Category Archives: End Stigma
This post is crossposted By Analía Sierra
When our eyes met
At first everything was new, I did not know what to expect. I got at the end of those nine months without enough information but with all the excitement and expectation that would be the most important moment of my life.
I had many fears, and they all were reason for my hospitalization- I have always been a healthy woman and have never been in a similar situation- My concern about that was big, I have never liked the idea of going through a surgery and this was the closest I was going to be to a surgery room … In my mind I had the old phrases , which grandmothers and mothers say, “You will forget everything, … it is a special moment and such a joy when you deliver your child all pains stops” … When the moment arrived, everything went slowly. They were long 11 hour of waiting … waiting for something I wasn’t sure what or who, if the anesthetist, the obstetrician or my child deigns to leave …
Analía’s blog is also available Spanish
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Tell your story to help raise awareness for maternal mental health issues so that more women will get treatment and fewer will suffer. Submit your blog here
Source: When our eyes met – WMMH Day
The second in a series of blogs by Dr Robert Nettleton, Education Advisor, Institute of Health Visiting, on his travels to Cape Town, South Africa through his Florence Nightingale Foundation Travel Scholarship 2017. He met our director, Simone Honikman, and our clinical team at Mowbray Maternity Hospital:
“The connection between a ‘trauma-informed’ approach and infant and perinatal mental health was obvious from my visit to the Perinatal Mental Health Project team at Mowbray Maternity Hospital, led by Simone Honikman.
There is an ‘epidemic of mental distress among women living in adversity’. Alongside wealth, there are extensive townships or informal settlements that are a legacy of the apartheid era in which, for example, 50% of women are HIV positive and levels of domestic, gender-based and sexual violence are high, as is poverty. Providing for accessible front-line assessment of mental health distress is a priority, through providing training to a range of workers and also within the community through ‘social connectors’ (I’ll learn about this more next week).
A challenge that resonated for me was about promoting quality and consistency in a fragmented system where there is also a heavy reliance on separate NPOs (not-for-profits) as providers of services.
Two key learnings for me were:
- The importance of what Simone calls ‘self-care’ – what we might call supervision with a substantial restorative component. I met, briefly, Charlotte who provides counselling out of a cubby-hole of an office in a maternity hospital. Her heart was bigger than her office! Maintaining resilience is something that we know is important, and the ‘Sollihull Approach’, while not rolled out in Cape Town, was something that colleagues recognised as applicable.
- The dilemma of seeking to deliver a quality service within a very low-resource environment. This resonated with me as we face resource pressures in the UK. We discussed and reflected on what would be the essential elements of a service (the ‘active ingredients’ or ‘programme mechanisms’) and what could be delegated or substituted without placing effectiveness at risk. The ability to form effective empathic relationships is one of those essential elements common to both South Africa and the UK, as is support and supervision.”
What is empathic engagement and why is it important?
Empathy is the ability to perceive the meaning and feelings of another person and to be able to communicate these to that person. Empathy is a core aspect of building relationships and positive client interaction. When care workers engage empathically with clients, clients feel empowered, service uptake is improved and clients are more likely to adhere to recommended interventions and treatment regimens. There are also benefits for the care workers who report less burnout and enhanced work satisfaction.
Studies have shown that empathic engagement does not necessarily take up more time, is not emotionally exhausting like being sympathetic, and does not overburden the care worker, as the client maintains responsibility for their own problems. In addition, this type of communication can actually save time, effort and expense as the relevant client issues are more quickly identified resulting in early and more effective management.
Building up to empathic skills: learning about maternal mental health
Stigma, related to a lack of understanding and negative stereotyping of those with mental illness, is a significant factor in communities and among care workers. We attempt to reduce this stigma through the provision of background information about maternal mental illness and related medical and social problems. We encourage participants to work in small groups, engage with, discuss and apply our training material in a way which is relevant to their unique situations and work environment.
We noted a gap between the perceived ability and actual ability of workshop participants to engage empathically. Most participants struggle to “listen” and accept the client’s perspective without judgment. Instead, they very quickly assume they understand the problem and revert to “telling” and “fixing” based on their own perspective and experience.
Read more on how to develop a meaningful training, how to support trainers and how to evaluate the training process in our Learning Brief
A number of new studies have found that stress, depression or anxiety during and after pregnancy can have long lasting effects on the development of your child.
We have translated some of those findings into an Issue Brief and added some of our recommendations for evidence based interventions for parents.
This Issue Brief outlines not only the risk factors for parents, but also encourages the building of resilience to prevent or lessen the negative impacts for children.
“Caring for mothers and fathers – is caring for the future”
One in three migrant women from low- and middle-income countries has symptoms of perinatal depression
Migration and perinatal mental health in women from low- and middle-income countries.
In this systematic review and meta-analysis the authors summarising the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC).
Even though they found that the prevalence of perinatal depression is very high among migrant women, the data they found was insufficient to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population.
Furthermore the authors stress, that given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority.
Read the abstract in the BJOG – International Journal of Obstetrics and Gynaeocology
Interested in mental illness among displaced, migrant and refugee women in South Africa? Read our Issue Brief
#DignityInMind – Raising Awareness on World Mental Health Day
On Monday 10 October 2016 people across the globe will commemorate World Mental Health Day, and in Cape Town, South Africa, it’s no different.
With four screenings of various documentary films focusing on mental health in South Africa, the #DignityInMind Documentary Film Festival aims to educate and empower Capetonians to speak up about mental health.
The festival forms part of the #DignityInMind campaign spearheaded by the Alan J Flisher Centre for Public Mental Health (CPMH). This year’s campaign brings together mental health organisations from across the entire country to share their ideas and support one another’s activities for an even bigger campaign and an online hub where information and events are shared.
The #DignityInMind Festival will be taking place at the Labia on Orange in Cape Town. This will include he much-anticipated Cape Town premiere of Doc-U-Mentally, a documentary looking at the physical and mental challenges five doctors on a 30-hour shift at Ngwelezane Hospital in Empangeni, KwaZulu-Natal face.
Other documentaries to be screened, include Voices from the Edge. This short film investigates the work of the Programme for Improving Mental Health Care in South Africa and Nepal and takes the viewer on a journey of 2 Nepalese and 2 South African families personal experience of living with, or supporting a family member living with mental illness.
Caring for Mothers confronts viewers with the massive challenges South African mothers with perinatal mental health problems face every day and it shows how the Perinatal Mental Health Project aims to relieve this burden.
Normal is a short documentary looking at a day in the life of Dr John Parker, a psychiatrist at Lentegeur Psychiatric Hospital and the director of the Spring Foundation.
Shows rotating these films will be screened at 11:30, 13:45 and 16:00. The Doc-U-Mentally premiere will take place at 18:15. Entry for all four shows will be R40 and can be booked by calling 021 424 5927. Ticket will also be available at the door.
For a full programme, please visit the #DignityInMind campaign website at bitly.com/mentalhealthsa.
The Alan J Flisher Centre for Public Mental Health (CPMH) grew out of a shared vision and commitment to collaboration between members of the Department of Psychiatry and Mental Health at the University of Cape Town (UCT), and the Psychology Department at Stellenbosch University (SU).
This year’s initiative is possible thanks to the following partners:
Adding their voices to this year’s call for dignity in mental health, are the Perinatal Mental Health Project (PMHP), Programme for Improving Mental Health Care (PRIME) and the Mental Health Innovation Network Africa (MHIN Africa) – all from UCT – and Cape Mental Health (CMH), the South African Federation for Mental Health (SAFMH), RuReSA & the Rural Mental Health Campaign (RMHC), LifeLine Western Cape, Khuluma, the Ithemba Foundation & the Mental Health Information Centre (MHIC).
Bush Radio is a proud media sponsor of the #DignityInMind campaign.
Suicide prevention is a serious public health priority, globally and in South Africa (SA). The World Health Organization (WHO) estimates that annually 800 000 people die by suicide, with the number expected to rise to 1.53 million by 2020. For every completed suicide there are approximately 20 non-fatal suicide attempts. As many as 75% of suicides occur in low and middle income countries.
In SA suicide accounts for 9.6% of all unnatural deaths and there is approximately one completed suicide every hour. Data from the National Injury and Mortality Surveillance System suggests that 80% of suicides in SA are male and the number of suicide deaths is highest among individuals of 15 to 29 years of age.
Read the full blog by Dr Jason Bantjes on our DignityInMind campaign site.
To mark World Suicide Prevention Day we’d like to focus on suicidal thoughts during the perinatal period
Mothers’ emotional needs can go undetected during the perinatal period where there is much attention on the baby and women often face multiple difficulties. Studies have shown that women at risk for suicide may be easier identified, by increasing screening of expectant and new mothers for major depression and conflicts with intimate partners. Thus care providers and family may be able to detect symptoms and signs of suicidal thoughts and possibly prevent further distress or the development of suicidal behaviour.
Symptoms and warning signs include
– Talk of suicide or dying “If I died, would you miss me?” or “It would be better if I were not here or dead.”
– Depressive symptoms, including feelings of guilt, hopelessness or no sense of the future.
– Feeling isolated or wanting to be alone “No one understands me”.
– Obsessive thinking – thinking ‘too much’, especially about harming oneself or dying
– Giving things away (clothes, expensive gifts), “When I am gone, I want you to have this.”
Read this and other Issue Briefs on our website
#WSPD16 will be commemorated on 10 September
Join the conversation on Twitter with the hashtag #WSPD16
“Cindy* neglected her four children to such an extent that social workers removed the youngest two, both toddlers.
But after Nadia Drotsche, a social worker dealing with Cindy, attended a course on empathic training, she realised that Cindy might be depressed rather than an uncaring and lazy parent.”
Abused in labour, depressed after giving birth – pregnancy can be a nightmare for women. But an inexpensive intervention by the Perinatal Mental Health Project (PMHP) is trying to change this by teaching caregivers to listen, empathise, and identify depression.
Read more in this article by Kerry Cullinan in the Daily Maverick