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.


The election of Cyril Ramaphosa as President of the country brought a new spirit and a belief that all South Africans could live and work together for the benefit of everyone. A new beginning looms as we move from an era of darkness marked by corruption, State capture, kleptocracy and the systematic plundering of the country’s resources. Ramaphosa’s State of the Nation address on 16th February 2018 challenged us to explore our commitment to building bridges and looking to the future with hope as we seek a shared prosperity.

H Nowbath

Child Mental Health is an ideal state – a goal to which all countries should continually strive. It’s well enshrined within the Millennium goals 2015-2030 of the WHO. Child Mental Health (CMH) is a state of total wellbeing of the child rather than just the absence of illness. In South Africa our approach to CMH has become the treatment in some children of defined Mental Illness, even more the management of distress and behaviour problems with the aim of helping them fit into systems they need to progress through. There are more barriers to
Mental Health than enhancers. Here I will focus on Mental Health service barriers to achieving Mental Health in our children.

H Clark

With days left of school holidays, your kids will be squeezing in every late night, lazy morning and fun in the sun they can. Nothing spoils their holiday than an eleventh hour rush to get ready to go back to school. Trading holiday fun for school can be difficult for any child, but for children living with Attention Deficit Hyperactivity Disorder (ADHD), getting used to classrooms and homework again can be a challenge.

Sourced from MYADHD. Q&A by L Kelly

1. It’s all about them
Many patients who start therapy initially find it very selfindulgent, foreign and peculiar to spend an hour only talking about themselves. Some more anxious patients may worry that they come across too selfcentred and others just may find it strange to have a space dedicated completely to themselves. It’s important for them to know they can leave the social niceties of reciprocal conversation behind in therapy and make it all about themselves! They’re invited to explore and verbalise any thought that comes to mind, no matter how
frivolous or arbitrary these may be. What they speak about doesn’t have to be well thought out and neatly packaged and it’s okay for them to speak in an unfiltered way. It’s when they are able to do this that

S Tsarafi

Within the mental health field, the definition of parasuicide is somewhat debated. In the South African setting, the term tends to be applied to patients who are admitted for medical care due to purposeful selfinflicted injury that did not result in death. This includes overdose of medication, ingestion of harmful substances, and hanging. Parasuicide is, however, distinct from habitual self mutilation.

D Tzoneva

We all know that at some point we’re likely to have trouble with our health. And, because we ‘know’ this, you’d think it would make it easier for us to cope when our particular spot of bother comes along. Those who are philosophical and
more detached and who rely on their rational minds in a crisis, might have the advantage here. However, getting bad news, whether about work, a love affair, or your health can frequently be difficult, even devastating. Usually when something negative happens to us, like failing an exam or being rejected by a partner or being in an armed robbery, it’s our ego, the part of our mental functioning responsible for regulating our relationship to reality that takes the hit.

L Gower

Aetiology and Symptoms
Psychogenic Non-Epileptic Seizures (PNES) or pseudoseizures are ‘attacks’ that may look like Epileptic seizures: they are time-limited, paroxysmal changes in movements, sensations, behaviours, or consciousness. They’re also often misdiagnosed as Epileptic seizures. However, they’re not caused by abnormal electrical discharges in the brain (epileptiform activity and there is no electrical activity on an EEG), as is the case in Epilepsy. PNES episodes are, instead, a manifestation of Psychological distress.

J Rice

About 12% of the general population and as many as 50% of all psychiatric patients suffer from a Personality Disorder. Personality Disorders are a predisposing factor for other Psychiatric Disorders or medical conditions, and are frequently associated with Comorbidity, such as Depressive or Anxiety Disorders. They are also associated with other problems, such as regular job changes, divorce, increased accidents and premature mortality. The medication used, e.g. mood stabilisers, can lead to weight problems and the so-called metabolic syndrome. Treatment resistance – for example a poor response to antidepressants in someone presenting with a Depressive Disorder, can be due to an underlying Personality Disorder.

M Böhmer

As a GP you are often the first professional someone consults with, when they are feeling off colour. You then have the tricky job of figuring out their level of physical and mental health, and the role stress may be playing in their symptoms. Then it’s a matter of finding the source of that stress, while knowing that everyone goes through work and personal stress in their day to day life. So when is work the cause of your patient’s illness, and what can you do about that?

C Linde

I want you to try something; as you sit where you are place your feet firmly on
the ground, become aware of your posture, the seat underneath you, the sounds in your environment. Now bring your attention to your nose and feel as you breathe cold air in and warm air out. Focus only on your breathing, if you are distracted by a thought – that’s okay, acknowledge it and bring your attention
back to your breathing. See if you can do this for five minutes.

Were you able to centre yourself? If you were, that’s an experience of Mindfulness. For many this might be a near impossible task! Grounding oneself, feeling centred and practicing mindfulness is an incredibly difficult skill.

S Green

My world began to gradually shrink. By sixth grade, I was afraid to go to school. I needed my mom to stand outside the classroom. Just thinking about being at school made me so nervous I couldn’t even get out of bed to get there some days.

I saw different doctors but no one seemed to be able to help me. “Maybe it’s stress?” “Maybe it’s not enough sleep?” “Maybe it’s just a teenage stage?” they would say.

R Bernstein

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