Make a Mental Note

“Without mental health there can be no true physical health” – Dr Brock Chisholm, the first Director-General of the World Health Organisation (WHO)

Dr Brock Chisholm was a psychiatrist who asserted the notion that mental and physical health are linked, and an increasing amount of evidence highlights the impact that mental illnesses — particularly depression and anxiety — can have on physical health. Even though this may be the case, policy unfortunately still continues to lag behind when it comes to addressing mental health issues in South Africa.

Wednesday, 10th October marks this year’s World Mental Health Day, which will focus on young people and their mental health. Presented by the World Federation of Mental Health, the goal of this day is to raise awareness about mental health issues and encourage people to help those dealing with such issues.

Statistics show that approximately a third of South Africans will suffer from a mental health condition in their lifetime, which can affect a person’s capacity to maintain relationships and a job. However, the stigma attached to many mental health issues makes it even more difficult for those affected to get the help that they so vitally need, which causes further problems — be that physical, social or financial.

One of the first steps in dealing with mental health issues is to quash any ill-informed and damaging attitudes. This can be done by raising awareness as to the facts, so that we can develop a better understanding of the problems that so many people face. Once it is widely recognised that a mental health issue is a valid medical issue, we can set about further identifying causes and working on better solutions.

Mental Health and Medical Schemes

Being diagnosed with a mental health condition can be unnerving, and understandably comes with questions regarding treatments and long-term prognosis, as well as what will be paid for by medical aid. However, the Director of the South African Depression and Anxiety Group (SADAG) notes that “individuals accessing mental health and psychiatric services are frequently uninformed, not only about what services are offered, but also about what to expect from mental health and psychiatric professionals. Mental health and psychiatric patients frequently complain that they haven’t been told their diagnosis, what the medication they have been prescribed is for, or what to expect from the medication. “

There have been some disturbing issues with medical aid schemes in South Africa, as psychiatric patients often haven’t enjoyed the same rights as those with more general medical conditions (in both the public health sector and by private medical aid schemes).

Although some medical aid providers have tried to make changes to their plans, it is still often the case that not all medical conditions are afforded equal consideration. It’s important to understand that a psychotic episode can be compared to a heart attack in its unpredictability and debilitating nature.

However, psychiatric medications are prescribed less readily than medications for heart disease, and some medical aids only cover 15 outpatient visits each year or three weeks of hospitalisation for patients with mental illnesses.

Costs can become quite substantial when it comes to treating a mental illness, and many patients who have found the right treatment are unable to afford it. Sadly, the majority of people in low to middle-income brackets don’t receive any treatment for severe disorders. It is a Catch-22 situation in that a mental illness can severely impact someone’s financial productivity, leaving them in a situation where they don’t have the necessary funds to treat their condition in order to be able to function properly and earn money again.

This World Mental Health Day, it’s important to know your rights when it comes to the treatment you are eligible to receive for a mental health condition. Your expectations should be in line with what your scheme offers, so don’t hesitate to arrange a meeting if you have any doubts.

Medical schemes currently have Prescribed Minimum Benefits (PMBs), which provide access to a basic minimum of health services, regardless of the chosen plan. These are a feature of the Medical Schemes Act to ensure that medical schemes fully cover the costs related to the diagnosis and treatment of emergency and chronic conditions. Even a hospital plan should offer PMBs, although a medical aid provider can have certain conditions to obtaining these benefits.

Try to set aside some time to familiarise yourself with your scheme’s provisions and protocols, and make any changes if necessary. Prioritise both your mental and physical well-being, and don’t underestimate the prevalence or effects of mental health conditions.

Information for this blog was sourced through leadsa.co.za.