Overcoming barriers to accessing mental health care in South Africa

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One of the few silver linings of the Covid-19 pandemic has been that more people have realised that they’re not alone in experiencing depression, anxiety, grief, trauma and other mental health conditions – and have become more open to talking about their experiences. At the same time, the growing availability of app-based counselling services like Kena Health has also made accessing mental health help easier than ever.

Yet, despite progress in raising mental health awareness and growing social acceptance, many people still don’t seek help when they experience mental health problems, an issue that is especially acute in Africa. Taking South Africa as an example, we’re going to look at the three biggest barriers to seeking mental health support today.

1. Lack of awareness and understanding

The single biggest barrier to getting help is knowing that there’s a problem. Mental health is seldom taught or addressed in schools and there’s generally a low level of awareness in society of the symptoms of different mental health conditions. People who need mental health help often misidentify symptoms or their causes and so struggle with them for months or years, excusing them or believing that they’re caused by something else. This is exacerbated by the cultural stigma that often surrounds mental illness.

2. Social stigma

In many communities in South Africa, and elsewhere on the African continent, mental health and mental illness remains heavily stigmatised. This stigma most often takes one of two forms: it’s either seen as a form of weakness in the individual suffering from the condition, or, in more extreme cases, as a form of possession, requiring spiritual treatment. This makes it very difficult for people who have a mental health condition to come forward in their families or communities to ask for help, because they often face social isolation.

As a result, people tend to ‘suffer in silence’ ashamed to share their mental health struggles with others.  They try to push through by turning to self help techniques or even substance abuse.

3. Difficulty accessing mental health professionals

It won’t come as a surprise to learn that South Africa doesn’t have enough people working in mental health professions to serve its population – what might come as a surprise, however, is the scale of the shortage. Take psychiatrists as an example: they are fundamental to correctly diagnosing and prescribing the correct medication for mental health conditions, yet according to data from South African Society of Psychiatrists, there are only 1.52 psychiatrists per 100 000 people in the country, and they’re mostly concentrated in just two provinces – Gauteng and the Western Cape. This compares to more than 30 per 100 000 for some countries in Europe – almost 20 times more. We also see a similar shortage in psychologists and mental health counsellors. The result is long wait lists, high prices and lack of access in small and rural communities.

Taken together, these three factors result in a significant number of cases of mental illness going undiagnosed and untreated. Fortunately, new ways of accessing mental health care are changing this situation for people across South Africa.

How Kena Health is improving access to mental health services

Perhaps the single biggest change happening at the moment to address these barriers is the broader shift to digital mental health apps like Kena Health – a mobile, app-based service that dramatically improves access to mental health professionals by offering a private, affordable, remote access service.

Because Kena also allows an entire mental health counselling session to be done over text, it gives people seeking mental health help the opportunity to keep their counselling sessions completely private. In fact, since launching in March 2022, over 50% of Kena Health’s mental health consultations have been done using text only, making it the most popular option, followed by voice calls, then video calls.

Kena also allows people to have mental health consultations remotely. This gives people easy access to counsellors outside of their area while at the same time lowering the cost, making counselling affordable for significantly more people.

Improving access and helping people feel more comfortable, private and secure when seeking help contributes to greater education and understanding – improving awareness of mental health issues and reducing stigma. By changing how we access services, app-based care is one of the biggest drivers of change in our social attitude towards mental health.

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