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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

Research helps farmers save with irrigation
2017-02-15

Description: Irrigation research Tags: Irrigation research

Marcill Venter, lecturer in the Department of
Agricultural Economics at the University of the
Free State, has developed the mathematical
programming system, Soil Water Irrigation
Planning and Energy Management in order to
determine irrigation pump hours.
Photo: Rulanzen Martin

Her advice to farmers is that they should make sure they are aware of the total cost (investment and operating costs) of an irrigation system. In most cases the investment cost is low, but the operating cost over the lifetime of the system is high.

“It is very important to have a look at the total cost and to install the most economic system,” says Marcill Venter, lecturer at the University of the Free State (UFS), who has done research on the economic sustainability of water-pipe systems.

Irrigation systems important components for farming
This research comes at a time when many farmers are relying on their irrigation systems due to persistent drought and low rainfall during 2016. South Africa has also experienced an abnormal increase in electricity tariffs in recent years. Due to tariff increases which threaten the future profitability of irrigation producers, the Water Research Commission (WRC) has launched and financed a project on the sustainable management of irrigation farming systems. “I had the opportunity to work on the project as a researcher,” says Venter.

The heart of every irrigation system is the water pipes that bring life to crops and livestock, and this is what Venter’s research is about. “Water pipes are part of the whole design of irrigation systems. The design of the system impact certain factors which determine the investment and operating costs,” she says.

Mathematical system to help farmers
Venter and Professor Bennie Grové, also from the Department of Agricultural Economics at the UFS, designed the Soil Water Irrigation Planning and Energy Management (SWIP-E) programming model as part of the WRC’s project, as well as for her master’s degree. “The model determines irrigation pump hours through a daily groundwater budget, while also taking into account the time-of-use electricity tariff structure and change in kilowatt requirements arising from the main-line design,” says Venter. The model is a non-linear programming model programmed in General Algebraic Modeling System (GAMS).

Design of irrigation system important for sustainability

The main outcome of the study is that the time-of-use electricity tariff structure (Ruraflex) is always more profitable than the flat-rate structure (Landrate). The interaction between the management and design of a system is crucial, as it determines the investment and operating costs. Irrigation designers should take the investment and operating cost of a system into account during the design process. The standards set by the South African Irrigation Institute (SAII) should also be controlled and revised.

Water-pipe thickness plays major role in cost cuts
There is interaction between water-pipe thickness, investment and operating costs. When thinner water pipes are installed, it increases the friction in the system as well as the kilowatt usage. A high kilowatt increases the operating cost, but the use of thinner water pipes lowers the investment cost. Thicker water pipes therefore lower the friction and the kilowatt requirements, which leads to lower operating costs, but thicker pipes have a higher investment cost. “It is thus crucial to look at the total cost (operating and investment cost) when investing in a new system. Farmers should invest in the system with the lowest total cost,” says Venter.

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