In the drama series 13 Reasons Why, a teenage girl commits suicide and leaves behind audio tapes identifying the 13 people she believes played a part in her decision to take her own life.
The Netflix series explored topics such as depression, stress, substance abuse, bullying, trauma and rape, putting into focus the spectre of mental health challenges facing not only the youth but also the adults in societies around the world, including SA.
According to the World Health Organisation, by 2030 more people will suffer from depression than any other health problem. It is vital that an investment is made in children and young people’s mental health to prevent a generation of children suffering from entrenched mental health problems as adults.
Psychologists and counsellors say the drama series confirms the view that most common mental health disorders begin in youth and adolescence and yet are not diagnosed until later in life.
With only about one psychiatrist to every 100,000 people in SA and fewer than 400 psychiatrists practising in the private healthcare sector, which serves nearly 9-million people, there are inadequate numbers of specialised mental healthcare workers to serve the population. This has led to poor access to mental healthcare and, ultimately, complications and costly hospitalisation for the young and old suffering from mental health problems.
This is not a South African problem. According to the UN, 20% of the world’s population aged 14-24 suffer from mental-health conditions every year.
In a report, Social Inclusion of Youth with Mental Health Conditions, the UN says 85%-89% of this age group lives in low-income countries, which lack "quality" mental health systems. It says in their transition from childhood to adulthood, the youth are most vulnerable to mental health problems due to psychological and emotional changes that happen during this period.
This is not surprising. Young people lack the problem-solving skills and cognitive ability needed to effectively deal with stress. This leaves them vulnerable to psychological disorders such as depression, anxiety and other trauma-related disorders.
While it cannot be claimed that young people suffer more from mental illnesses than adults, it is clear that they are not able to articulate their problems in the same manner as adults. Youth can experience symptoms differently from those experienced by adults with mental diseases. Some diseases, such as depression, can manifest in teenagers as irritability or other behavioural problems that adults might not recognise.
Entering grade 12 or going to university is meant to be a liberating experience for a young person, but often it isn’t. Students are increasingly faced with the stress attached to the transition of moving to university and all the pressure that studying can bring, but within the current economic climate, they are also facing greater financial worries.
As high school students transition into university, they have to become independent and adapt to different teaching methods. The combination of living away from home for the first time, their workloads and new friendships may trigger a latent mental health illness.
Some seek help from counsellors as they grapple with depression, relationship problems and academic challenges. Some may confront stigma at school, university or in the rest of society.
Mental health is a complex issue and cannot be solved through a singular intervention. Adults can work to combat the stigma that surrounds mental health; guide children, particularly high school and university students through coping mechanisms; be there for them as supporters; and learn the signs of depression and suicidal behaviour to make sure they receive help. Effectively identifying mental health issues and managing them in childhood and adolescence is one way to make a difference.
Without the right support, stress and isolation can lead to far deeper problems — like depression — and can result in young people dropping out of their studies.
Far too many students in SA are living with mental health problems and without the support they need to get the most out of high school or university. Far too many people suffer in silence.
Children should be encouraged to attend stress management or resilience training workshops, take regular exercise, eat healthily and have enough sleep
Mental health must be given the same priority as physical health. Giving children the treatment they need as soon as they require it will help ensure that those suffering from a mental health problem will have a fair opportunity to succeed in life. If a young person is feeling depressed or anxious over a number of weeks, they should be encouraged to go for counselling, especially if they don’t understand what is happening in their lives or feel overwhelmed by problems.
Children should be encouraged to attend stress management or resilience training workshops, take regular exercise, eat healthily and have enough sleep.
After recognising that the integration of mental healthcare into primary, community-based care requires training, Medscheme has developed a mental health programme that promotes collaboration between general practitioners, specialists and auxiliary caregivers.
A Medscheme care manager will communicate regularly with family practitioners regarding potential new cases and treatment response. When treatment targets are not met, the family practitioner is alerted and will be able to review the treatment plan while having access to specialist advice from the Medscheme psychiatrist decision support service.
In the near future, family practitioners will have access to online and face-to-face professional development initiatives to enhance their skills, as well as standardised care pathways to guide treatment decisions.
Encouraging young and old people to be open about mental illness and extending available therapies will help to ensure intervention is available at the earliest opportunity, giving both young and old people a chance to lead fulfilling lives.
• Pedersen is CEO of Medscheme, a subsidiary of AfroCentric Group.
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