Maternal Mental Health in Cameroon

Didier Demassosso met online with PMHP Director, Simone Honikman, and junior researcher, Lele Sigwebela to discuss his journey with maternal mental health in Cameroon. During Didier’s work with a local mental health organisation that provides psychosocial support to adolescents/teens mothers -UNIPSY- he noticed the growing problem of maternal mortality among teen mothers. This sparked his interest in maternal mental health in adolescents and adult mothers. The World Maternal Mental Health Day campaign validated for him that poor maternal mental health is globally recognised as a risk factor for maternal mortality.

Didier Demassosso is a clinical psychologist and educator. He works with communities in Cameroon in health and mental health promotion. Didier is the co-founder and communication and public relations officer of “UNIPSY et Bien-etre” a clinical psychology and mental health organisation working in Cameroon to promote mental wellness. Additionally, he is the assistant secretary general of the Association of Science Journalists and Health Communicators for the Promotion of Health in Cameroon (AJC-PROSANTE). He has had consultancy positions with the WHO in the provision of MHPSS (Mental health and psychosocial support) in the South West regions of Cameroon.

Didier developed a working hypothesis linking high blood pressure, physical risk factors during pregnancy, and possible increased maternal mortality rates – to the absence of mental health care services in Cameroon. He became interested in the causes of the high rates of maternal and child mortality in Cameroon and developed a small mental health service. The service involves an introductory psychoeducational information session. Following the session, Didier administered the EPDS to a variety of women: new mothers, pregnant mothers with children and breast-feeding mothers. Women received their scores (range 0-30) via SMS and were given information on what the scores means. High risk mothers (with scores of 10 or more) were offered individual counselling sessions which were organised via SMS. Follow up included reminders and resources via SMS. The SMS service was also offered to low-risk mothers, providing them with the opportunity to seek support.

In 2018, at Mount Mary Hospital (Buea), Didier screened 30 women for symptoms of antenatal depression. Most of the women screened had high literacy levels and over 80% had very high EPDS scores (15 or more). During post-screening interviews with Didier, the high-risk mothers easily spoke of the quality and nature of their emotions. Many attributed their sadness to their partner mistreating them or being absent. However, none of them related their psychological symptoms to problems with their mental health. In 2020, Didier worked in the District Health Centre in Kumba, where most women have low or no literacy levels and are subsistence farmers. Many are seriously affected by the ongoing armed conflict in south west Cameroon.

In March 2019, during an antenatal clinic after he gave a mental health talk, Didier conducted EPDS screening with the collaboration of the staff of the maternity ward of mount Mary hospital in Buea, Cameroon

Following the same process as in Buea, he found that nearly two thirds of 29 women had high EPDS scores (with scores of 10 or more). The main concerns reported by these women were low access to psychosocial support and poverty.

From Didier’s experience, there was a very low uptake of counselling by high-risk mothers. He believes this could have been due to the pregnant women not seeming to accept and understand that mental health status can affect pregnancy. However, women in Kumba responded well to the SMS service, despite the minimal uptake of counselling. 

Didier has observed in the community a substantial lack of knowledge about mental health and hesitancy to speak about mental health matters. He also expressed that maternal health professionals have difficulty in understanding and supporting mental health interventions because their knowledge of mental health is limited. In government (public) hospitals and clinics, provisions for mental health are limited; there are few mental health nurses or occupational therapists. Furthermore, counselling and clinical psychology services are not offered by the government and as a result, there are no formal internships for clinical work. In fact, Didier provides his services for free, as a volunteer.

However, interest in mental health and maternal mental health is developing in Cameroon. There are experts and psychologists specialising at local institutions in this field. However, the mental wellness sector remains small and mostly private. Didier is confident that the more that women are encouraged to have conversations about maternal mental health, that greater awareness will be generated and hence, that advocacy work will be more impactful. In 2019 and 2020 Didier hosted public talks and radio interviews in Cameroon aimed at health professionals and the public, to encourage the development of conversations about maternal mental health. Online advocacy and promotion have also been an effective methods to raise awareness in his country.

World Maternal Mental Health day was celebrated for the first time in Cameroon on the 1st of May 2019 in the maternity ward in Mount Mary Hospital Buea and the for the second time in Kumba.

Didier believes that it was because he advocated for the link between maternal wellbeing and mental wellbeing, that many health workers are really open to the initiative. Presently, the UNIPSY project staff are trained to identify risk factors and provide support for pregnant teens experiencing distress.

Didier is also a consultant for Ministry of health, who are very open to enable mental health services. However, there is a need for funding. Although maternal mental health awareness is only at the beginning stages in Cameroon, there is a strong will to make services accessible. He believes that “Mothers need to know about mental health. If you’re not feeling happy there is someone who can help you.”

Providing the evidence for sustainable policy change

By Siphumelele (Lele) Sigwebela, Junior Research Officer

The research process often starts out like looking for a needle in a haystack. You read through reams of information and try to figure out what is missing, what has not been considered, and what can be improved. At PMHP the service, clients and community guide the research.

The service informs us about the reality of maternal mental health care. We analyse outcomes from our service and notice the patterns that emerges from the report. We garner insights  from various stakeholders, from service providers, academia and affiliated local and regional organisations to support our investigation. With teamwork and continued input from these stakeholders, we develop research that can impact and send a clear message about what is needed and what is unseen in our clients’ communities. 

Although our research has revealed a strong prevalence of mental health problems which are exacerbated by violence, hunger and poverty. It has equally revealed how we can adapt services and interventions, through collaboration to support mothers. At the heart of it, our research tells the story of a hard-stricken community and its efforts to improve lives.

Visit our website to find out more about PMHP’s Knowledge Generation programme.

The PMHP advocacy approach and key messages for this campaign

The PMHP advocates for action towards maternal mental health care for all mothers. Our advocacy efforts aim to influence and change perceptions and awareness about maternal mental health across a wide range of audiences.

We contribute to global maternal mental health initiatives and engage with regional, national and local stakeholders to build the case and influence policy and practice for integrated maternal mental health care.

Poor mental health of mothers and caregivers can significantly shape children’s futures. It can have a huge impact on cognitive development and risk of mental ill health for the child, in both the short and long term.

We need greater investment in maternal mental health care. We must invest in caregivers in the same way that we invested in vaccines – to be universally accessible for all.*

We must invest in early screening and treatment for maternal depression and anxiety. This will have a high return of investment not just for women, but for the whole family and the whole of society.*

* Adapted key advocacy messages by the #MHForAll session on mental health of parents and adult caregivers.

Visit our website to find out more about PMHP’s Advocacy for Action programme.

Mental Health Journeys

Stories from our clients 

Lulu felt ashamed and guilt for not being able to provide for her children’s basic needs.

Lulu’s* second baby was born when lockdown began. Lulu had not prepared for the arrival of baby and to make matters worse, her husband was now without a job. She felt completely hopeless and often described feeling down and depressed. Conflict between her and her partner increased after the birth of baby, with Lulu feeling he was not doing enough to support her.

Graphic by Graeme Arendse

Counselling with Liesl offered Lulu a safe space to talk about the fears and anxieties she was experiencing as a mother, in the midst of a pandemic, with little access to resources and no support from family and friends. Lulu experienced a lot of shame and guilt around not being able to provide for her children’s basic needs. The counselling also offered the opportunity to explore resources where Lulu would be able to get support.

Lulu proudly started volunteering at a local non-profit organization after she was referred there by Liesl for support with baby supplies. Lulu has expressed appreciation for having the opportunity to work with women who share similar experiences to hers; unemployment, poverty and other vulnerabilities. This informal “support group” has functioned as an emotional refuge for her and others during this difficult time. It has been a long time since Lulu has felt good about herself.

Lulu continues to make use of the counselling programme. With Liesl’s support, Lulu has started looking for a full-time job. She continues to work hard on developing herself. Lulu has shown great commitment to the counselling programme and often expresses her appreciation for the ongoing support.

*Not the real name of the client. Some details have been changed to protect anonymity. 

“The atmosphere in the house was tense”

My name is Johanna. When Sr Matsha examined me at the clinic, she noticed that I was very quiet during the examination. Although everything was fine with my pregnancy, Sr Matsha knew that something was wrong with me. I had filled in a mental health screening questionnaire, which is routinely offered in the clinic. I had a high score but didn’t understand what it meant. When Sr Matsha approached me to offer a referral to the PMHP counsellor, I started crying and couldn’t talk. Sr Matsha arranged for me to see the PMHP counsellor right away because she did not feel comfortable sending me home in such a state. The counsellor saw me immediately.

I had woken that morning with a feeling of dread. My partner had come home in a bad mood from work the night before and the atmosphere in my house was tense.

Graphic by Graeme Arendse

Before I left for my appointment at the clinic, I needed to prepare breakfast, get my 7-year-old ready for school, and arrange for my 3-year-old to stay with a neighbour. My partner was not satisfied with the porridge I had made for him and started yelling at me. I kept quiet and continued getting the children ready. After I had taken my younger child next door, my partner asked me if I had gossiped about him to the neighbour. I said no, and started walking out my house with my older child. He began hitting me on the arms and face, pushing me against the wall and calling me a liar. My child ran away, crying.

While I was telling my story to the counsellor, I already started feeling better. Over the next few sessions, the counsellor focused on the ongoing cyclical nature of abuse in my home. Eventually, I felt empowered to leave my partner. When he would not accept my decision and threatened to kill me, the counsellor assisted me in taking out a police protection order against him. I ensured my family’s safety by arranging to stay with my cousin, who had experienced a similar situation and was supportive. With the help of the counsellor, I was able to cope with this situation and have a healthy pregnancy.

*Not the real name of the client. Some details have been changed to protect anonymity.

For more stories from PMHP clients visit our mother’s stories

The PMHP is committed to client confidentiality in keeping with the ethical requirements of professional mental health practice. The client stories reflect common scenarios or sets of circumstances faced by many of our clients. Pseudonyms are used and details are changed. The stories are not based on any one particular woman's experience, unless an individual explicitly chooses to share her story with or without her name attached.

Providing a holistic space for Hanover Park mothers

PMHP services is more than ‘just’ counselling

By Tyla Prinslo, PMHP Mental Health Counsellor

The picture painted from the peripheries of a community is never quite the real thing. When news is shared about the difficult circumstances or gun violence it tends to fill you with a sense of dread. This dread has become immersed in empathy and urgency to act. 

Becoming part of the community as a mental health ally introduces a more nuanced look at life in the area. The opportunity to work with mothers, is not something to be taken lightly. In that first encounter I have been invited into a generational experience of life and its meaning. There has been a journey, where mothers are seen, held and valued. Where knee-jerk survival is put on pause for just a moment and the counselling experience invites: peace. 

Peace takes on various forms, ranging from information and empowerment to emotional literacy. Maternal mental health involves a collaborative effort to repair bonds, strengthen personal agency and ignite hope.

PMHP providing a space for moms and staff 

PMHP Hanover Park counselling site and garden

During the Hanover Park site construction, PMHP worked in partnership with the Community Health Clinic infrastructure and joined forces with the ‘Greening of Hanover Park Project’ and planted a garden at the facility. During development, the Western Cape experienced a period of significant drought and subsequent water crisis. Thus, the garden at the site includes water-wise plants and fynbos found throughout the western coast of South Africa. Facility staff have expressed great appreciation for the opportunity to enjoy a calming, therapeutic garden in what is an often challenging working environment.

In addition to the garden, the Ebrahim family, who regularly support PMHP projects and have a keen interest in maternal mental health, donated a bench for visitors to sit and enjoy the vibrant garden.


Much time has been spent on the development of the bench. We want to encapsulate the spirt of the women who use our services, the Ebrahim family and the Hanover Park MOU. We reached out to Lovell Friedman, a local mosaic artist and activist, to design and create the bench.

Vuyiseka with her children Inathi Mzamo and baby Wakhile Mzamo working on the new HP bench

Lovell has designed benches for activist organisation “Rock Girl!” who brings awareness to sexual violence in South Africa. She has trained numerous mosaic artists from previously disadvantaged communities who are now working independently.

Lovell and her team of mothers are excitedly working on the mosaic bench which we hope will provide a tranquil, calming space for mothers attending our service. We are excited to reveal the bench later in May.


Below are video messages from Farouk and Raeessa Ebrahim:

Dr Raessa Ebrahim on collaborating with the PMHP to create a comfortable environment for mothers attending the HP counselling site

Dr Farouk Ebrahim on the Ebrahim’s connection to South Africa

Expanding our circles of support

Prior to the COVID pandemic, PMHP started a Mother-baby support group. We hope to continue these when it is safe to do so.

Read more about our Mother-Baby support group in Hanover Park in this blog post.

The PMHP Mother-Baby Support Group in Hanover Park

By Thanya April, PMHP Counsellor

Thanya April, PMHP Counsellor, with group participants

In response to PMHP clients expressing their extreme hunger during the COVID pandemic, Liesl Hermanus linked with a local community organisation providing meals to families in need.

In this blog post, Liesl describes her experience engaging with the Alcardo Andrews Foundation.

“We all have something we can share and help with” – insights from Hanover Park, Cape Town, South Africa

By Liesl Hermanus, Clinical Services Coordinator

The Alcardo Andrews Foundation Task Force Team delivering cooked meals to different satellite stations in Hanover Park.

PMHP response to COVID19 with virtual counselling

In response to crisis of the COVID-19 pandemic, our counselling service at Hanover Park needed to be adapted. Our two counsellors, Liesl Hermanus and Thanya April explored new ways of engaging with clients whilst adhering to physical distancing regulations. Before the lockdown, telephonic counselling was used to check in with clients and to conduct postnatal assessments. Since then, we have expanded our telephonic service and added a digital platform to include the use of WhatsApp for keeping connected with clients. Where possible, we conduct some sessions via Skype.

Left: Liesl conducting a brief counselling session with a client over WhatsApp

Right: Thanya testing the e-counselling platform on Skype

The mothership – from humble beginnings to thriving services (Part II)

This blog is part of our #maternalMHmatters series

PMHP’s investment in Maternal Mental Health in South Africa
Liesl Hermanus, PMHP Clinical Service Coordinator with HP staff (left) client (centre) and during a virtual counselling session (right)

Liesl Hermanus joined the PMHP in 2011 as part of the Hanover Park research team, having completed her psychology internship in Hanover Park through CASE (Community Action towards a Safer Environment). She holds an Honours degree in Psychology from the University of the Western Cape and is an HPCSA registered counsellor. From 2007 to 2010, Liesl served as a counsellor at the National Responsible Gambling Programme providing support to people with gambling problems and their family members. She was a school counsellor at St Anthony’s Primary School before joining the PMHP.

Returning to work in the community of Hanover Park after her internship placement appealed to Liesl, and her familiarity with the particular challenges faced by this community adds enormous value to the PMHP service located here. Liesl is a Capetonian and has a son.

In this blog post Liesl shares her reflections.

Working in the Hanover Park community ’10 years on’

I remember the day I came across the PMHP job application for a mental health officer in Hanover Park and thinking to myself “Wow, this is really something I could see myself doing”. Five years prior to that I had completed my psychology practicum through a NPO, CASE, in Hanover Park. In addition to that, my late grandfather was living at an old age home in the area and I was in and out of his place at the time. And then, my mother who is a clinical nurse practitioner, had previously worked at Hanover Park Community Health Centre. I remember I would wait for her to come home from nightshift and as soon she walked through the door, I would ask her “Who came in last night?” She always had stories for days. This was my first introduction to Hanover Park.  There were many factors pulling me back to this community. Not only had I felt a sense of familiarity with the community but also an awareness of the adversities and vulnerabilities those living in Hanover Park were facing.

I have a morning routine where I go to every department in the MOU to greet my colleagues – what a great way to start my day. Staff often have very interesting stories to share, this was generally the best part of my day. Through sharing stories about our lived experiences both inside and outside of the workspace, we came to know each other on a deeper and more personal level.

For the first few years of working in Hanover Park, I had always been warned not to go anywhere on my own and I was made to feel the area wasn’t safe. I often found it ridiculous that I was having to drive to the shop which was a stone’s throw away from the facility. Sharmaine, the health promotions officer at the MOU, often accompanied me across the road when I was feeling brave enough to walk. But there was one day Sharmaine wasn’t around and I desperately needed something from the shop. And so I decided to walk across the road on my own, something I had never done before. I saw Hanover Park in a different light this day. The culture and energy of this community was so palpable in the air. The taxi drivers and fruit vendors on the terminus all greeted me and many had recognized me from the MOU. At no point did I ever feel threatened. This was the first walk of many on the streets of Hanover Park, an experience that made me want to tell the story of those living in this community. The next few years would see me meeting so many different people and going places some wouldn’t dare. I refused to let fear stop me from experiencing this community and its people and made it my mission to change the narrative about those living on the Cape Flats, particularly men, using photography as a medium to do so. Today, I have an online profile dedicated to the community of Hanover Park, dedicated to telling the untold stories of the people living here.

I recall 2019 being a particularly hard year. The gang violence seemed worse during this time compared to previous years and the effects of working in a community where there is constant trauma seemed to have taken a toll on me. I was also supervising two psychology interns at the time in addition to running the clinical services site. I was running on empty and thought that perhaps it was time to pursue other avenues. I decided to start looking for other work. This was one of the hardest decisions I have ever had to make in my life. Hanover Park and maternal mental health had become my life. The idea of doing anything else seemed nearly impossible but something was amiss for me, and I was no longer happy. Something needed to change.

However, instead of leaving, I successfully applied for a promotion. Now, nearly ten years later I can proudly say I am the Clinical Services Coordinator of the PMHP at Hanover Park MOU.

And then there was 2020 and Covid-19. It became obvious to me that many clients were being deeply affected by the Coronavirus pandemic and resulting lockdown. Large numbers of clients were now facing more severe hunger and other forms of vulnerability. Pregnant women and new mothers were struggling to take care of themselves and their newborn babies without sufficient support from their families and the broader communities.

It was in the process of trying to identify organizations in Hanover Park that could possibly assist our clients with food support that I learned about Aunty Avril, the founder and director of the Alcardo Andrews Foundation. I remember the day I met Aunty Avril. It was 21 April 2020. I recall phoning her and explaining how with Covid-19 and lockdown we were seeing an increasing number of clients at Hanover Park MOU appealing for assistance with food. Without asking for anything in return, Aunty Avril agreed to accept pregnant and postnatal mommies for food support.

At this point, all I knew about Aunty Avril is that she was feeding around 600 people daily in Hanover Park. One evening I decided to Google “Avril Andrews” and couldn’t believe all the articles and videos about the amazing work she has been doing. It was the first time I learned about her son Alcardo, who was gunned down in 2016 and that the organisation was started in response to his untimely death. I learned about the “Moms Move for Justice” group initiated by Aunty Avril where she was supporting other mothers who had lost children to gang violence. There was one article in particular that caught my eye, which was published by The Daily Maverick. The heading read “Hanover Park’s safety net for the needy: We’re here because Aunty Avril is here for us”.  When lockdown was announced, Aunty Avril closed her daily feeding programme. But it wasn’t long before she started serving again. She could not ignore the calls of the many hungry people outside her home.

It is amazing thinking about how the nature of our relationship evolved over time from very professional in the beginning to that of a mother and daughter. There is one message Aunty Avril sent that will always stay with me: “I don’t have words to say how grateful I am to have met you. I lost my son four and a half years ago but I’m blessed with a daughter coming alongside and supporting me. Thank you. I appreciate you.”

As challenging as 2020 was, it was also a time of change, both personally and professionally. I had officially taken on the role of PMHP Clinical Services Coordinator, the highlight of my fifteen-year career working in mental health. I don’t know if I will be around for another ten years, but I certainly hope the PMHP will still be, continuing to support vulnerable pregnant women and mommies not only in Hanover Park but the greater South Africa.

The mothership – from humble beginnings to thriving services

This blog is part of our #maternalMHmatters series

PMHP’s investment in Maternal Mental Health in South Africa

Why Hanover Park?

Hanover Park is a low-income community in which the social and demographic hardships faced by women and girls increase their vulnerability to common mental health conditions, especially during pregnancy.

Around 6600 women and girls attend the Midwife Obstetric Unit (MOU) every year, yet no dedicated mental health support service was available when we started our services in 2011. By locating a maternal mental health service in Hanover Park MOU, we were able to serve a broader range of beneficiaries from the greater Klipfontein Sub-district who access this site for maternity care. These communities are among the most disadvantaged of the Cape Flats.

Image: Typical low-cost Apartheid-era council flats in Hanover Park

Women live in fear of the volatile gang violence on the streets, where shootings and crossfire deaths are regular occurrences. At the same time, they frequently experience violence in their own homes. With low-socio-economic status, it is extremely difficult for these women to exercise agency over their situation in their homes and on the street.

Our own peer-reviewed research shows that one-third of the women for whom we provide counselling, experience violence in their homes – at the hands of their partners or other members of the household.

The PMHP response

The PMHP received support from Truworths Social Involvement Trust for the construction and furnishing of a three-roomed clinic building with garden at our Hanover Park site on the premises of the Community Health Centre (CHC).

Here, we provide mental health screening, individual counselling and follow-up care for women attending the adjacent Midwife Obstetric Unit at the CHC. Our mental health counsellor – now clinical coordinator – Liesl Hermanus, has been with us for 10 years and is well integrated in to the CHC setting and local community.


Hanover Park in pictures: from the folder storage room to our HP counselling garden

Prior to the construction of our building, mental health counselling took place in a folder storage room.
From construction site to opening of the PMHP HP counselling site

On March 2012, the PMHP unveiled its new building. We were honoured to have UCT Vice-Chancellor, Dr Max Price, as our Guest of Honour. In his speech, he acknowledged the PMHP for serving the University’s ‘core commitment to being a socially responsive Afropolitan university’.

Left to right: PMHP Director Dr Simone Honikman, Thabisa Xhalisa and Sharon Kleintjes (Board of Advisors) and then UCT Vice-Chancellor Dr. Max Price

Since then, the garden has been transformed and cared for by our Maintenance Assistant Godfrey Abrahams.


PMHP Maternal Support Service

Initially, the counselling service at Hanover Park operated through our mental health screening tool development study. This research resulted in the development of a brief, validated tool for depression, anxiety and suicidality which has been incorporated into the Maternity Case Records (the national standard booklet of maternity stationery).

Since then, the PMHP provides individual, face-to-face counselling by trained counsellors. The counsellors assess each client and adopts a flexible approach to suit individual needs. These interventions may include containment, psycho-education, bereavement counselling, debriefing of traumatic incidents, relaxation and breathing exercises, couple and family counselling, as well as suicide and impulse risk management. The PMHP maintains a continuum of care for clients into the postnatal period.

In 2020, to augment the PMHP service, we added a part-time, junior-level counsellor, to Engage, Assess and Triage (EAT) all screen-positive women into low-intensity or high-intensity care, according to their needs.
Low-intensity care involves counselling facilitated by the junior counsellor while high-intensity care involves counselling and psychotherapeutic interventions from the more experienced, professional counsellor.

The aim of this stepped-care approach is to ensure greater intervention coverage of the women attending the MOU. This, combined with distance-based digital support (Skype, WhatsApp and telephone), established during the COVID-19 pandemic, is described in the new PMHP service flow diagram below:

PMHP Adapted Service Diagram

PMHP’s investment in Maternal Mental Health in South Africa

To commemorate World Maternal Maternal Mental Health day and Maternal Mental Health week we will be highlighting our investment in maternal mental health in under-resourced communities in South Africa.

We are starting this series with this short introduction video (click on the image to play)

Watch this space for daily updates from our #maternalMHmatters in Hanover Park series!

16 Days of Activism against Gender-Based Violence – a perspective from Hanover Park, South Africa

The African continent has the highest reported rates of violence against women. South Africa, in particular, has been identified as one of the most violent countries in the world. Gender-based violence (GBV) is a risk factor for some of South Africa’s most prevalent and serious health problems, including

  • HIV and sexually transmitted infections
  • unintended pregnancy
  • pregnancy complications, including miscarriages
  • substance abuse
  • and common mental disorders, such as post-traumatic stress disorder, depression, anxiety as well as suicidality.

The consequences of abuse can be carried from one generation to another. Abuse and violence undermine social cohesion and the social and economic development of a nation.

Today, 25 November 2020, marks the start of the #16Days of Activism Against Gender-Based Violence campaign. As an organisation focused on mothers and their children, we will be using this time to highlight GBV against pregnant women and new mothers, from our mental health service site in Hanover Park, Cape Town.

Hanover Park and surrounds

The majority of our clients reside in Hanover Park and immediate surrounding areas and are at a high risk of experiencing GBV due to a variety of factors. On the one hand, these women live in a volatile community experiencing gang violence on a regular basis – both in their homes, and on the streets. On the other hand, women in Hanover Park have low-socio-economic status and are often marginalised by society. It is extremely difficult for these women to exercise agency over their situation in their homes and on the street.

Our own peer-reviewed research* shows that one-third of the women for whom we provide counselling, experience gender-based violence in their homes – at the hands of their partners or other members of the household.

The PMHP Response

Since 2012, we have provided a comprehensive maternal support service at the Midwife Obstetric Unit (MOU) in Hanover Park. This includes information sharing with women, screening, counselling and psychological therapies, facilitated referrals according to need, and case management.

Our comprehensive, trauma-informed counselling service incorporates several possible ways to work with our clients to address GBV. These include trauma counselling, interpersonal and cognitive behavioural therapy, safety planning, social support and managed referrals, as well as follow-up care, with the opportunity for remote support sessions (Skype, telephone) according to clients’ preferences. In addition to this, our counsellors work very closely with a wide network of NGOs including shelters, food support organisations, social services and addiction treatment facilities so that referrals may be facilitated, as needed, while we maintain an ongoing therapeutic relationship with the women. Survivors of GBV often require continuity of care and ongoing psychological support to overcome the impact of the violence and to develop strategies to optimise the safety and wellbeing of themselves and their children.

Trust and safety

Our on-site counsellor at the MOU, Liesl Hermanus, together with our junior counsellor, Thanya April (who is currently working remotely), create a safe space for vulnerable pregnant and postpartum women. A significant amount of time goes into the foundational work of building the therapeutic relationship so that the client feels she can trust the counsellor. This then helps the client establish clear goals and have agency in working with the counsellor towards her own safety and wellbeing.

Resources and stories

Throughout the #16days campaign, we will be sharing informational resources for women experiencing GBV. These resources were created over the years and some have been adapted for the Messages for Mothers campaign as a response to the increase in domestic violence during the COVID-19 pandemic

Also, we will be using this campaign to share some of the realities of the lives of our clients experiencing GBV. In order to protect the anonymity of our clients, we will change names and identifying details and combine elements of more than one case into these stories.

———-

*Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed-methods study (2018)
S Field, M Onah, T v Heyningen, S Honikman, BMC Women’s Health
DOI: 10.1186/s12905-018-0612-2

The impact of COVID-19 on pregnant women’s mental health

Women in our communities show enormous strength and resilience in looking after the wellness of their families under difficult circumstances. The COVID-19 pandemic has added to this stress.

While women are looking after the wellness of their families, it is of utmost importance that they also look after their own wellness and mental health. Pregnant women are particularly vulnerable to mental health risks. The  Covid-19 pandemic adds worries about the risk of infection, job security and financial constraints onto existing perinatal stress. Globally, incidences of anxiety and depression among pregnant and postnatal women are at an all-time high.

The Royal College of Obstetricians and Gynaecologists notes that “Pregnant women are not immune to the mental health impacts of the pandemic and may be more at risk given the many compounding factors, including the fear of becoming infected, transmitting the infection to her infant if infected, social isolation, financial difficulties, potential reduction in household help, insecurity, and the inability to access support systems. Particular attention should be paid to these aspects of maternal care.”

In response to the multiple challenges that expecting or new mothers face, the PMHP has teamed up with other organisations that work closely with mothers, and have resources and experience in supporting mothers, to form the Messages for Mothers (M4M) alliance. Together with Embrace, Grow Great and Side by Side we have developed culturally appropriate mental health messages to support mothers during these difficult times.

These messages include tips on managing stress, depression and anxiety as well as coping with family violence during the pandemic.

Throughout the coming week, we will be posting several mental health messages, which are compiled in this easy to print brochure.

Follow our social media channels to learn more:

ico-social-twitterico-social-facebookico-social-blogico-social-youtube
ico-social-instagram

 

 

Further readings:

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