A Call to Action: October is Mental Health Month!

written by Prof Theo Lazarus, Fatima Peters, and Dr Kyle Bester for the Division for Research and Methodology

Mental health challenges leave no age, socio-economic, gender, educational or occupational group unscathed. From young children to the elderly, mental health challenges, generally referred to as stress, anxiety, or depression, have increased exponentially and it is time to act with conviction and fervour.

Although mental health has been recognised as a critical part of human life, a stark realisation of the vulnerability of individuals to stressful events became evident during and following the COVID-19 pandemic. The global COVID-19 pandemic has led to a widespread increase in depression, anxiety, and post-traumatic stress disorder, particularly due to the sudden and untimely loss of loved ones and high levels of uncertainty. As we look ahead, providing support to one another and striving to promote mental well-being for people around the world are paramount.

The recent spate of athletes who have either left their respective sporting pursuits permanently or temporarily or resorted to self-destructive behaviours, is unprecedented. The adage that ’good physical health equals good mental health’ is being challenged daily. The impact of mental health challenges on individuals and families, as well as on employers, has become pervasive in modern societies. Furthermore, the technological uptake of online interaction for work and learning has added to the burden on people’s mental health and finding new ways to manage school and work environments contributes to the mental burden. At an individual level, self-care is important especially when managing demanding work and learning environments. Economical but high reward physical and social activities can enhance work life balance and address aspects of stress, anxiety, and depression.

Like physical health, mental health requires regular ‘maintenance’ sessions to identify areas of potential emotional or relational difficulties. Without regular self-appraisal by the individual (in the case of an adult) or by a parent (for a child) or a partner in adulthood, mental health challenges may quickly escalate into crises of daily life that impact health, educability, relationships, employability, and society as a whole.

Ongoing strife between countries and ethnicities continue across the globe, filtering across media platforms and leaving a sense of doom, helplessness, and despair. There is likely to be a numbing of emotions at the continuous and increasing destruction of people, leaving a sense of despair that plays out in aberrant behaviours in daily life.

It has been long recognised that mental health difficulties are at the core of most physical illnesses, often described as the psychosomatic component of health and disease, and therefore constitute a foundational pillar of all health programmes. Against this background, a call is made for individuals and families to protect and enhance their mental health as well as that of their loved ones, particularly in the pervasively traumatic circumstances that confront societies worldwide. In light of these living conditions, access to psychological services should become part of all healthcare provisions across countries, and increased attention to training mental health professionals should be given utmost urgency.

Therefore, mental health professionals, and particularly health care professionals in South Africa, should consider availing their services, where possible, to communities where they work, to include financially disadvantaged communities in their service offerings. Group interventions and activities that facilitate affordable psychological wellness would meaningfully connect people to each other for support and further the creation of sustainable support networks.

To achieve the above, we call on the South African government to make available suitable and appropriate compensation, treatment, and recovery environments to mental health professionals. In addition, a significant effort should be made to destigmatise psychological interventions in communities by showcasing the impact appropriate interventions have on individual and family functioning and society in general. Furthermore, the South African government should consider making available funding instruments for mental health care professionals to provide psychological support services with the aim of initiating interventions that can be sustainable for the communities most vulnerable and in need in South Africa.

World Mental Health Day 2024

Brief history of World Mental Health Day

by Mr Sulaiyman Philander from the Division of Research and Methodology 

World Mental Health Day is a global initiative founded by the World Federation for Mental Health (2022). First celebrated on October 10, 1992, it aims to promote mental health advocacy and educate the public about mental health issues. Over the last three decades, it has become an annual observance encouraging individuals to reflect on their mental well-being and engage in conversations about mental health. This year, the focus is on mental health in the workplace, an area gaining attention due to the increasing pressures of modern work life. The 2024 theme, “It’s Time to Prioritize Mental Health in the Workplace,” highlights the need for a holistic approach, advocating for mental health awareness and practices that foster thriving work environments (Akiyama, 2024).

South Africa: A unique perspective

Work-related stress, long hours, and the blurring of work-life boundaries — particularly exacerbated by the COVID-19 pandemic and South Africa’s complex economic climate — have made it crucial for both employees and employers to take a proactive role in mental health care (Kotera et al., 2021; Van Der Vaart & De Beer, 2021). Employers should remain cognisant of the relationship between promoting positive mental health, a motivated work force and productivity. Creating supportive work environments, preventing burnout, and providing accessible mental health resources for employees align with both this year’s theme and existing literature.

In South Africa, the workplace poses unique challenges, especially for emerging adults (18-29 years) (Naudé & Esau, 2024; Olonisakin et al., 2024). Many workers face long hours, high stress, and job insecurity, leading to increased rates of burnout and mental health issues (Kotera et al., 2021; Van Der Vaart & De Beer, 2021). The contrast between high unemployment among emerging adults and the pressures on those employed creates a complex dynamic placing significant strain on an already overburdened mental healthcare system. Mental health care, both before joining and within the workplace, is not a luxury but an urgent necessity to ensure individuals remain productive, healthy, and engaged.

This October 10th: Take care of your mental health

World Mental Health Day 2024 reminds us to prioritise our mental health, especially in environments where stress and pressure are common. Whether you are employed or job-seeking, taking time to care for your mental well-being is vital. Mental health involves more than managing stress; it is about cultivating meaningful emotional experiences, nurturing supportive relationships, and maintaining a sense of purpose, regardless of employment status (Van Der Vaart & De Beer, 2021; Van Lill & Bakker, 2022). This year, let us collectively promote mental health by:

• Being open about workplace struggles and encouraging open dialogue among colleagues.
• Striving for meaningful and engaging lives, whether employed or unemployed (Thill et al., 2020; Van Der Vaart & De Beer, 2021).
• Being kind to yourself and others while also utilising existing mental health resources (Kotera et al., 2021).
• Striving for purpose, whether at work or in our communities (Van Lill & Bakker, 2022).

Mental health support resources:

• Find a psychologist PsySSA directory
• South African Depression and Anxiety Group (SADAG) contact details
• SADAG support group – Unemployment and job seekers
• National Mental Health Policy Framework and Strategic Plan 2023 – 2030

* OpenAI’s (2024) ChatGPT was utilised to assist with editing and structuring the article.

References

Akiyama, T. (2024, April 17). “It is time to prioritize mental health in the workplace”. World Federation for Mental Health. https://wfmh.global/news/2024.24-04-17_wmhd2024-theme

Kotera, Y., Mayer, C.-H., & Vanderheiden, E. (2021). Cross-cultural comparison of mental health between German and South African employees: Shame, self-compassion, work engagement, and work motivation. Frontiers in Psychology, 12, 627851. https://doi.org/10.3389/fpsyg.2021.627851

Naudé, L., & Esau, M. (2024). The quest for a “soft life” and the transition into adulthood: Views from South African emerging adult students. Emerging Adulthood, 0(0), 1–15. https://doi.org/10.1177/21676968241273135

Olonisakin, T. T., Adedeji, A., & Idemudia, E. S. (2024). Examining psychological outcomes of social inequality for Black South Africans. Studies in Clinical Social Work: Transforming Practice, Education and Research, 94(1), 45–66. https://doi.org/10.1080/00377317.2023.2222171

OpenAI. (2024). ChatGPT (Sep 13 version) [Large multimodal model]. https://chat.openai.com/

Thill, S., Houssemand, C., & Pignault, A. (2020). Effects of meaning in life and of work on health in unemployment. Health Psychology Open, 7(2), 1–11. https://doi.org/10.1177/2055102920967258

Van Der Vaart, L., & De Beer, L. T. (2021). Engaged but exhausted: Work-related wellbeing profiles of South African employees. International Journal of Wellbeing, 11(4), 88–105. https://doi.org/10.5502/ijw.v11i4.1823

Van Lill, R., & Bakker, T. M. (2022). Significance as component of meaning in career narratives of unemployed graduates. South African Journal of Psychology, 52(3), 301–312. https://doi.org/10.1177/00812463211059280

World Federation for Mental Health. (2022, August 22). About the World Mental Health Day. https://wmhdofficial.com/about-the-world-mental-health-day/

A Lifetime with ADHD: Beyond the Diagnosis to Understanding the Ongoing Impact

by the Division for Research and Methodology 

To commemorate National ADHD Day (14 September), the PsySSA Division for Research and Methodology sought to summarise the different manifestations of Attention-Deficit/Hyperactivity Disorder and its’ implications on behaviour across the lifespan.

What is ADHD: Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental condition characterised by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with general functioning or development. An ADHD diagnosis is based on criteria outlined in the DSM-5-TR, which includes symptoms being present for at least six months and causing significant impairment.

While ADHD is commonly identified by primary symptoms of inattention, distractibility, and poor executive functioning, the American Psychological Association (APA) differentiates between three specific types of ADHD. Recently, specialists have also recognised additional common comorbidities that accompany an ADHD diagnoses, and recommend three more subtypes. Each type presents with different brain function issues, which cause different symptoms, and require specialised treatment protocols. Our infographic summarises these types and their presenting symptomology.

The impact of ADHD: Insights into the South African prevalence rates are limited, but estimated to be between 2-16% in children (Boshomane, Pillay, & Meyer, 2020; Botha & Schoeman, 2023). Adult estimates are somewhat lower, at 2.5-4.2% prevalence (Schoeman & Leibenberg, 2017), although it has been noted that 60 – 70% of children diagnosed with ADHD continue to have symptoms in adulthood (Belanger et al., 2018).

Possible causes for this larger estimated range in children include overdiagnosis in younger populations (and underdiagnosis in older groups), varying methodologies and assessment practices employed to make diagnoses, and limited expertise from practitioners (Schellack & Meyer, 2016). Given the life-changing impact of an ADHD diagnosis on an individual and their families, it should not be a diagnosis that is made in haste. Rather, practitioners should be careful in ensuring that they’re obtaining as holistic a view of their client as possible, before assigning the “ADHD label”.

Having untreated ADHD affects nearly every aspect of a person’s life and has been associated with school underachievement, family conflict, drug abuse, legal difficulties and poor work performance. Additionally, even though ADHD does not cause other psychological problems, it is common that other disorders (such as mood, anxiety, substance abuse, and learning disorders) occur alongside it, making diagnosis and treatment more challenging. Stimulant medications, such as Ritalin or Adderall, are often prescribed to manage ADHD symptoms in both children and adults. However, before medicating a client, it is important to identify their specific ADHD presentation type, as stimulants can make some forms of ADHD worse, as indicated above as well. Sometimes medicinal reactions can be extreme, causing hallucinations, violent outbursts, volatile temperaments, psychosis and suicidal behaviour. Alternatively, engaging in some form of sport or art form (for example, music) has been shown to improve or reduce the frequency of ADHD symptoms.

PLEASE do not use this article as a diagnostic resource; it is meant for informative purposes only. The South African Depression and Anxiety Group (SADAG) has a toll-free ADHD helpline (0800 55 44 33), please reach out to them if you are concerned that you or a loved one may have undiagnosed or misdiagnosed ADHD.