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Is Mental Health the next pandemic?

17 June 2021 Bonitas Medical Fund

The Covid-19 pandemic, now in its 3rd wave, continues to have an exponentially negative effect on people’s mental health. Globally, people are afraid of falling ill and infecting those around them.

Some have lost family and friends, they continue to be physically distanced and isolated from loved ones and support groups and, in many cases, have lost jobs and businesses have closed. All these factors create the perfect storm of stress, depression and anxiety.

In the weeks following the announcement of the national lockdown in March 2020, Lifeline South Africa recorded over 4 000 calls a day — the number they usually get in a week. Calls to the South African Depression and Anxiety Group (SADAG) more than doubled, while calls to Childline and gender-based violence centres also increased.

It's no wonder experts are calling it a ‘mental health’ pandemic and predict that depression as well as post-traumatic stress, which has been on an upward slope, will increase.

Even before Covid-19, it was estimated that one in three people would be affected by mental illness in their lifetime. Statistics indicate over 17 million South Africans are dealing with anxiety disorders of various forms. And although great strides have been made in understanding and treating mental illness – stigma and ignorance still remain powerful obstacles to effectively battling this threat.

Despite its prevalence, we remain unprepared to deal with mental illness. Lee Callakoppen, Principal Officer of Bonitas Medical Fund, gives us some insights into mental health, the signs as well as how and why you should seek help.

What is mental health?
Mental health refers to the cognitive, behavioural and emotional well-being of an individual. It’s an essential component of health, necessary for us to function effectively. It helps to determine the way we handle stress and make choices. Preserving good mental health helps us balance activities, efforts and responsibilities to achieve psychological resilience and enjoy life. However, the mental health of an individual is not static, it changes from time to time.

Mental illness refers to the health conditions involving changes in emotion, thinking or behaviour (or a combination of these). It affects the way a person experiences and behaves in the world around them. Issues with mental health disorders are of huge health concern and can contribute to the development of mental illnesses such as depression, anxiety, bipolar mood disorder or schizophrenia.

According to Karestan Koenan of Harvard T.H. Chan School of Public Health, adults with small children or who are helping care for elderly parents, are typically experiencing the worst mental health issues during the coronavirus pandemic.

How is Bonitas assisting its members with mental health issues get through this global pandemic?
Our predictive identification model puts us at an advantage as we are able to identify members who are at a higher risk, thereby ensuring early intervention to give them with the support and tools they need to manage their mental health status, during this pandemic and beyond.

We continue to raise awareness of the mental health programme we offer, which includes hospitalisation, treatment of substance abuse, consultations and visits, procedures, assessments, therapy and/or counselling (in and out of hospital). Our mental health care managers contact members to discuss symptoms and provide guidance with steps on how to manage their condition.

We provide members with access to digital support tools and engage with members on all platforms to provide educational material on mental health. Our resource hub helps people understand the condition and steps they can take to remain mentally healthy. We currently drive education to our members to help them identify early warning signals of mental distress and ensure quality care and appropriate referrals.

What are the emerging trends and predictions in mental health and how will it impact the healthcare industry?
A recent web-based survey identified Post-Traumatic Stress Disorder (PTSD) symptoms, depression, anxiety, insomnia, perceived stress and adjustment disorder symptoms as mental health issues due to Covid-19.

PTSD is a common mental disorder caused by psychological trauma. Previous epidemic studies have reported high prevalence rates amongst people exposed to trauma in terms of losing loved ones, being hospitalised if Covid-19 positive and experiencing the realistic or unrealistic fear of infection, social isolation, stigmatisation.

Why has the Covid-19 pandemic made a focus on wellness more important than ever?
Covid-19 has touched everyone’s life, regardless of status, race or gender. It has made us reflect on many aspects of our lives, including the importance of health and wellness. It has made us realise how vulnerable we are. What is clear is that a more holistic view – both physically and mentally – and a preventative and self-care approach to wellness will greatly assist when we are faced with a pandemic such as Covid-19.

Do you think that people with mental health issues may not have asked for help because of Covid-19?
National lockdown, which was something new to all of us, may have resulted in some people being reluctant to seek medical care, for fear of contracting the disease and perceived contravention of lockdown regulation. But, on the whole, our members who have been battling with mental health issues have reached out to seek help.

We introduced virtual care in April last year and offered it free to all South Africans, until the end of 2020. During the year, to help people battling to deal with the stress of the pandemic, we expanded it to include psychiatrists and psychologists.

Our psychiatric and substance dependency and rehabilitation admissions and out of hospital treatment data show a direct correlation between when lockdown was instituted, the various levels of the lockdown, as well as the first and second wave. Although the number of admissions decreased over time, we noted the substance dependency rehabilitation cases have markedly increased in Quarter 1 of 2021.

Also, it helps that recently we have seen a positive shift in more people actively seeking treatment, this as a result of a better understanding and education about the disease. A number of public figures have also come forward to raise public awareness of mental illness, sharing their personal stories and experiences.

Recognising the signs
The signs and symptoms can vary but, in general you may find you, your loved one, a family member or friends experiencing any of these:

• Being frequently sad, depressed and gloomy for long periods
• Feeling overwhelmed by life’s problems
• Changes in eating habits with weight loss or gain
• Struggling to concentrate and make decisions
• Loss of energy and lack of motivation
• Constant stress and anxiety over work, finances, life, friends and family
• Emotionally distant
• Frequently tearful
• Having difficulty sleeping, or sleeping more than usual
• Loss of interest in activities
• Being easily irritated or more aggressive
• Having thoughts of death or suicide
• Drug or alcohol abuse may also be a sign of underlying mental illness

Help is at hand
If you recognise or experience any sign of mental illness, it’s important you seek help as soon as possible. Go and see your doctor, a psychologist or even a social worker – support and assistance is available. There are specialised mental health programmes available through private medical aids or NGOs to help identify the problem, offer the right treatment, support you through the process and help you manage your condition to improve your quality of life.

For the past few years there have been warning signs that mental health has become more prevalent. However, people are becoming more comfortable about accessing care and the stigmatisation seems to have declined as it is more recognised in the clinical arena. However, more can be done to raise awareness and we will continue to focus on developing benefits to support mental health.

It is not an imaginary disease, but a disease where the biochemistry of the brain is impacted and, due to the devastating impact it has on individuals and their direct contacts, (ability to be employed, fully productive, add value to society, on family and friends) it is critical that we support everyone through their journeys, both from a curative as well as preventative perspective.

There is no doubt that Covid-19 is exacerbating mental health issues on a global scale and we know that mental and physical health are co-dependent, which is why it’s important to look at integrated care now, to prevent this becoming the next pandemic.

 

Quick Polls

QUESTION

Healthcare brokers have long complained about inflation-plus medical scheme contribution increases; but pandemic may have changed things. What will pandemic-induced changes in hospital utilisation do to medical scheme contribution increase patterns?

ANSWER

Below inflation increase for 2022, then back to inflation-plus
Long-term trend of below inflation increases
Inflation-linked hikes for 2022, then back to inflation-plus
This is a 2-year hiccup, inflation-plus increase trend remains in place
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