Mental Health Matters is published five times a year with the objective of bringing information and support to South Africa’s GP’s in their role as first line care givers and identifiers of mental health issues.

Sept/Oct 2017  I CURRENT EDITION  I VOLUME 4  I NO. 5

In the midst of the Life Esidimeni tragedy, in which almost 100 mental health care users died and others were harmed, causing unbearable distress to their
families, the Department of Justice quietly published a draft Bill to amend to the Criminal Procedure Act (CPA). The Bill followed the 2015 Constitutional
Court judgment in De vos v Minister of Justice and Constitutional Development, a case about the treatment of people with mental illness and intellectual disability by the criminal justice system, and in which the court declared certain provisions of section 77(6)(a) of the CPA to be inconsistent with the Constitution and invalid.

U Rugege

• What is PMB ?
• Debunking myths about PMBs
• Understanding chronic conditions benefit?
• Which mental illnesses are covered by PMB’s and which ones are not?
• Which is the medical aid that caters best for mental health?
• What is the PMB for different medical aids or different schemes?

A Sweidan

Whilst the obvious shortterm goal is to treat the identified children presenting to us with Anxiety, it should be obvious from the preceding articles that finding and actually treating these individual children is a drop in the ocean, compared to the challenges posed by the extent of the crisis at this time. We also know that so many children have no access to mental health services in their communities whatsoever. We, as mental health and health professionals, together with those from multiple sectors of our communities and broader society need to be working together on a multilevel model for addressing the increased incidence of Anxiety in South African children.

H Clark

In the second quarter of this year I had the privilege to represent The South African Depression and Anxiety Group (SADAG) and South Africa at the fourth annual Global Patient Advocacy Summit. The summit was hosted and organised by Lundbeck in Copenhagen, Demark with this year’s theme; “One voice – together we will make a difference.”

Z Mbele

Bipolar Disorder (BD) in children and adolescents is recognised as a valid, clinical entity. Once considered to be a rather uncommon condition, it’s noteworthy that BD in adolescents occurs at a prevalence of 1.8% in diverse community samples and up to as much as 20 – 30% in clinical settings and in-patient populations. The diagnostic criteria for DSM-5 are the same for children and adolescents, as for adults. More recently concern has arisen that BD in adolescents has gone from being under-recognised to misdiagnosed and over-estimated. Much of the controversy around making a diagnosis of BD in adolescents has arisen out of the fact that diagnostic criteria have limitations in their developmental relevance.

WJ Duncan

As humans we are by nature, social creatures. We have an innate desire to be accepted by others. Our survival in the world relies heavily on effective social functioning, enabling us to avoid danger, access resources, protection and life-partners. Effective social cognitive functions are essential for aspects such as empathy, decision-making in social contexts, social judgements and identifying the emotions of others. The ability to interpret social cues is therefore important in our everyday capacity to live among people, get along and fit in.

L Taljaard

Pregnancy and having a child is a time of growth and hope, but it’s also a time when a woman is very vulnerable. Not everyone experiences the glow of the perfect pregnancy, and caring for a new baby is often hard, unrelenting and lonely. Many women experience frustration, resentment, guilt and anxiety, and in turn seek help for these feelings.. The challenge for health professionals is to differentiate between these often normal feelings and perinatal mental illness.

B Vythilingum

These are three examples of different types of people who presented with suicidal ideation and suicide attempt. As people can present at various life stages and for various reasons and with a multitude of symptoms, it’s important to be aware of the warning signs of Suicide. I’ve broken them up into three categories: what people say, how they act and what they feel:

G Chiba

These are banners we see very time we attend conferences in America. All over the internet there are warnings, horrifying anecdotes and statements about the dangers of stimulant use in children and adults. Every day, I hear statements like: The popular myths surrounding the use of stimulant medication include that they are addictive, harmful to the brain, and can change personality. What is the truth?

R Liebenberg

Chronic pain is one of the most common complaints in physicians’ practices worldwide, affecting individual patients, their social networks and productivity in the workplace. The annual costs of chronic pain in the United States of America (USA) exceeds $100 billion annually. Chronic pain is associated with functional impairment, temporary and permanent disability,
psychological distress, sleep disturbances, mental health problems and substance use disorders. It’s reasonable to assume the treatment gap (i.e. those who would benefit from treatment but never receive it) in local populations is significant, although there exists little empirical data to inform accurately on this. Subsequently, pain and the optimal treatment is as much of a social issue as a medical issue.

M West

Any individual diagnosed with Anxiety and Depression is acutely aware of the severe consequences on their overall functioning. These conditions can impact extensively and intensively on cognitive, behavioural, emotional and physical well-being. From cycles of negative or racing thought patterns, to withdrawal from social relationships, to labile emotional reactions to physical exhaustion (among other symptoms) anxiety and depression are associated with widespread and debilitating impacts. The standard evidence-based recommended treatment for these conditions, has traditionally been a combination of psychotropic medication and/or cognitivebehavioural psychotherapy.

K Pillay

If I could communicate one thing to General Practitioners, it would be that AUTISM IS TREATABLE. Asperger’s syndrome is one of several previously separate subtypes of autism which now fall under the umbrella diagnosis of Autism Spectrum Disorder (ASD) in the Diagnostic and Statistical Manual, DSM-5. It’s recommended individuals who previously had a wellestablished diagnosis of Asperger’s disorder be given the diagnosis of ASD. The DSM-5 specifies three
severity levels: “requiring very substantial support”, “requiring substantial support”, and “requiring support” across two diagnostic domains: social interaction and communication, and restricted, repetitive patterns of behaviour. ASD is increasingly prevalent, with an estimated 1 in 68 school-aged
children having been identified as having ASD in a Center for Disease Control report published in 2016.

J White

Schizophrenia and everyday functioning

Schizophrenia is a chronic, debilitating disorder associated with significant impairment in social and occupational functioning. The relationship
between Schizophrenia and impaired functioning may be driven in part by deficits in Social Cognition, which encompasses different key mental processes
that enable us to process social information, interact with other human beings, and make sense of the everyday world around us.

S Kilian, H Luckhoff, R Emsley

My name is Alex and I have Bipolar Disorder! Now before everyone in unison simply replies “Hi Alex!” I wish to tell you my story. Growing up with a schizophrenic Afrikaans uncle and a father whose bloodline promotes Bipolar, I wasn’t winning any genetic popularity awards.

Zane Wilson Founder SADAG

  • Neil Amoore,
  • Psychologist, Johannesburg
  • Kevin Bolon,
  • Psychologist, Johannesburg
  • Dr Jan Chabalala,
  • Psychiatrist, Johannesburg
  • Dr Lori Eddy,
  • Psychologist, Johannesburg
  • Lee-Ann Hartman,
  • Psychologist, Johannesburg
  • Dr Frans Korb,
  • Psychiatrist/Psychologist, Johannesburg
  • Professor Crick Lund,
  • Psychiatrist, Cape Town
  • Dr Rykie Liebenberg,
  • Psychiatrist, Johannesburg
  • Dr Colinda Linde,
  • Psychologist, Johannesburg
  • Zamo Mbele,
  • Psychologist, Johannesburg
  • Nkini Phasha,
  • SADAG Director, Johannesburg
  • David Rosenstein,
  • Psychologist, Cape Town
  • Professor Dan Stein,
  • Psychiatrist, Cape Town
  • Professor Bernard van Rensburg,
  • Johannesburg
  • Dr Sheldon Zilesnick,
  • Psychiatrist, Johannesburg
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