Mental Illness Awareness Month

You are seen, and help is available.

It is important to change how we see and talk about mental illness. When we openly discuss it, support those affected, and encourage them to seek help from professionals, we can make a big difference in our community’s mental health. This helps people get the right treatment sooner, which can lead to better outcomes for everyone involved.

What is the difference between mental illness and mental health?

Understanding the distinction between mental illness and mental health is crucial. Mental illness refers to a wide range of mental health conditions or disorders that affect a person’s mood, thinking, and behaviour. Examples include depression, anxiety disorders, schizophrenia, eating disorders, and addictive behaviours. On the other hand, mental health broadly refers to overall psychological and social well-being and positive mental functioning (Elmer, 2023). These terms are often used interchangeably because they share similarities, however, they are not the same.

What is the prevalence of mental illness in South Africa?

Mental illness awareness is important, given its prevalence in South Africa. A study published in 2022 indicates that approximately 26% of South Africans suffer from probable depression, with even higher rates in certain provinces, such as the Northern Cape, which reports a 39% prevalence of probable depression and 29% prevalence of probable anxiety (Craig et al., 2022). Various socio-demographic factors, including adverse childhood experiences, genetic, socio-economic status, geographic location, age, marital status, and education levels, influence this prevalence.

What benefits do medical scheme members have?

Medical Scheme members can consult psychiatrists or psychologists for diagnosis and treatment. Prescribed medication and therapy sessions may be included through Prescribed Minimum Benefits, which covers diagnosis, treatment, and care for various mental health conditions.

• Outpatient care is covered to address psychological and emotional challenges and includes individual and group therapy sessions.
• Medication prescribed for mental health illnesses, such as antipsychotics and mood stabilisers, are covered. Psychiatric in-hospital treatment for acute mental health crises or severe conditions is available where necessary. The benefit of long-term chronic medication is also available for mental health conditions identified on the PMB Chronic Disease List (CDL).
• Medical schemes offer support during emergencies and may cover rehabilitation programs for issues like substance abuse. Some schemes offer additional support, such as stress management programs or counselling services over the phone. These benefits ensure members can receive the necessary care to manage their mental health effectively. It’s important to check with your specific scheme to understand exactly what services are covered and how to access them.

CDLs provide specific treatment procedures for mental health conditions, including consultations with relevant practitioners, specialists, pathology, and radiology. Additionally, auxiliary services from social workers, physiotherapists, and occupational therapists must be funded while in the hospital as part of a multi-disciplinary management team, with an emphasis on behaviour change and encouraging independence. Pre-authorisation of auxiliary services is key/preferred to ensure adherence to the acceptance consultation norms and exception management.

Medical schemes may require a designated service provider (DSP) to treat these diseases, failing which a co-payment may be charged. In the absence of a DSP, any healthcare provider may be used and must be fully funded as a PMB level of care, up to a maximum of private rates. The medical scheme may also use medicine formularies to determine if the prescribed medication is on the list of medicines covered. Should the treatment not be included in the formulary, the treating doctor must provide a detailed motivation for why the medication in the formulary will not be effective.

How can mental illness arise unexpectedly?

• Mental health conditions can often arise unexpectedly due to life situations and stressors. These may lead to a life-threatening situation where an individual is posing an immediate threat to themselves or others, is extremely disoriented or disconnected from reality, has a significant inability to function, or is highly distressed and uncontrollable.
• Extremely distressing or terrifying experiences, such as abuse or the loss of a loved one, can eventually lead to mental health issues. These traumatic events have the potential to alter emotions and the brain, which can result in disorders like anxiety or depression.
• Drug or alcohol abuse can worsen mental health conditions or even cause them to develop.
• Loneliness, or feeling disconnected from others, has a negative impact on mental wellness and contributes to mental illness.

How are mental health emergencies addressed?

In the event of a mental health emergency, an initial 72-hour assessment is conducted to ensure the physical safety of the member and surrounding personnel, including family and healthcare workers, and to manage physical symptoms. Mental health emergencies differ from other medical emergencies in that the danger of harm to society is also considered. Mental health emergencies are covered in the PMB regulations as emergency medical conditions, and the use of a designated service provider, therefore, does not apply to the initial emergency care.

How do we overcome the stigma?

It is important to change how we see and talk about mental illness. When we openly discuss it, support those affected, and encourage them to seek help from professionals, we can make a big difference in our community’s mental health. This helps people get the right treatment sooner, which can lead to better outcomes for everyone involved.

During Mental Illness Awareness Month, it is essential to remember that you are seen, and help is available.

 

References

Craig, A., Rochat, T., Naicker, S. N., Mapanga, W., Mtintsilana, A., Dlamini, S. N., Ware, L. J., Du Toit, J., Draper, C. E., Richter, L., & Norris, S. A. (2022). The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: A national survey in South Africa. Frontiers in public health, 10, 986531. https://doi.org/10.3389/fpubh.2022.986531

Elmer, J. (2023, April 18). Understanding the difference between mental health and mental illness. Healthline. https://www.healthline.com/health/mental-health/mental-health-vs-mental-illness#mental-health

Mayo Clinic. (2022). Mental illness – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968

Mental Health Resource Center/ (2023). Causes of Mental Illness. WebMD. https://www.webmd.com/mental-health/mental-health-causes-mental-illness