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“The objective of Men’s Health Month is to heighten awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. This month allows healthcare providers, public policymakers, the media, and individuals to encourage men and boys to seek regular medical advice and prompt treatment for disease and injury. The response has been overwhelming with thousands of awareness activities around the globe.”
I want to preface this article with a story. This is not a story of triumph or even a love story. This story starts with a young boy. Not much after his 10th birthday in fact. He met a wise man who used to be a very powerful warrior. He used to regale the children of his village with heroic stories of battle and facing many monsters that he encountered along the way. All the other children wanted to be like this great man, except this boy. The man was intrigued by this boy as he never marveled at the battles with the sea monsters or the trolls in the mountain but rather he showed interest in why the man chose to face these challenges. One day the boy saw the aged warrior sitting under a tree overlooking the valley. Cautiously the boy approached him, “Sir, do you mind if I join you?” He asked. “Certainly my boy!” He replied enthusiastically, as if his loneliness spoke on his behalf. The boy sat down in silence next to the retired warrior.
After a short while the man asks “Do you want to hear some of my stories? The great battles? The powerful monsters?”. “Yes sir, but I don’t want to hear the stories you tell the other children in the village.” Responded the boy while picking little blades of grass. “No? Which stories do you want to hear?” The man asked surprisingly. “I want to hear the story of why you went on these adventures. Why do you never tell us about the failures or the friends you had? I know all of the stories of what you had done but you never told us what scared you or anything other than what you think we want to see when we think of you.” the boy said in a very kind manner. The old warrior was silent, clearly taken aback by this. “What do you mean boy? My stories are the ones that will carry my name into history and songs, like all the warriors before me. That is the way of the great warriors.” He retorted almost gleefully.
“That is the thing that I do not understand sir, you want to be remembered for all your great deeds and heroic labours to inspire others to be like you, but you don’t want others to know who you were as a person.” The boy countered. “Who I am does not matter as much as what I accomplished to those who seek to be like me, little boy, the person I am may just break down the legacy I am meant to leave behind.” The old man says honestly. “Oh, can I ask you a question? To you, not to the warrior you are meant to be.” The boy says while taking the time away from his meticulous grass picking. The old man nodded. “What is the hardest thing you have ever done?” The boy asked. “Admitting to my fellow warriors that I am scared of facing the monster that we are sent to slay.” The old man said. “What scares you the most?” The boy asked while moving closer to the old man. As a tear ran down his war battered cheek the old man said: “Asking for help”…
The purpose of this story is not to take away from those who seem to have conquered all but rather to share the idea of how society has influenced the stigma of men’s mental health. You never know what those around you may be going through. From the automated responses of “Im fine” to the isolated patterns of emotional acting. The newest war that the world is facing is the mental health war. Traditional masculinity which is supposedly influenced by the Stoic philosophy has created a battlefield the requires the hiding of wounds in fear of appearing weak. The reluctance to seek help, the fear of societal judgement and rejection has resulted in men falling into the abyss of addiction and suicidality.
Treatment of physical illness or injury is not frowned upon as to live a key requirement is to have a healthy body. When it comes to mental illness, so many of today’s men are bound by the painfully heavy bonds of masculinity. Emotions are for the weak. Everyone has issues and this is my burden to carry. Those who love me would rather see me die on the battlefield than see me fall off my horse. If Stoicism has taught us anything, reality needs to be accepted for what it is, not what we wish it to be. Acceptance is not approval but rather acknowledgement of fact.
Ask your male friends how they are doing. Check in on them and be honest with them how you are doing. Don’t fear not being fine. The actions, attitudes and thoughts you hang on to can be of value to you and others or they can be the whip that inflicts pain onto you.
Sometimes the bravest thing anyone can do is ask for help.
Mental Health Help Resources
https://www.groundup.org.za/article/how-accesspublic-mental-health-services
https://www.globalcitizen.org/en/content/ways-southafricans-take-care-of-mental-health/J
Start or join a support group / support group: www.sadag.org.
Men’s Health Month in June focuses on raising awareness about the health challenges confronting men and advocating for early detection and treatment of diseases. In South Africa, this initiative holds significant relevance due to the distinctive health issues men encounter. These include high rates of HIV/AIDS, tuberculosis (TB), and the escalating burden of non-communicable diseases (NCDs) like hypertension and diabetes, making men’s health a pressing public health concern demanding urgent attention (van Heerden et al., 2017).
A foremost concern in South Africa is the heightened prevalence of HIV/AIDS among men. Men exhibit lower rates of HIV testing and tend to seek healthcare only at advanced disease stages (Sileo et al., 2018). This delay not only compromises their health outcomes but also elevates the risk of transmission to others, necessitating concerted efforts to promote regular HIV testing and early treatment.
Mental health emerges as another critical area necessitating attention. South African men often grapple with societal expectations to suppress emotions and avoid discussing mental health issues, potentially leading to adverse outcomes such as elevated suicide rates (Rammopo, 2021). Moreover, suppressed emotions may serve as a risk factor for functional neurological disorder, predisposing men to various physical health complications, including hypertension, diabetes, cerebrovascular accidents, and seizures. Facilitating open dialogues about mental health and ensuring accessibility to mental health services are crucial steps in addressing this issue effectively.
Additionally, substance abuse, particularly alcohol consumption, represents a significant concern among South African men (Lawana & Booysen, 2018; Mohale & Mokwena, 2020). This behaviour is associated with diverse health ramifications, including liver disease, cardiovascular complications, cerebrovascular disease, diabetes, and hypertension (Parry et al., 2011), and heightened risks of accidents and violence. Hence, public health campaigns aimed at curtailing alcohol consumption and advocating healthier lifestyles play a pivotal role in mitigating this issue.
Addressing lifestyle factors such as poor dietary habits, sedentary lifestyles, and smoking is also crucial in mitigating men’s health conditions in South Africa and globally. Encouraging regular health check-ups, promoting healthier dietary practices, and advocating for increased physical activity can play a significant role in alleviating the burden of NCDs among men.
Men’s Health Month serves as a poignant reminder of the imperative to address the unique health challenges confronting men in South Africa. Through concerted efforts encompassing awareness-raising, early detection and treatment initiatives, and promotion of healthy behaviours, tangible strides can be made toward enhancing health outcomes and reducing the burden of preventable diseases among men.
Reference List
Lawana, N., & Booysen, F. (2018). Decomposing socioeconomic inequalities in alcohol use by men living in South African urban informal settlements. BMC Public Health, 18, 1-9.
Mohale, D., & Mokwena, K. E. (2020). Substance use amongst high school learners in the south of Johannesburg: Is this the new norm?. South African Family Practice, 62(4), , e1–e6. https://doi.org/10.4102/safp.v62i1.5122
Parry, C. D., Patra, J., & Rehm, J. (2011). Alcohol consumption and non‐communicable diseases: epidemiology and policy implications. Addiction, 106(10), 1718-1724.
Rammopo, O. (2021). Constructions of Depression from Black Men Residing in Mabopane [Master’s thesis, University of Johannesburg]. UJ Content. https://hdl.handle.net/10210/501592
Sileo, K. M., Fielding-Miller, R., Dworkin, S. L., & Fleming, P. J. (2018). What role do masculine norms play in men’s HIV testing in sub-Saharan Africa?: a scoping review. AIDS and Behavior, 22, 2468-2479. https://doi.org/10.1007/s10461-018-2160-z
van Heerden, A., Barnabas, R. V., Norris, S. A., Micklesfield, L. K., van Rooyen, H., & Celum, C. (2017). High prevalence of HIV and non‐communicable disease (NCD) risk factors in rural KwaZulu‐Natal, South Africa. African Journal of Reproduction and Gynaecological Endoscopy, 20(2), e25012. https://doi.org/10.1002/jia2.25012.
The South African National Integrated Men’s Health Strategy 2020-2025 (the Strategy) is a framework for action to work towards the goal that Every South African man and boy is supported to live a long and healthy life. South African men generally have poor healthseeking behaviours and are less likely than women to engage health services across the care cascade, resulting in adverse clinical outcomes for many preventable illnesses. In addition, the health system misses key opportunities to engage with men who do seek services by not offering comprehensive and integrated services to those men who access services for specific conditions.
The Strategy aims to deliver a comprehensive and integrated package of care for men and boys across the life course. The overarching aim of the Strategy is to improve the overall health and wellbeing of South African men and boys. At the heart of the Strategy are four core objectives and associated actions that are designed to drive meaningful progress towards the Strategy’s overarching goal. These include a clear commitment to:
The Strategy advocates for a life-course approach in tailoring interventions to engage and support South Africa’s diverse men and boys across all stages of their lives, with a focus on adolescents (10-19 years); young adults (20-35 years); older men (above the ages of 35); and aging men (above the age of 50) as well as high risk men and boys.
Health is influenced by a complex range of factors, or health determinants. Targeted actions are identified to meet the Strategy’s goal and objectives – actions that require the engagement and collaboration of a wide range of stakeholders from across South Africa. They include all levels of government, the health sector, other sectors, with non-government organisations (NGOs), community-based organisations (CBOs) and faith-based organisations (FBOs), researchers and experts, and, of course, with men and boys themselves.
Critical to the success of this Strategy is a clear commitment to implementation planning and to taking an active approach to evaluating, monitoring and communicating progress over time. By providing a framework for gender-focused health, this Strategy highlights South Africa’s commitment to taking collective action to create a healthier future for men and boys.
The Strategy identifies seven key priority health issues which have been identified as key causes of morbidity and mortality for all South African men:
The following platforms are available for men, or those close to men who need mental health support:
Department of Social Development Substance Abuse Helpline: 0800 12 13 14, SMS to 32312
South African Depression and Anxiety Group (SADAG): 011 234 4837 or 0800 21 22 23 or 0800 12 13 14 (24Hrs) SMS to 31393, http://www.sadag.org
Suicide Crisis Helpline: 0800 567 567
References:
Welcome Ngwenya, M., & Olivia Sumbane, G. (2023). The Urgency of Access to Men-Centered Mental Healthcare Services to Address Men’s Sensitive Issues in the Communities of South Africa. IntechOpen. doi: 10.5772/intechopen.108493 (https://www.intechopen.com/chapters/84694)
The South African National Integrated Men’s Health Strategy 2020-2025 (https://knowledgehub.health.gov.za/system/files/elibdownloads/2023-04/Men%2526%2523039%253Bs%2520Health%2520Strategy.pdf)
Today, you have the power to shape the future—cast your vote in the 2024 National Elections! Your voice matters, and each vote contributes to the path we take as a community and nation. Casting your vote in today’s National Election is not just a right; it’s a profound responsibility. Don’t miss the opportunity to make your mark and help decide what tomorrow will look like. PsySSA encourages you to participate in democracy, take to the polls, and cast your vote!
Alexa Russell Matthews – BSS in Social Work (UCT), MA in Play Therapy (UP) – is a registered Social Worker who works for Arise Family – an NGO based in the Western Cape whose mission it is to see every child in a thriving family, regardless of who constitutes that family. Arise works to preserve and strengthen families through programmes written and developed in South Africa, but which have reached a training cohort in the Global South as part of their training and consulting suite of services.
Child Protection Week helps remind us of the vulnerability of children within society. South Africa’s children are vulnerable for a myriad of reasons – from the economic hardships, under resourcing in communities most at risk and vulnerability to continuous and complex trauma, the challenges for mental health professionals supporting children and families are real. In addition to this, it is recognised that over 50% of South African’s children, i.e. over 10 million children do not live with a biological parent. They may live with an extended family member or alternative caregiver – some of which is formalised in the alternative care system, but for many children, this is not.
Children are said to need three things to succeed in life and break out of the poverty trap: i) a good enough education, ii) a consistent relationship with a primary caregiver and iii) support for that caregiver. As psychologists, the role of support for children in the education sphere as well as within their families and communities is important. An opportunity to partner or collaborate with other role players while advocating for children to have the best possible foundation exists. Role players may be social workers, educators, health care professionals and community-based organizations relevant to the child’s context all matter in offering a family care and support.
The purpose of the South African Children’s Act of 2005 act is to establish what is needed for the protection of children to flourish and thrive, ideally within their families of origin wherever possible. What this means is that should there be a suspicion of risk (neglect, abuse including sexual, physical, emotional, and psychological) as well as medical and educational neglect is that this renders that person responsible who has been made aware of this to report. Any person working with children is accountable and held liable to the act. As mandatory reporters, self-awareness of personal fears and biases matter – without this there is often a reluctance to report or fear of disruption of family units that then do not lead to any further intervention.
Themes and trends emerging within the greater child protection landscape currently include an increase in sexual abuse disclosure, anxiety & depression, and self-harm (including increased substance use and anti-social behaviours). The expected risks to children following the Covid pandemic lockdown are being noted.
Developing good working relationships with the relevant child protection organisations and Forensic & Child Sexual Offences officers within your local SAPS are helpful ways of building broader support networks for psychologists to refer and consult with, as well as continue to strengthen services for children in need of care.
The adage that it takes a village to raise a child remains equally true for the protection of children. Not only to raise them but to protect them also.
Social Work manager for Child Welfare SA Grahamstown.
The Role of Child Welfare and Social Work
During Child Protection Week, the South African Association of Counselling Psychology (SAACP) wish to draw attention to the important role Child Welfare and our Social Work colleagues play in the protection of our children. Nasiphi Matshaya, Social Work Manager, Child Welfare Makhanda, shares her thoughts:
As a child protection organization, our work is guided and governed by the Children’s Act, (Act 38/2005) working to ensure that the best interests of the child is always served. Most of the cases reported to our office are as a result of child abuse (sexual, emotional and physical), neglect, substance abuse by the parents, poor/inadequate parenting skills, domestic violence between parents etc. Our social workers work with two types of cases, each managing over 120 cases. We have statutory cases, where children have been removed from their parent’s care due to dire circumstances at home and are placed in foster care or registered Child and Youth Care Centres (CYCC) via Court Orders. Our other focus is on prevention cases where we work intensively with families in order to keep children within the family system.
Contrary to many people’s beliefs, the focus of our work is NOT to remove children from their families, but to do whatever we can to keep children in their homes and with their biological parents if at all possible. Obviously, there are times when we have no other choice but to remove children via Form 36 (which is the form used to legally remove children) from their parents as their safety would be at risk if left in their care. This process is done in Court and the approval of removal is endorsed by the Presiding Officer.
On a typical day, our social workers will be involved in family meetings, investigating children’s home circumstances, interviewing parents and family members, teachers, counselling children and their family members, report writing for children’s courts, appearing in court for foster care reviews, and referring children for therapy. This work requires considerable commitment, endurance and skills as social workers face challenges every single day in their work including child abuse, neglect, domestic violence, inadequate living conditions.
Our staff respond to children in crisis, operating within a highly pressurized work environment. It therefore requires experienced and caring staff members who are able to think on their feet in crisis situations. As the Child Protection Week approaches, our social workers will be going around to schools and communities creating awareness on child protection.
Vice Chair for the Registered Counselling and Psychometry (RCP) Division at PsySSA
Call to Develop Child Protection Policies for Social Media
In South Africa, National Child Protection Week (CPW) is observed annually to raise awareness of children’s rights as per the Children’s Act of 2005. The campaign strives to ensure safety, care, and protection for all children in various forms, including health, education, community, and social development. South Africa faces alarming rates of violence against children, and this is an overwhelming challenge to be tackled. Despite focused and progressive laws, policies, and actions to prevent and reduce violence against children, it remains a severe issue.
A targeted manner to address this issue could be through creating and enforcing child protection rights on digital platforms and social media. This article is inspired by a recent scandal exposed on Twitter, a popular social media platform. A young girl approximately aged 16/17 years was observed to be groomed by a pastor within her community. Sadly, these are all too common scandals in our communities, with increasing statistics of sexual violence and gender-based violence. Allegedly, the girl hailed from a poor, marginalized community and was spoiled by the pastor with luxuries such as takeout food, clothing, jewellery and a brand-new iPhone. Social media users observed this and were able to determine that the girl was still in high school, and the pastor was well-known and married within his community. While some adult social media users were wise and handled the situation with thought and consideration for the child in question, many ridiculed and mocked the child and her choices. Videos of the child and her high school uniform soon flooded platforms and many attempted to showcase the “poor” choices of this child. Over-exposure to social media platforms that are mixed with a variety of users across all ages, ethnicities and genders may prove concerning. Unfortunately, this could also lead to this child being a victim of cyber-bullying.
As the world develops, children are being introduced to smart technology from younger ages compared to before. We know children to be vulnerable and curious, and earlier exposure to social media may have detrimental effects on many levels. The young girl from this scandal may have been a victim of grooming, and then faced further ridicule whilst also having her face and high school plastered on an open social media platform. Cyber-bullying refers to bullying, threats or intimidation that occurs on electronic platforms. It may have severe psychological impacts on an individual, including negative self-esteem, low mood, antisocial actions and may even lead to suicidal ideation and thoughts (Albikawi, 2023).
The use of technology has permeated every area of our lives, and the creation of Artificial Intelligence (AI) may soon surpass limits of protection. While AI has become a recent advancement in technology, social media has been present for long enough to warrant child protection policies. Deliberate exposure of minors, their faces and potential locations is extremely dangerous. Whilst every effort is focused on prevention and reduction of crimes against children, including violence and abuse, there is a growing need for stringent measures of child protection on social media platforms. The responsibility for child protection in both actual and on digital environments lies upon the community. As the world advances into the wonders of smart technology, our responsibility to extend protection and guidance must progress all the same.
References:
Albikawi Z. F. (2023). Anxiety, Depression, Self-Esteem, Internet Addiction and Predictors of Cyberbullying and Cybervictimization among Female Nursing University Students: A Cross Sectional Study. International journal of environmental research and public health, 20(5), 4293. https://doi.org/10.3390/ijerph20054293
Vice Chair for the Society for Educational Psychology of South Africa (SEPSA) Division at PsySSA.
A Minority Perspective
Child Protection Week is an opportune time for concerned colleagues to Refresh, Rewind and Restart on critical issues regarding Children. We have been accustomed to focusing on macro issues like Child Abuse, Bullying, Gender-based and the like. This is wholly justified as there are mounting studies that confirm the escalation of violence against children in its various forms.
As complex society further complicates innocent children again become the most affected party. A vulnerable sub-population that receives scant attention from the professional community is the Children of Divorced parents. While international literature is replete on this topic local literature is limited. It appears confined mostly to academic pursuits with little influence and cross-pollination over policy and practice.
Children of Divorce present with a unique set of dynamics mostly that go unnoticed or misunderstood. Hence it warrants appropriate awareness, growing attention and proverbial protection. Child Protection Week is a convenient time to bring this susceptible population into the main frame. It is reported that almost one in three marriages end in divorce. This equates to about nineteen thousand couples who dissolve their marriages annually. Further, the biggest casualties of a failed marriage are the children and at a conservative estimate this is between thirty-eight to fifty-seven thousand every year. From a statistical perspective, it may not appear significant. In psychological terms, if left unnoticed it has the potential to grow into unmanageable proportions.
Divorce involves the spouse, the children and the extended family as well as a chain of official personnel including, the opposing attorneys, Social Workers, Psychologists, the Office of the Family Advocate and the presiding Judge in Court. As expected spouses are usually engaged in an acrimonious dispute, children are confused and torn between the opposing parents and the extended family playing the blame game. While matters concerning the welfare of the children are predicated in the Children’s Act 38 of 2005 and subsequent amendments, it is moot whether the paramount principle of “Best Interests of the Child” is followed through to the letter. This becomes particularly pertinent when considering the traumatic overt and covert psychological constructs that children in particular experience. This ranges from adjustment problems, loss, grief, anxiety, depression, sadness and suicidal ideation. In addition, children start performing poorly academically, lose interest in social activity, have difficulty adapting to change, are emotionally sensitive, have anger/irritability, feelings of guilt, destructive behaviour, increase in health problems and loss of faith in the family unit.
Thus adversarial lawyers, template-following social workers, and forensic psychologists, work according to the regulations OFA and the learned judges have to “dig deep into the Pierian Spring” of psychology before they make an informed decision on reluctant children caught up in the divorce maze of their parents’ divorce.