.#Mental Health Matters
In June this year, the World Health Organization (WHO) hosted a virtual launch of its most recent and comprehensive world mental health report to date, titled: Transforming Mental Health for All. What is striking from the report are similarities globally in mental health trends.
The report noted that mental health presentations have escalated since the onset of the COVID-19 pandemic, and that psychosocial and psychological concerns have become more serious. The most common global mental health presentations, depression, and anxiety were even more pronounced during the COVID-19 pandemic and continue to be so. The pandemic has also brought into sharp focus, the linkages between socio-economic contexts and mental health. In South Africa, these contexts are highly gendered and racialised.
In his introduction to a WHO report, the Director-General of the organization Dr Tedros Ghebreyesus, stated: ‘…we need to transform our attitudes, actions and approaches to promote and protect mental health, and to provide and care for those in need (WHO, 2022, p.v.).’
As we think about mental health during this mental health awareness month, questions around transformation in relation to mental health offer critical points of engagement. Perhaps an apt starting point is the recognition that mental health is a human right. A rights-based approach locates mental health, as a state of well-being of the psychological, emotional, spiritual, and social, within citizenship. A rights-based approach requires that we consider the contexts and conditions that promote mental health and those that increase the risk of mental illness and vulnerability, and that discriminate and marginalise. What individual, personal factors and external socio-economic, political, and historical conditions would promote such a state of mental wellbeing?
In his book, Madness, and Civilization (1961), Foucault argues that the concept of “madness” is a social and cultural construction which determines how “madness” is known and experienced within a given society. Definitions of “madness”, “mental illness” and “mental health” have evolved over the years from a biomedical model definition of individual disease to ones that recognise the complex social, economic, political, and historical intersections embodied in a state of individual wellbeing. Definitions of mental wellbeing and health are increasingly noting the linkages between individual wellbeing and collective wellbeing. Fanon (1961) provides a powerful account of the relationships between social and cultural conditions and mental illness in which systems of oppression (coloniality) are central to the experiences of suffering.
How might we engage with contemporary notions and experiences of mental health and mental illness against this historical and political backdrop, specifically in our South African context?
In considering this question, I draw upon my work as a mental health practitioner with students in our University context. However, the issues that are raised are not specific to students only, but to society in general. Over the past two years, students have been presented with a range of psychosocial and psychological issues. Similar to the WHO report, we have noted an increase in presentations that were related to anxiety, depression, grief, bereavement, and interpersonal relationships. Many students reported feeling overwhelmed and not being able to cope as well as having frequent thoughts of suicide. Indeed, we have witnessed the tragic passing of some students in the past year alone.
When exploring options and support systems, students revealed several barriers to mental wellbeing, including material and structural conditions, access to resources, and inadequate support systems. The marked socioeconomic disparities that characterised the apartheid era and that continue into the current democracy have significant effects on mental health due to the continued hardships that students face.
Marginalised individuals have an increased risk of suffering mental health issues due to experiences of discrimination. Students who recognise that they might benefit from support are sometimes discouraged to disclose this or to access support due to the ongoing stigma around mental illness which is often associated with weakness or a form of escapism, or it is ignored or trivialised.
What changes can we initiate in our spaces to dismantle the stigma around mental illness? What can be done to offer more consistent forms of support? How do we build psychological resilience and strengthen preventative measures?
If we go back to the point of mental health as a human-rights issue, then it becomes clear that dismantling stigma will require ongoing and robust engagement and awareness of mental health and mental illness. Mental health cannot be separated from conversations about social justice and citizenship. More integrated approaches to mental wellbeing, including the strengthening of community-based partnerships, as well as the inclusion of a range of Western-based and African-centred support systems, are essential. However, the starting point is with each one of us.
What are our thoughts about mental health and mental illness? What are our responses to those who may be mentally unwell? What language do we use when we talk about mental health and about persons who might be mentally unwell? Are we aware of our own sense of wellbeing?
Note: UKZN offers free and confidential personal counselling to students on the toll-free line 0800 800 017 during business hours. Students are also encouraged to consult the College Student Support Services webpages which contain more information. The ICAS toll free number is 0800 254 255.
Dr Angeline Stephens is the Manager of Student Support Services in the College of Humanities. She is also an executive member of the Sexuality and Gender division of the Psychological Society of South Africa (PsySSA). Her work is informed by feminist, critical and decolonial approaches to psychological praxis, especially in relation to the intersections of gender, sexuality, violence, and work with marginalised people.
*The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of KwaZulu-Natal.