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#TheConversationContinues: Mental Health Awareness

03 November 2022 | Story Dr Munita Dunn-Coetzee | Photo Kaleidoscope Studios

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

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology

2006-05-17

Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor). At the back from the left were Prof James du Preez (Departmental Chairperson: Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species. Disease control can not rely on vaccination alone and other disease-control options must be examined.

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans. Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI. “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance. During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations. Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry. “The average life cycle of a broiler chicken is 42 days. After this short time, they are slaughtered. As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum. This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar. Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons. “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus. One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.

“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry. This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

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