potential suicide. It appears that General Practitioners (GP’s), in rural areas would like to be further educated about the devastating consequences of untreated depression. Like most countries in the world, many of our GP’s only have a limited amount of lectures on depression and suicide whilst they are in medical training, and are thus often ill-equipped to handle or identify cases such as these in their practices.
One South African advocacy group that has chosen to take the initiative in this field, however, is the well-integrated Depression and Anxiety support Group. In response to the increasing numbers of suicides amongst the SA population, particularly in teens and young adults, the Support Group launched a Depression and Suicide Prevention Programme (DSPP) in February of this year. The Global Alliance of Mental Illness Advocacy Network (GAMIAN) developed the program for use by support groups and healthcare professionals throughout the world. South Africa is the first country outside the USA to implement the programme.
The DSPP has several goals. These include raising awareness of the causes and indicating appropriate treatment for depression, educating mental health professionals and general practitioners about depression and suicide, improving recognition, diagnosis and treatment for suicidal patients, improving the understanding of the adequate length of time to take medication and receive therapy, therefore ultimately reducing the number of suicides and suicide attempt in South Africa.
The Depression and Anxiety Support Group is lucky enough to enjoy tremendous support from most of South Africa’s practising psychiatrists – of which there are only 250 in the entire country. Many distinguished and prominent psychiatrists have presented suicide prevention programmes on the Support Group’s behalf. However, the accompanying workbooks are so well planned and concise that even novice speakers are able to present effective education campaigns or workshops on the subjects.
To date, the Support Group has completed over 28 of these DSPP programmes and the results are very encouraging. The turn out of doctors varies from a low of 12 to a high of over 50. The Support Group has subsequently expanded the programme to include other mental health professionals at the same meetings. Gynaecologists (who may be exposed to post-natal depression in their patients), psychologists and psychiatric nurses have all been included in the audience.
The programmes have yielded interesting qualitative findings regarding the disparity of knowledge about depression amongst mental health professionals. In general, GP’s in urban areas attend meetings more frequently and are fairly well informed about the latest developments. On the other hand, GP’s in rural areas appear to have fewer opportunities to learn about depression and suicide, and have found the DSPP programme to be particularly useful. Common questions asked by the audience have been how one goes about certifying (institutionalising) suicidal patients, which medications are the most effective, the success of therapy and medication combined, facts about post-partum depression, and the relative safety of medication in pregnant women.
Schools have also been targeted as part of The Suicide Prevention Programme. The youth of today have to deal with numerous pressures in an increasingly demanding and competitive society. The threat of suicidality in teens and young adults is being combated through talks and educational campaigns country-wide. Schools interested in this project should contact the telephone numbers below.
There is high praise for the DSPP from knowledgeable professionals, Dr. Franco Colin, a prominent Pretoria psychiatrist, believes that awareness and education are imperative to reduce or control the increasing rate of suicide in South Africa. “Early recognition of mental disorders in general is vital to detecting signs of suicidal behaviour. Educating professionals and the public to behaviour indicative of suicide is necessary to alleviate the problem and reach out to those who are suffering”.
Kirsten Chalmers, the South African co-ordinator for The Suicide Prevention Programme, believes that the programme has made a significant impact throughout South Africa: “Around the country the programme has been received with great enthusiasm and we have had numerous requests to come back and talk more on depression and suicide, as doctors felt this was a topic not discussed openly enough.”
Overall the DSPP programme has been very well received by many different parties. The psychiatrists who presented it feel honoured to be associated with a programme of such high quality and extensive content. The doctors believe it to be truly valuable and have requested similar programmes to be presented, whilst sponsors such as Eli Lilly, Pfizer, Roche, Smith-Kline Beecham, Solvay Pharmaceuticals, Synthelabo and Zoloft have been very supportive and have agreed to fund more such initiatives. The programme requires minimum work for an amazingly successful pay off.