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15 October 2020 | Story Angie Vorster | Photo Supplied
Angie Vorster is a Clinical Psychologist in the School of Clinical Medicine, University of the Free State

As a mental healthcare provider, I approach the end of every year with some trepidation. As soon as the August winds start to blow in Bloemfontein, we tend to see a distinct increase in our community’s psychological distress. The year 2020 has not spared us this increased burden of suffering.

This year has presented humanity with extreme challenges and our university community has felt this to our core. The latest research indicates that the South African population has been affected by the pandemic in various ways and on various levels but none less severe than our psychological health. One in three South Africans will present with a psychological disorder during our lifetime (and this was prior to the Covid-19 outbreak); and the effects of the pandemic have caused a significant rise in depression, anxiety and trauma symptoms among South Africans.

In mourning 

We are experiencing exceptionally high levels of financial stress due to the impact of the disease and lockdown on our economy. We have endured months of social distancing, fears surrounding our own health and the well-being of our loved ones, our financial safety, managing our children’s home-schooling, adapting to distance-learning and concerns about the academic year being salvaged. We have had to experience loss after loss. We mourn loved ones, colleagues and acquaintances that have become ill or passed away due to the pandemic. We have mourned the loss of our normal lives. The hugs, handshakes, casually touching someone’s arm, the shows, sporting events, weddings, graduations and braais we took as for granted. We grieve for a time before sanitising and masks and avoiding contact with our fellow humans was the daily norm. We miss our offices and tearoom banter. We miss being with our students. Amid all of these losses we know that our rates of gender-based violence, suicide and substance abuse have increased. When people are forced to spend time with others in confined spaces amid increasing financial, health and social stressors, frustration and fear may lead to damaging reactions and dysfunctional coping mechanisms. 

World Mental Health Awareness Day on 10 October could not have arrived at a better time. This year the World Health Organisation is encouraging investment into mental healthcare across the globe. While this is an essential step in increasing access to mental healthcare services, it is also only one aspect in the use of psychological treatment resources. One of our most important barriers to providing mental healthcare often lies within us. Mental illness remains one of the most stigmatised conditions in society; even though each one of us will be affected by our own, or our loved ones’ mental-health problems at some point during our lives. Some of the common problematic and erroneous beliefs society holds about people who struggle with mental illness is that they are somehow deviant, dangerous, weak or even faking it. Unfortunately, our healthcare workers are not immune to such prejudicial attitudes and neither are their patients. Self-stigmatisation occurs when we internalise these discriminatory generalisations and fail to access mental health care because we believe that we should be stronger, or just pull ourselves together or worry about the impact of receiving a psychiatric diagnosis on our career or our relationships. 

Silence is one of the most insidious barriers 

We fear being judged by our healthcare providers, our employers, colleagues, family and friends. This culminates in a situation where we lead lives of quiet desperation – numbing our distress with distractions and substances and perhaps even work. The silence surrounding mental health is one of the most insidious barriers to accessing treatment – because you cannot be helped if nobody knows you are suffering. This is the tragedy of suicide, which more frequently than we wish to believe, is the final symptom of depression and severe psychological illness. I have had to assist more patients than I care to recall to work through the trauma and grief of losing a loved one to suicide. Perhaps one of the most tragic aspects of this is that almost all would sit in utter shock recalling how their loved one had seemed fine. How this came out of the blue. How he or she had never told anyone how difficult life had become for them. How hard it was to get out of bed each morning. How much energy it took to go through the motions of a normal day. How ultimately they were so ill that they believed that they were a burden to their family and friends. How they could see no hope of relief from their pain other than to end their lives. And nobody knew. They were silent in their suffering because of fear of stigma, judgement, rejection or being viewed as a burden. 

The surprising gift of the pandemic

Mental illness does not discriminate against anyone. It affects professors, students, support staff and the greater university community equally. Nobody is spared these struggles. This is what we all share,   the human experience of life's seasons which we cannot do alone. When we need the help of more than our resilience, support structure and exercise routine. This is where the pandemic has brought some unexpected gifts. Prior to March of this year, it was very unusual for psychologists to provide online or telephonic therapy. In fact, many medical aids were uncomfortable covering teletherapy. Once we had no other alternative; however, we all had to adapt. Suddenly I no longer only saw patients who were able to attend sessions at my office. Now I could assist students and doctors who were in lockdown across the country. I could refer patients to the appropriate therapist, irrespective of where they were. Patients no longer had to negotiate the uncomfortable experience of waiting in a psychologist's waiting room or being seen leaving an office looking upset or need to take time off work to attend a session. Now patients can access their psychotherapist from the containment and confidentiality of their own space, and we in turn, are more freely available as we are not bound to a specific venue. 

Receiving psychological treatment is becoming as normal a part of well-being as going for a run, or eating healthily or spending time with our social support system. And this is what is going to save lives. The more we normalise the use of psychological services, the less stigma and silencing we will be subjected to.

We survived a pandemic 

As a clinical psychologist I proudly tell my students, colleagues and patients that I have my own psychotherapist without whom I would not be the therapist, colleague, friend and mom I am. There is no shame in owning our vulnerability and reaching out for assistance in order to make meaningful and even enjoyable the few journeys around the sun that we have left. So this October of 2020 should be the month when we start the conversation about our mental health. And by doing, so we permit those around us to do the same. We have survived a pandemic that changed the world and our daily lives. It's okay not to be okay.

Opinion article by Angie Vorster, Clinical Psychologist in the School of Clinical Medicine, University of the Free State

News Archive

Institutional research culture a precondition for research capacity building and excellence
2004-11-16

A lecture presented by Dr. Andrew M. Kaniki at the University of the Free State Recognition Function for research excellence

16 November 2004
The Vice Chancellor, Prof. Frederick Fourie
Deputy Vice Chancellors, Deans
Awardees
Colleagues and ladies and gentlemen

It is a great pleasure to be here at the University of the Free State. I am particularly honoured to have been invited to present this lecture at the First Annual Recognition Function for Research Excellence to honour researchers who have excelled in their respective fields of expertise. I would like to sincerely thank the office of the Director of Research and Development (Professor Swanepol), and in particular Mr. Aldo Stroebel for facilitating the invitation to this celebration.

I would like to congratulate you (the UFS) for institutionalizing “celebration of research excellence”, which as I will argue in this lecture is one of the key characteristics of institutional research culture that supports research capacity building and sustains research excellence.

Allow me to also take this opportunity to congratulate the University of the Free State for clocking 100 years of existence.

Ahmed Bawa and Johan Mouton (2000) in their chapter entitled Research, in the book: Transformation in higher education: global pressures and local realities in South Africa (ed. N. Cloete et. al Pretoria: CHET. 296-333) have argued that “…the sources of productivity and competitiveness [in the knowledge society and global economy] are increasingly dependent on [quality] knowledge and information being applied to productivity”. The quality knowledge they refer to here is research output or research products and the research process, which (research) as defined by the [OECD] Frascati Manual (2002: 30) is:

“…creative work undertaken on a systematic basis in order to increase the stock of knowledge, including knowledge of man, culture and society, and the use of this stock of knowledge to devise new applications”

The South African Government has set itself the objective of transforming South Africa into a knowledge society that competes effectively in the global system. A knowledge society requires appropriate numbers of educated and skilled people to create quality new knowledge and to translate the knowledge in innovative ways. To this end a number of policies and strategies like the Human Resource Development [HRD] Strategy for South Africa, the National Plan for Higher Education (NPHE) and the South Africa’s Research and Development [R&D] Strategy, have highlighted human resource development and the concomitant scarce skills development as critical for wealth creation in the context of globalization. The key mission of the HRD Strategy for instance is:

To maximize the potential of the people of South Africa, through the acquisition of knowledge and skills, to work productively and competitively in order to achieve a rising quality of life for all, and to set in place an operational plan, together with the necessary institutional arrangements, to achieve this.

The R&D Strategy emphasizes that maximum effort must be exerted to train the necessary numbers of our people in all fields required for development, running and management of modern economies. Higher education institutions like the University of the Free State have a key role to play in this process, because whatever form or shape a university takes, it is expected to conduct research (quality research); teach (quality teaching – and good graduates); and contribute to the development of its community! Thus the NPHE states that the role of higher education in a knowledge-driven world is threefold:

Human resource development;

High-level skills training and

Production, acquisition and application of knowledge.

Quality research output or knowledge which as argued is critical in determining the degree of competitiveness of a country in the knowledge economy is dependent upon quality research (process). Both the process of producing quality research and its utilization cannot and does not happen in a vacuum. It requires an environment that facilitates the production of new knowledge, its utilization and renewal. It requires skilled persons that can produce new knowledge and facilitate the production of new skills for quality knowledge production. Such an environment or in essence a university must have the culture that supports research activity. Institution research culture (that is a conducive and enabling institutional research culture) is a precondition to research capacity building. Without an institutional research culture that facilitates the development and nurturing of new young researchers it is difficult, if not impossible for a university to effectively and efficiently generate new and more quality researchers. Institutional research culture is also necessary to sustain quality research and quality research output or research excellence. It facilitates the development and sustenance of the institutional and people capacities required to do research produce quality research and generally attain research excellence!

We do recognize that the patterns of information and knowledge seeking, and knowledge generation vary among field or disciplines. For example, we know that in the humanities knowledge workers often work individually, and not as collaboratively as do those of the sciences, they all however, require supportive environments – institutional research culture to achieve and sustain research excellence. An institution does not simply attain a supportive research culture, but as Patricia Clements (English Department, University of Alberta, Edmonton) in her presentation Growing a research culture argues, research culture has to be grown [and maintained]. It unifies all natural and engineering scientists; medical researchers, humanists, and social scientists.

I therefore am of the view that Institutional Research Culture is critical to research capacity building and research excellence. I therefore want to spend a few minutes looking at the characteristics of research culture. To be effective, institutional research culture has grown and sustained not only at the institutional level, but also at the faculty, school and departmental levels of any university.

What is Research Culture?

In the process of researching on institutional research culture I identified several characteristics. Many of these overlap in some way. I want to deal with some of these characteristics; some in a little more detail while others simply cursorily. In the process what we should be asking ourselves is the extent to which an institution, like the University of the Free State, and its faculties, individually and severally, is growing and or sustaining this culture.

Institutional Research Strategy: As a plan of action or guide for a course of action, the institutional research strategy must spell out research goals that a university wants to achieve. It must be a prescription of what the university needs to be done with respect to research. As a strategy it is neither an independent activity nor an end in itself, but a component part and operationalization of the university policy or mission. ( Related to this is the Establishment of Institutional research policies)

Includes and makes public the targets, e.g. achieve so many rated scientists and make sure that every year we have so many SAPSE publications. That way people keep an eye on research agendas of the university and nation.

The UFS is obviously on its way, having launched its own Research strategy (A Strategic framework for the development of research at the University of the Free Sate. August 2003). Note that this strategy refers specifically to the “Culture of research” Fig 1

A set of administrative practices to support and encourage research. Patricia Clements (English Department, University of Alberta, Edmonton) in her presentation Growing a research culture argues that that research activity and output within the her Faculty (Arts) were very low and, in spite of the numbers of staff, with no Associate Dean for Research in the Faculty as though they had accepted that research belonged to Medicine and Science and Engineering, and teaching, separated from inquiry, belonged to the Arts. With the change in the thinking about research and development of research culture, it became clear that there was a major role for research support in a faculty her size (now about 360 full time continuing academic staff). The faculty developed a support system for research and began to address the SSHRC issues.

Reduce the bureaucracy system and micromanagement of research! This however, also implies that there is capacity and policies and procedure to manage and guide research processes

Establishment of Intellectual Property regulations and assistance

Research ethics policy and safeguarding by research administration

Focused, applied and suitable nature of the delivery mode (an institution open to new methodologies for conducting research

Programmes suited both full and part-time study particularly at graduate level (Mainly at Faculty/school and department level, and depending on what’s manageable)

Hiring senior academics to engage in, teach on and supervise postgraduate students to facilitate exchange of and transfer ideas and most importantly mentorship especially in view of declining numbers of researchers in particular fields

Quality instruction and facilitation in learning about research processes

A high retention rate of students maintained by the supportive and challenging learning environment and the use of online facilities to support collaboration and in-class learning

Availability of research grants: and awareness of sourcing funds from external sources like the National Research Foundation; Water Research Commission; Medical Research Council, private philanthropies and others outside the country. For example an institution should be able to assess how much of the slice the available funds (NRF etc) its able acquire and possibly top slice from institutional budget.

Adequacy of the financial reward system to encourage university staff members to do research (General Celebration of achievement for research excellence and achievement. This ranges form Annual reports mention; celebratory dinner. At Alberta researchers were given lapels. I don’t know of any academic who do not feel a sense of achievement to get into print or recognised. Access to research facilities within and outside the institution

Provision of infrastructure to support university-based research (e.g. equipment, admin support, etc.) – but also awareness of publicly funded and available research facilities and equipment!

Internet connectivity and changes in the bandwidth of the internet to download articles

Subscription to related bodies by the library so that researcher can download articles

Facilities and resources to attend international conferences to keep one updated

Number of visiting professors/speakers targeting senior scholars and invite them to lunch to ask them to participate and to encourage their best graduate students to do so within the institution and across institutions

Research training seminars for research students including young academics

Participation of staff/students in delivering research papers to national and international conferences

Establishment of research groups to provide interaction frameworks to achieve critical mass of research-active staff

Facilitation for more research time: Targeting new scholars and giving them reduced teaching loads in their first year or two for the purpose of developing their research programs. For the purpose of helping new colleagues to see the shape of South African research support, personalizing it, and creating research community

Take research to the community and argue its necessity, and utility

And, finally celebrating excellence. We must recognize achievement - parties and public recognition for colleagues who achieve splendid things in their research.

In conclusion, I want to reemphasize that research culture has to be grown it does not simply exist in an institution. If it is grown it needs to be nourished, nurtured and sustained. An institution cannot simply leave on borrowed reputation and expect to remain research excellent. It is on this basis that instruments like the National Research Foundation rating system recognizes excellence within a given period of time and not necessarily for a life time! This it is believed encourages continued research excellence.

THANK YOU and best wishes

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