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It’s okay not to be okay

15 October 2020 | Story Angie Vorster | Photo Supplied

Angela Vorster_web read more — 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

Open letter from Prof Jonathan Jansen to all UFS students

2014-02-22

Dear Students of the University of the Free State

In the past four years there has emerged a new consensus on the three campuses of the University of the Free State (UFS) about the things that divide us – such as racism, sexism and homophobia. Students and campus leaders have worked hard to develop this new consensus in residences and in the open spaces on campus. There can be no doubt that new bonds of friendship have developed across the markers of race, ethnicity, class, religion and sexual orientation. I bear witness to these new solidarities every day on the campus.

You chose a white student to head up the transformation portfolio on the SRC. You chose a black captain to head up the university’s first team in rugby. You chose a white “prime” as head of residence to lead a predominantly black men’s residence. You chose a South African woman of Indian descent as Rag Queen and last week, a black student from Cape Town as the men’s Rag winner—choices not possible and never made before in our campus history. Many of you have intimate friends who come from different social or cultural or religious backgrounds. You learn together, share rooms together, pray together and party together. In other words, in the day to day workings of this university campus, you have demonstrated to campus, city and country that we can overcome the lingering effects of racism and other maladies in this new generation. You have helped create a university community inclusive of people of diverse religions, abilities, class and sexual orientation.

I have said this repeatedly that from time to time this new consensus will be tested – when a minority of students, and they are a small and dwindling minority, still act as if these are the days of apartheid. And when that consensus is tested as it was this week, and as it will be tested in the future, only then we will be able to assess the strength and durability of our progress in creating a new South African campus culture of human togetherness based on respect, dignity and embrace.

The real test of our leadership, including student leadership, is how we respond when our transformation drive is threatened.

Let me say this: I have absolute faith in you, as students of this great university, to stand together in your condemnation of these vile acts of violence and to move together in your determination to maintain the momentum for the Human Project of the University of the Free State. We have come too far to allow a few criminals to derail what you have built together in recent years.

There will, no doubt, be unscrupulous people on all sides of the political spectrum wanting to milk this tragedy for their own narrow purposes. There will be false information, rumours and exaggerations by those who wish to inflame a bad situation to gain mileage for their agendas. That is inevitable in a country that is still so divided.

I ask you, through all of this, to keep perspective. Two or ten or even twenty students behaving badly do not represent 30,000 students; a minority of violent and hateful persons do not represent the ideals, ambitions and commitments of the majority. At the same time, let us be realistic – anyone who thinks you can drive transformation without resistance clearly does not understand the difficult process of change.

The events of the week remind us, however, that we still have a long road to walk in deepening social and academic transformation at our university. Yes, we have invested hundreds of hours in training and mentorship; we have created new structures – such as the Institute for Reconciliation and Social Justice – to capture the energy and imagination of students driving transformation; we have created many opportunities for students to study and travel on this and other continents to enable cross-cultural learning; we have established formal and informal opportunities to dialogue about difficult issues on and off campus between students and their leaders; and we crafted new curricula to enable teaching and learning on the big questions of our times.

But this is clearly not enough, and so I have decided on the following immediate next steps:

We will meet for several hours next week to think about how we can deepen the transformation of our university after this terrible incident.
We will arrange a University Assembly on the events of the past week so that we speak with one voice on human wrongs and to re-commit to human rights and we will continue with open forum discussions during the months to come.
We will review the entire spectrum of programmes, from orientation to residence life to the undergraduate curriculum, to determine how effective our interventions really are in reaching all students with respect to basic issues of human rights.
We will review our media and communications strategy to determine how far and deep our messages on human rights travel across all sectors of the university community. In this regard it is important that the campus be blanketed on a regular basis with our condemnation of human wrongs and our commitment to human rights.
We will commission the Institute for Reconciliation and Social Justice to review the events of the past week and make recommendations on how we can improve the campus environment so that all students are protected from harm inside residences, classrooms and in open spaces of the campus.
We will take the questions raised during this week into the academic community and to the general staff of the university so that all personnel also engage with our own roles and responsibilities with respect to campus transformations.
We undertake to make annual report-backs on transformation to all stakeholders in public forums so that students and staff and external communities can track the progress of the university on matters of human rights on campus.

I wish to thank my staff for acting firmly as soon as this tragic event came to our attention. We worked through the night to find and identify the perpetrators. We traced the two students and immediately handed them to the police. They were expelled. And throughout this process we offered counselling and support to the victim of this violent act.

The two former students were expelled and will now face justice in the criminal courts. It is hoped that in the course of time they will come to their senses and seek restoration and reconciliation with the student they so callously harmed. They are not part of the university community anymore.

That is the kind of university we are.

Jonathan D Jansen
Vice-Chancellor and Rector
University of the Free State
20 February 2014

Note: The use of the word ‘campus’ refers to all three campuses of the UFS, namely the Bloemfontein Campus, South Campus and Qwaqwa Campus.

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