Medical staff, police and teachers are among South Africa’s frontline workers in the grip of a mental health pandemic, say experts and unions.
Durban - South Africa’s frontline workers are in the grip of despair as depression, strenuous working conditions and safety concerns take their toll.
Grief-stricken public servants are still battling with the impact of Covid-19, and while many healthcare workers have quit their jobs, police officers are considered to have a high suicide risk.
The South African Depression and Anxiety Group’s (Sadag) operations manager Cassey Chambers warned that public servants were under immense strain even before the pandemic.
“We know through research that public servants, especially those working on the frontline, often deal with higher levels of depression, anxiety, stress, burn out and trauma because of the nature of their work and then when you add Covid-19, and all the things they had to adjust to really quickly, it was a recipe for disaster.”
She said extended working hours, stress, and worrying about the well-being of their loved ones complicated matters even further.
“For a lot of people working on the front line, that was incredibly difficult, and we are still seeing the impact now. Global research is showing that the second pandemic to come out of Covid is the mental health pandemic.”
Chambers said mental health experts reported that many people were seeking help because they were unable to function as they did previously, but, generally, public servants, especially health care workers, were not.
“Doctors and nurses are really good at looking after other people but are not always good at looking after their own mental health,” said Chambers.
She said in South Africa, more women were diagnosed with depression probably because they accessed help sooner than men, but men were four times more likely to die by suicide than women.
“While men might not be diagnosed and might not be seeking help when they see depression symptoms, they are not getting help until it’s too late and they feel suicidal,” Chambers said.
“This definitely tells us that men do have depression. They just have poor help-seeking behaviour.”
The frequency of mental health issues and, at times, suicide among police officers was the result of deep-rooted challenges faced by many within their ranks, said Police and Prisons Civil Rights Union (Popcru) spokesperson Richard Mamabolo.
He said over the past two years, at least 20 officials had committed suicide, prompting calls for urgent steps to curb the trend.
Mamabolo said officers were frequently exposed to incidents that endangered their lives, while the gruesome scenes they witnessed resulted in persistent mental and emotional stress.
He said, often, it also resulted in injury or severe psychological shock, which caused sleep disturbances.
“A study on South African suicide rates reveals that officers of the SAPS are 11 times more likely to commit suicide than the average South African citizen and are five times more likely to commit suicide compared with police suicide rates internationally,” said Mamabolo.
He said the country ranked among the highest in terms of violent crime in the world, and this, as well as other pressing human tragedies, competed for police attention.
“This scale and scope of crime and restiveness is enough to put immense pressure on our 177 794 staff capacity that is expected to service a population of more than 60 million, all of which is complicated by the underlying causes of crime in South Africa, which are embedded in a complex mix of inequality, disenfranchisement and the legacy of apartheid.”
Mamabolo said this was further compounded by the limited chances of promotion, the shortages of resources and unfair practices in relation to compensation.
He said there were also inconsistencies in the leadership which continued to cause divisions in the law enforcement environment.
South African Police Union (Sapu) spokesperson Lesiba Thobakgale said they were concerned with the lack of mental health support for officers.
“Police officers do suffer from stress informed by the nature of their job as they attend crime scenes which are traumatic, and they don't get debriefed thereafter,” he said.
Like Popcru, Sapu has also blamed the failure of the Employee Health and Wellness (EHW) programme for not providing the help the officers need.
Teacher unions say mental health should be made a priority, given the stress levels their members have to deal with.
South African Democratic Teachers Union (Sadtu) general secretary Mugwena Maluleke said there were no official records of who was on stress leave or had been admitted to rehab to conquer their addictions.
He said in general, many schools had teachers who took long leave to deal with mental health challenges, but this was not documented for confidentiality reasons.
“Teachers are highly affected and really struggling to deal with their stress levels because of the workload that was exacerbated by Covid. They are calling for mental health to be an agenda item in all platforms to demystify this urgent matter,” said Maluleke.
Basil Manuel from the National Professional Teachers Organisation of South Africa (Naptosa) said teachers were under a lot of stress, and there were no reliable support systems to help them.
He said violence in schools, large classes with up to 60 pupils in some cases and the ramifications of Covid-19 were things teachers had to deal with every day.
Manuel said these high stress levels manifested in many ways, like absenteeism, substance abuse and a lack of focus.
While some teachers opted for early retirement, leaving them with financial problems, the education system also lost experience which could not be acquired overnight. “When you see how many people are just desperate to break away, it’s sad,” he said.
Democratic Nursing Organisation of South Africa (Denosa) spokesperson Sibongiseni Delihlazo said they had raised the issue of mental health as a matter of urgency with the government, especially when they were in the midst of the pandemic.
He said health facilities were severely understaffed, and many healthcare professionals, not just nurses, had left the medical profession, especially at the height of Covid.
“They are overburdened and do not have any time to recharge, and many leave applications by nurses during Covid-19 were declined on the basis that there was not enough staff. That means those that are at work must be burnt out to death," said Delihlazo.
He said they had not received any support from the government.
“They were depressed because they were losing patients left, right and centre, and this took a huge toll on them, and the psychological effects of this are huge. Why was this happening unabated?"
Delihlazo said, previously, there were support structures at government facilities, but these no longer existed.
“For instance, you used to have psychologists who were on standby at healthcare facilities and whenever healthcare professionals were going through trying times. The psychologists were around, and they would debrief them on the spot so that they were able to heal and do the work the patients required.”
Delihlazo said only the Steve Biko Hospital in Pretoria beefed up its psychological support during this time.
He said research by the International Council of Nurses found they were either moving to other professions or resigning because of depression and a poor support system in facilities where they worked.
“Poor pay and burnout were also reasons, and that obviously put a lot of pressure on the few healthcare workers that we do have.”
He said this drove healthcare workers away from the public sector, and the government could do a lot to improve the situation.
However, Department of Public Service and Administration spokesperson Moses Mushi said most departments had employee health and wellness programmes in place. Some departments had internal professionals who provided counselling to staff, while outsourced external service providers usually had a network of professionals to assist employees with mental health issues.
Mushi said departments also had various physical activities like aerobics, soccer and netball to reduce stress and other mental health issues.
He said from January to June this year, only 3 362 public servants out of about 1.3 million took “long incapacity leave”, which could be 30 days or more and for a number of ailments.
The Independent on Saturday
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