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03 November 2022 | Story Dr Munita Dunn-Coetzee | Photo Kaleidoscope Studios
Dr Munita Dunn-Coetzee
Dr Munita Dunn-Coetzee, Director: Student Counselling and Development.

Opinion article by Dr Munita Dunn-Coetzee, Director: Student Counselling and Development, University of the Free State.


 October was Mental Health Awareness Month, and we have just commemorated it under the theme 'Make mental health and wellbeing for all a global priority’. The month provided us with even more opportunity to raise awareness about mental health challenges and advocate for a reduction in stigma as well as in the discrimination that people with mental health challenges are often subjected to. This ignites the conversation again, but does the conversation stop?

 

Mental health among students has increasingly been given a spotlight in popular and professional media. The increase in mental health issues is due to a myriad of reasons, some intrinsic, some due to the culture and increased use of social media, some due to the change in student profile, and some due to the changes in service scope of universities, among other reasons. Mental health challenges among student populations are a common occurrence globally. 
Student success and mental health

I spend my work day aiming to assist psychologists, counsellors and social workers at the University of the Free State’s (UFS) Department of Student Counselling and Development (SCD) to help students flourish and thrive. This is a fulfilling position, as I have the privilege of working with people and their deepest concerns. Unfortunately, the severity of mental health challenges with which students currently present has changed significantly over the years. Students tend to enroll at higher education institutions with already diagnosed psychiatric disorders. The adjustment to higher education can be intensified by societal trauma, crime, violence, poverty, health issues, and a lack of sufficient academic preparation for tertiary education. This has implications for the number of sessions of therapeutic intervention a student needs, increases the number of other medical professionals involved in managing the student’s health, and has implications for academic and student success. Where does this leave us with our conversation?

The global COVID-19 pandemic added another variable, as it has unfortunately heightened the risk factors generally associated with poor mental health – financial insecurity, unemployment, fear. Meanwhile, protective factors – social connection, employment and educational engagement, access to physical exercise, daily routine, access to health services – decreased dramatically. The pandemic has essentially impacted every facet of our lives. In my experience, students are struggling mostly with depressive tendencies, anxiety, challenging parental relationships, suicidal ideation (thinking about committing suicide), and substance abuse challenges. Over the past six months the SCD had more students present with suicidal ideation, suicide attempts, as well as psychotic episodes, than in the past few years. The levels of anxiety and depression among UFS students are high, and the COVID-19 experience highlighted the need for adequate mental health care.

Mental health is a global issue

In recent years, there has been increasing acknowledgement of the important role mental health plays in achieving global development goals, as illustrated by the inclusion of mental health in the UN’s Sustainable Development Goals. The World Health Organization (WHO) pleads for increased investment on all fronts – from increasing access to quality mental health care and effective treatments, to research and more mental health awareness campaigns. 

To adequately address our student population’s mental health challenges, a multi-faceted approach is needed, as highlighted by the WHO. This is a systemic intervention on a large scale. I believe that one should have a layered approach when offering services. The rationale behind the variety of online resources available for all UFS students is to foster the mental health of students and to assist them in building resilience during these times of uncertainty. Mental health self-help literature (articles, videos, and podcasts) was developed, designed, and distributed to each registered student on a weekly basis via email, and placed on Blackboard (the UFS academic platform), the UFS website, and social media.

What is the UFS doing in response?

The UFS Careline is exclusively available to registered UFS students, managed by the South African Depression and Anxiety Group (SADAG), operated by trained and registered counsellors, accessible 24 hours, seven days a week, and at no cost to students. It started in September 2020 and is still going strong. Currently about 70% of our students can be helped in this manner before therapeutic interventions are needed.

A physical trauma response from ER24 has been added since 1 October 2022, to assist SCD in responding to psychological emergencies, especially after hours and over weekends. This will be piloted for six months to evaluate effectiveness before long-term decisions can be made. This is a very exciting prospect! SCD is collaborating with Kovsie Health on this endeavour. 

We have trained a group of students on all three campuses – the ‘SCD Influencers’ – and they assist us with marketing, conversations, and spreading the word to students. They also act as a crucial link in our communication from students – ensuring we know what is going on in the student communities, what the trends are, and how students experience SCD. 
SCD also believes in building partnerships and engaging with different role-players on a frequent basis. SCD has a strong working relationship with the different entities in Student Affairs, the Residence Heads at the residences and day-residences, Protection Services, Kovsie Health, among others. I believe this is also the best way to address any challenges – to work in a team with different expertise. And the conversation continues…

I want to pause at the individual conversation. Within each system individuals are involved, and individuals have the power to influence a system significantly. Some of our students come from backgrounds where they had to fight for literally everything they wanted. Most of our students are first-generation university students and do not have the necessary social or parental support when attending university. This can significantly impact one’s mental health, and it can lead to mental health challenges. We also need to remember that mental health challenges do not discriminate – they occur everywhere. A poor socio-economic stance does not predict poor mental health. A dysfunctional system does not define you. Each one of us has been born with resilience, and I believe the way you use it can change our lives. The most important thing is to keep on trying, despite your circumstances, and believe in yourself. You choose. You CAN do this.

What do I mean by an individual conversation? We tend to forget ourselves and focus on others. Please make time for yourself, for what is important to you, and try to balance the different dimensions in your life. We need to be in conversation with all the dimensions in our life – from physical (running/ going to the gym) to spiritual (praying/ meditating) and mental health (practicing acceptance of yourself and others, practicing activities that mentally stimulate you, getting to know yourself and what might be possible mental triggers in a situation). Have you had your individual conversation today? Mental health is so much more than merely awareness raising during October – let’s continue the conversation all year round. 

News Archive

Nuclear Medicine on the forefront of cancer research
2017-07-10

Description: Nuclear Medicine on the forefront of cancer research Tags: Nuclear Medicine, cancer research, Dr Je’nine Horn-Lodewyk’s, tumour detection method, cancer, Department of Nuclear Medicine 

Dr Je’nine Horn-Lodewyk’s tumour detection method
could be the cost-effective breakthrough needed to decrease
the mortality rate in breast cancer patients.
Photo: Anja Aucamp

The field of Nuclear Medicine in South Africa and the rest of the world are expanding rapidly due to the development of hybrid cameras and new radiopharmaceuticals. These developments have a huge impact on the diagnosis and therapy of cancer.

The most advanced of these cameras, Positron emission tomography combined with normal CTs (PETCT), are not yet widely available in South Africa due to the cost of the cameras and the radiopharmaceuticals. A more cost-effective alternative can be of great benefit. To achieve this, the focus should be on developing new radiopharmaceuticals that can be used with the current cost-effective gamma cameras, according to University of the Free State researcher, Dr Je’nine Horn-Lodewyk from the Department of Nuclear Medicine.

Fluorodeoxyglucose (18F-FDG), a radiolabelled glucose analogue, is currently the radiopharmaceutical most commonly used in PET/CT imaging for mainly oncology indications. Although it is considered the gold standard for imaging in several malignancies, it does have certain disadvantages. An 18F-FDG PET/CT diagnostic imaging study can cost between R25 000 and R35 000 for a single patient in the private sector. The 18F-FDG is also more radioactive, which requires much stricter handling and shielding to avoid high radiation dosages to staff and patients.

Successful research potential innovative solution
In the search for the ideal radiopharmaceutical for tumour detection, the South African National Nuclear Energy Corporation (Necsa) developed a local synthesis process for ethylenedicysteine-deoxyglucose (EC-DG). EC-DG is also a glucose analogue similar to FDG. They succeeded in labelling the compound with Technetium-99-metastable-pertechnetate (99mTcO4-), the most common nuclear medicine isotope used for approximately 95% of nuclear medicine procedures, creating 99mTc-EC-DG.

In partnership with Dr Horn-Lodewyk, this compound was successfully used in various animal models and clinical scenarios, resulting in approval by the Medicine Control Council to use it in a human study. Research is also planned in order to investigate diagnostic accuracy in other cancers like lymphoma.  The end result of this research can produce a radiopharmaceutical that is cost effective, does not require the use of costly specialised equipment, has no significant side-effects, no special patient preparation, renders late imaging possible, and has decreased radiation risks.

Dr Horn-Lodewyk is grateful for the support of her mentor, Prof Anton Otto, as well as Dr Gert Engelbrecht, Head of the Department of Nuclear Medicine, Prof Jan Rijn Zeevaart from North-West University’s Preclinical Drug Development Platform and Necsa, and Judith Wagener from Necsa. This innovative research would also not have been possible without the financial assistance of Dr Glen Taylor and Eleanor van der Westhuizen in the Directorate of Research Development.

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