South Africa was facing a mental health crisis prior to the lockdown, and there is a risk it will worsen if we are not proactive in dealing with it, experts have warned.
As government prioritised curbing the spread of Covid-19 by enforcing a lockdown which would restrict the movement of people and avoiding social interaction, similar efforts to support the mental health of people during this time were not initially prioritised, they add.
An online survey conducted by the South African Depression and Anxiety Group (SADAG), during the first few weeks of lockdown, which included views of over 1 200 participants, revealed that most (65%) of people felt stressed. SADAG is a non-profit organisation and the country's largest mental health support and advocacy group.
SADAG has since received more calls about anxiety, stress and depression, related to the lockdown. "Before lockdown we received 600 calls per day. Now we get between 800 and 1200 calls per day. Some days are quieter, but when there are changes in [lockdown] regulations or guidelines, there is a slight spike in the number of calls," said SADAG Operations Director Cassey Chambers.
People are dealing with stress brought on from retrenchments, pay cuts and even the idea of having to go back to work makes them anxious, Chambers explained.
When asked if authorities could have prepared better for the mental health implications of lockdown, Chambers said that at the time the physical aspects of Covid-19 like washing hands or social distancing to prevent the spread of the virus was prioritised. But the impact of the virus on other aspects of life such as employment, family and finances were not immediately considered.
Chambers said it was important to be proactive by addressing mental health issues by creating awareness and building resilience among people before it's "too late".
"We were already in a mental health crisis before Covid-19, but we did not have enough support and facilities. Now during Covid-19 it's even few and far between. If we do not make mental health a priority, the mental health crisis we had before Covid-19 could become even worse," Chambers said.
As the lockdown has progressed, there have been various responses to try support professionals as they deal with the mental health impact of Covid-19.
So far, SADAG has partnered with other health bodies such as the SA Medical Association and the SA Society of Psychiatrists, among others, and this week launched a nationwide support network specifically for healthcare workers.
The Healthcare Workers Care Network, which can be accessed via its website or through toll-free calls and text, has over 500 volunteer mental health professionals providing free support and pro bono therapy to doctors, nurses, community healthcare workers, among others, especially as they brave the pandemic which can take a toll given longer working hours and because they are at risk of burnout.
Chambers said the network was launched after observing from countries abroad that healthcare workers had felt the pressure of Covid-19, and even reported suicides.
SADAG also partnered with Business for South Africa (B4SA) in developing guidelines for managing mental health during Covid-19. The guidelines were released in May. "Mental health is under prioritised in pretty much all sectors … we're kind of going one step at a time to really create awareness," Chambers said.
When asked how the productivity of the workforce might be impacted by the mental health implications of Covid-19, Chambers said it was important for people to understand anxiety and depression impacts daily functioning.
Working in a crisis
"As much as the economy has opened, we are still working in a crisis. It has a huge impact on how we function," said Chambers.
Professor Renata Schoeman, head of the MBA in healthcare leadership at the University of Stellenbosch Business School, explained that people were experiencing different stressors during this time. For example, they might not have the stress associated with commuting to work anymore, or introverts may not find working from home stressful as they don't experience "people fatigue".
But there are others who are feeling the stress of retrenchments and the financial implications of that, or having to figure out how to use new technology to connect to work, or having to create a workspace at home while juggling family responsibility, and others are worried about whether they are delivering their tasks well to ensure they keep their jobs.
Some are also stressed about having to return to work, and whether they will cope with a new normal, having to wear personal protective equipment in some cases.
Schoeman said that in order to stay mentally healthy, even though they are physically distant, people should continue to tap into their support systems, via phone calls and the like, to remain "socially close". "They must take their emotional temperature," she explained.
Ensuring good mental health is a collective response from employers and employees, she added.
Individuals need to get back to the basics, such as getting enough sleep, exercising, eating healthily, staying socially connected with people or reaching out to others who may be at risk such as those living alone. Employees should also make sure they access healthcare when needed and at the same time, employers should offer a supportive environment such as allowing employees to attend consultations. There should also be a culture within the organisation which supports good mental health, she explained.
"This is a high-risk period. Maybe it's a good idea of thinking how we can tap into support systems and put support structures in place for employees," Schoeman added. Covid-19 might be an opportunity employers can leverage off to create the required support systems and to talk about it, she said. "Stigma is born out of misconception, ignorance or lack of knowledge. The best thing to deal with stigma is to have the conversation."
Clinical psychologist and author Dr Colinda Linde said that some people might be overworked during this time, as the boundaries between work time and home time have become "blurred". Some employees might feel they can't complain because they feel lucky to still have jobs. "I have heard many say that they responded to work calls and mails over weekends as it took a while for them to realise it was a Saturday afternoon!" she said.
The lack of certainty regarding lockdown regulations and for the future, especially when it comes to job security, has been gnawing at people. "The anchors people were used to, in an already ever-changing country, have now also shifted. We have never experienced a pandemic and there is also global uncertainty and anxiety about the future," Linde said.
Employers can help counter the feeling of mistrust or lack of certainty about what’s going on, by being transparent about salary cuts or retrenchments. "[It's] far better to keep staff in the loop, even if the news is bad," Linde explained.
"Both anxiety and depression impair cognitive functions such as making rational decisions, problem solving, sustaining concentration. Depression also impairs short term memory and motivation," Linde said. "Low energy and interest" are also symptoms of anxiety and depression. These factors will impact productivity of employees.
Linde has several tips for coping during this time. They include:
- Have a clear daily routine – scheduling time for work, rest and play and take breaks.
- Get dressed for the work day, even if it's at home.
- Use technology to stay socially connected.
- Pets can provide emotional support and companionship; don't discount this!
- Speak up if your workload is becoming unmanageable or if deadlines are unrealistic.
- Maintain your boundaries between work time and home time – it’s not clockwatching, it's protecting your ability to function efficiently and contribute optimally.
For more resources go to Dr Linde's website: www.thoughtsfirst.com
Sadag website: www.sadag.org
Discovery's podcast on Covid-19 and your health: https://www.discovery.co.za/corporate/podcast-covid19-and-your-health