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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

Prof Jonathan Jansen bids farewell to Kovsies

2016-08-31

Dear Kovsie staff and students

This is my final message to you all.

I wish to use this opportunity for some brief reflections, share a word of gratitude, and convey a sense of the future for our beloved university.

Since the announcement of my departure, I have had more than a dozen breakfasts with mainly students, but also staff, to offer an opportunity for the final sharing of thoughts and, of course, goodbyes. The most common questions asked at those breakfast sessions were the following, with my responses. I repeat them here, since these might also be of interest or concern to you.

What are your proudest achievements?
Two things. The increase in the academic standard for the UFS, both in terms of admission standards and pass rates, but also in relation to the requirements for appointment and promotion especially of professors. This is important because in a globally competitive world, a university stands or falls by the quality of its degrees. And for this you need the best students and the best professors.

What would you do differently, given another chance?
Nothing. I believe that leadership is about doing the best you can with the cards you are dealt in the circumstances in which you are placed. There is no point in second-guessing past decisions. I have always been ambitious as a leader, knowing that most of my goals would be met, and that some would not. That is normal in large and complex organisations, and so, I do not sit around pondering regrets, only remembering with gratitude the things we could achieve together.

What did you learn?
A lot. I learnt that our students have tremendous capacity for greatness both in their academic pursuits but also in their ability to live, and learn, and love together. I have learnt never to underestimate the capacity of our youth to excel in whatever they do. Sometimes I felt I was more ambitious for our students and staff, than they were for themselves. But I have constantly been surprised by the capacity of young students to rise above bitterness and division, and to make great our campus, country, and continent.

I learnt, again, that the overwhelming majority of our staff and students are good people, respectful of each other, and determined to work together to heal our broken past and build a more just society. And I learnt that it is much more fulfilling to build up than to break down, to embrace than to exclude, and to love than to hate.

Were you frustrated with the pace of transformation?
Sometimes, yes. But fortunately I studied educational organisations all my life, mainly schools and universities. Universities are called institutions for a reason, and on century-old sites like the historic Bloemfontein Campus of the University of the Free State, there are core beliefs, values, and practices deeply ingrained in the culture of the place.

Anyone, therefore, who believes that transformation is easy, has obviously never tried to change an old university. It is difficult. You will get blowback. You will get bad press. You will, sadly, lose the support of some people. Some believe the university is changing too fast while others will tell you it is not changing fast enough. As you press for change, you find the university going two steps forward and one step back; in these circumstances, the solemn duty of the leader is simply to ensure that the overall momentum is always forward.

For such a time as this –
a commemorative journey:
2009-2016 (PDF book)

I therefore budget for disappointment even as I relish the many changes we have experienced together over the past seven years. If you want to obtain an objective sense of the scale of the changes at the UFS, ask those students and staff who were here in 2009, not those who came recently. They will tell you that we have a very different university, even though we all acknowledge that there is still some distance to travel. Our remarkable story of change is told in the recent Transformation Audit of the UFS, chaired by Prof Barney Pityana; that Audit Report will be released after it is read and studied by the University Council at its November meeting.

At an individual level, I learnt that most campus citizens change quickly and others more slowly, and that one has a duty to constantly push for change, but also to be patient about change. And I learnt that the ideal change retains the best of our past even as we embrace a more just and inclusive future in which all campus citizens feel that the university truly belongs to each and every one of them.

Are you optimistic about the future of our university?
Yes. The UFS is a very well-managed university thanks to the exceptional talent in the management of our finances, human resources and information technology environments. By the end of 2016, we will have record enrolments, from undergraduates to doctoral students, which is good for our future income. We run a tight ship with regard to the university’s finances, and we have greatly improved the academic standard of our qualifications; in this regard, I am very proud of my senior management team, and the talented middle management personnel, and those who make things work at the coalface of our operations.

I am very concerned, however, about future funding of the 26 public universities and the extremely vulnerable situation of at least 10 higher-education institutions. The economy is not growing and the costs of running a modern university are escalating. The delays in government commission reports on tuition fees do not help, and there seems no urgency ‘higher up’ to make the tough decisions.

We have to ensure free education for the poorest students — that is the position of your senior management – but we also need to guarantee the financial sustainability of our universities. The task of the UFS leadership, in this period of uncertainty, is to manage those two expectations as best we can. But this cannot happen without your assistance, and I do ask that you provide the new Rector and his or her team with the same understanding and support which I have enjoyed from you.

In conclusion
I am grateful.

To the many hundreds of students who have passed through my office and our home, and who sat in my many lectures and engaged me in your residences – thank you for enriching my sense of life and leadership. I am grateful that Grace and I could support and mentor many of you over the years and see you graduate. I am a better leader because of you.

To the staff of the three campuses – there is no university Rector, I can assure you, who enjoyed more love and support than what you offered me since the day I arrived here. Students come and go, but you have been my foundation year after year, and I thank you for that.

To parents, friends, and followers off-campus, in South Africa and abroad – thank you for hundreds of letters, emails, phone calls, prayers and ‘packages of support’ (from biltong to books). In the most difficult times, you rallied from everywhere with a word of support, often on social media. Know this: your words kept me calm in the storm.

Thank you, everyone.

Goodbye.

Prof Jonathan Jansen
Vice-Chancellor and Rector
University of the Free State

Description: Prof Jansen saying goodbey Tags: Prof Jansen saying goodbey

Prof Jonathan Jansen steps down as UFS Vice-Chancellor and Rector (16 May 2016)

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