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A report from the Department of Psychiatry at the University of Cape Town (UCT), for the period of 2004-2014, states that one-third of the South African population suffers from some form of mental illness, and 75% of these sufferers do not get the appropriate help. Mental health issues create problems for sufferers, especially when they impact their ability to work and earn an income.
This is according to Dr Dominique Stott, Executive: Medical Standards and Services at PPS, who states that the high rate of sufferers not receiving the appropriate treatment is due to a combination of the perceived stigma associated with mental illness, lack of facilities, and the costs of treatment. “Whilst the patient may require medication, hospitalisation and psychotherapy in order to return to work, this is not always available to those who need it most outside private health care sectors.”
Feeling isolated and alone may be one of the first symptoms that a person is suffering from some form of mental illness, says Dr Stott. “At this point, if an individual is showing major behavioural changes which are noticed by friends or family members, there should be reason for concern, especially if there is a history of mental illness in the family.”
Other behavioural changes which could be a warning are inconsistent sleep routines, such as sleeping too much or too little, thoughts about death or dying, declining work or school performance, obvious substance abuse or avoiding social contact, she adds. “While a mental illness must be properly diagnosed by a healthcare professional, recognising the first signs can enable the sufferer to get the desired help early.”
Dr Stott states that when a patient does not acknowledge that they have a problem or feels as though nothing will help them, then a family member or friend should seek help and advice on their behalf with a medical professional sooner rather than later. “Any patient who has lost touch with reality will definitely requires urgent input from a specialist. Any potential sufferer who mentions, even casually, that they have nothing worth living for should be taken to an emergency room immediately to rule out the risk of suicide.”
Work- hardening * programmes* are beneficial for people at the right time as part of their recovery, she says. “This form of therapy is carried out by an Occupational Therapist who assists people in recovering gradually, to reintegrate back into the workplace. It can be daunting to have to face a work environment after weeks away from work, and this form of therapy, in addition to the input from the employer if required, will help to ensure the return to work is successful.”
Dr Stott states that, most patients with mental health disorders, most commonly depression and anxiety, will be able to return to work. “So from the outset, this must be encouraged to ensure the best eventual outcome. Studies worldwide have proven that staying off work for extended periods of time past a normal recovery period has no added benefit for the patient, and research continues to show that returning to work, even in a limited capacity initially, will help with the recovery*. The longer one stays off work, the more difficult it is to either find new work or return to the original employment.”
By not returning to work as soon as possible, the patient also risks losing their skills, or in the worst case being unemployed and financially worse off, which will lead to the patient becoming even more depressed and anxious, she adds. “Work should never be treated as the enemy. For all but exceptional cases, returning to work should be discussed from the start of treatment as part of the expected outcome with the medical professional and employer.”
Mental illness can be expensive to treat, and the amount of appropriate treatment programmes that are covered by the commonly known medical aids are limited, even inside the private health care sector, she says. “This is why it is so important to have adequate insurance cover in place. One needs to make sure that they have a medical aid and income replacement cover should they develop a mental illness which requires time off work. This is even more important if one is self-employed where time away from work means no income,” she concludes.