To gain understanding of the local perceptions of mental health, common mental disorders within the communities, and treatment options.

Transcription

1 26 November 2017 YOUTH ZONES: MENTAL HEALTH INFORMAL REPORT 2017 BACKGROUND Mental Health in South Africa According to the World Health Organization, neuropsychiatric conditions contribute 12% of the worldwide burden of disease and is projected to reach 15 % by The pervasive neglect of mental health research and care in lower- and middle-income countries has led to the movement of Global Mental Health and a call to action for a decrease of inequality in mental health provision (Patel, 2012). South Africa has a high prevalence of psychiatric disorders, with an estimated 30% of the population having a lifetime history of at least one of the mental health disorder (Stein et al., 2008). There is a particularly high prevalence (13.3%) and early age of onset (21 years) of substance use disorders in South Africa in comparison to other countries (Stein et al., 2008). Cases of psychotic disorder could be prevented by discouraging substance use (particularly cannabis and nyope) among vulnerable youths (Arseneault et al., 2004). Local data suggest that stigma and misinformation regarding mental illness is wide spread (Hugo et al., 2003) in South Africa. False beliefs and misunderstanding regarding metal illness influence treatment modality and help-seeking behaviour (Hugo et al., 2003). AIM To gain understanding of the local perceptions of mental health, common mental disorders within the communities, and treatment options. METHOD Three group discussion were held in local communities in South Africa with Doc Mabila and Ruth Verity Passchier. Participants included community leaders, youth, and adults interested in discussing mental health. Mental Health Visits Badirille Location, Brandvlei, 25/10/17 Questions and Issues Raised What is mental health? People who hear voices see traditional healers and are cured What is psychosis? What is stigma? Does abuse cause mental health? How do you treat depression? Dementia is common Addiction is common- particularity to alcohol and cannabis Cannabis is the most popular drug- does it help you focus? Does it cause mental disease? Difficulty remembering school work Psychology and Talk therapy- where to get it? Mental health patients frequent the library in the area

2 What should people do to get mental health help? How do you keep your mind healthy? Key Points Unaware of neurological damage caused by cannabis Need for psychological support for youth Unknown path to treatment for mental illness Lack of awareness about treatment availability for depression Kameeldrift, Pretoria North, 3/11/17 Questions and Issues Raised Is addiction inherited? Cannabis is used because it makes you concentrate and have good ideas What happens to a pregnant woman who uses drugs? Alzheimer s is common How do you treat addiction? Lack of motivation to stop using substances since there is little else to do Nyope is a commonly used drug. People who are using Nyope have been seen to talk to themselves, walk naked in the streets, hallucinate Alcohol abuse is common, especially binge drinking on the weekend. How to stop using alcohol? Lack of identification documents for youth who would like to apply for rehabilitation through SANCA Key Points Lack of motivation and unemployment leads to drug use in the youth Nyope and cannabis abuse are causing avolition and high prevalence of substance induced psychosis in this community There is lack of social support for families wanting to help addicts to treatment and rehabilitation

3 Ikemeleng, Rustenburg 19/11/17 Questions and Issues Raised Can people have mental illness who do not use drugs Does studying too much make you have mental illness? People who study further after school usually become mentally ill Stress can cause mental illness- stress about work, money and supporting family After trauma, people become hyper-alert and do not sleep well People with mental illness are bewitched Key Points Cultural belief that mental illness is due to witchcraft leading to stigma towards mental illness Post-traumatic stress disorder in people who have experienced psychological trauma It is possible that students under high levels of stress develop mental illness, creating stigma towards further education

4 SUMMARY OF FINDINGS The key issues raised by the communities were substance abuse, stigma towards mental illness, unknown path to treatment and lack of social support options for those in difficult social circumstances. FUTURE PLAN OF ACTION Stigma Mental illness in a common and medical treatment available. A better understanding of these disorders amongst the public would lessen stigmatisation and encourage the use of currently available and effective interventions (Hugo et al., 2003). Brief educational courses on mental illness have proved to reduce stigmatizing attitudes among a wide variety of participants (Rüsch et al., 2005). Substance Abuse in the Youth There is a uniquely high prevalence of substance use and substance induced psychosis in South African youth, thus providing an important target for the planning of local mental health services (Stein et al., 2008). Education on the danger and harmful effects of illicit drugs, and interventions to change behavioural patterns of drug abuse, is needed. Psychological Support and Medical Treatment Communities should be well informed about the biological causes of psychiatric disorders and about the availability of effective treatments at local primary care clinics (Hugo et al., 2003). Social Support Social work support is required to solve social issues such as lack of identification documents, grant application and availability for mental ill, social support to individuals in difficult social settings. Stressful social circumstances can add to the burden of mental illness. PROPOSED INTERVENTION The most prevalent and imminent threat to the mental health of the local youth appears to be substance abuse. An anti-substance abuse campaign, behavioural skills to counteract substance use, education on the detrimental effects, and easier treatment and rehabilitation access should be considered as possible solutions to this issues.

5 Intervention Options Programs aimed to provide young people with the knowledge and skills needed to resist social influences to engage in substance use have been shown to be successful in reducing drug abuse. Furthermore, programs that aim to increase general personal and social competence skills can reduce potential motivations to use drugs (Griffin et al., 2003). Intervention should teach a variety of cognitive behavioural skills for building self-esteem and resisting prevalent advertising (e.g. alcohol billboards). These are taught using specific techniques that include group discussion, demonstration, and behavioural rehearsal (Griffin et al., 2003). Workshops teaching such skills could be held by youth leaders within respective communities. Providing information about the immediate negative consequences of drug use and the high prevalence rates among adults and adolescents would form an important part of such an intervention. This could be integrated into the above mentioned behavioural skills, or adopted more broadly as an anti-substance abuse campaign supported by the local municipalities or government. The overall aim is to decrease social acceptability of drug abuse by reinforcing non-drug use norms and modifying pro-drug use normative expectations (Botvin et al., 2001). Lastly, there is a call for increased social and medical support for mentally ill and addicts in need of treatment and rehabilitation. This is a large scale issues and might benefit from discussion with government health leaders. CONCLUSION The topics raised in this report are in keeping with Global Mental Health issues experienced in other low- and middle- income countries. The proposed interventions and goals towards better provision of mental health, strategies that address the promotion of mental health, prevention of mental disorders, care, support, treatment and recovery of persons with mental disorders are in keeping with the World Health Organization Mental Health Action Plan (World Health Organization, 2013).

6 REFERNCES ARSENEAULT, L., CANNON, M., WITTON, J. & MURRAY, R. M Causal association between cannabis and psychosis: examination of the evidence. The British Journal of Psychiatry, 184, BOTVIN, G. J., GRIFFIN, K. W., DIAZ, T. & IFILL-WILLIAMS, M Drug abuse prevention among minority adolescents: Posttest and one-year follow-up of a school-based preventive intervention. Prevention Science, 2, GRIFFIN, K. W., BOTVIN, G. J., NICHOLS, T. R. & DOYLE, M. M Effectiveness of a universal drug abuse prevention approach for youth at high risk for substance use initiation. Preventive medicine, 36, 1-7. HUGO, C. J., BOSHOFF, D. E. L., TRAUT, A., ZUNGU-DIRWAYI, N. & STEIN, D. J Community attitudes toward andknowledge of mental illness in South Africa. Social Psychiatry and Psychiatric Epidemiology, 38, PATEL, V Global mental health: from science to action. Harvard review of psychiatry, 20, RÜSCH, N., ANGERMEYER, M. C. & CORRIGAN, P. W Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. European psychiatry, 20, STEIN, D. J., SEEDAT, S., HERMAN, A., MOOMAL, H., HEERINGA, S. G., KESSLER, R. C. & WILLIAMS, D. R Lifetime prevalence of psychiatric disorders in South Africa. The British Journal of Psychiatry, 192, WORLD HEALTH ORGANIZATION Draft comprehensive -mental health action plan Geneva.