National ADHD Day – 14 September 2024

National ADHD Day – 14 September 2024

A Lifetime with ADHD: Beyond the Diagnosis to Understanding the Ongoing Impact

by the Division for Research and Methodology 

To commemorate National ADHD Day (14 September), the PsySSA Division for Research and Methodology sought to summarise the different manifestations of Attention-Deficit/Hyperactivity Disorder and its’ implications on behaviour across the lifespan.

What is ADHD: Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental condition characterised by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with general functioning or development. An ADHD diagnosis is based on criteria outlined in the DSM-5-TR, which includes symptoms being present for at least six months and causing significant impairment.

While ADHD is commonly identified by primary symptoms of inattention, distractibility, and poor executive functioning, the American Psychological Association (APA) differentiates between three specific types of ADHD. Recently, specialists have also recognised additional common comorbidities that accompany an ADHD diagnoses, and recommend three more subtypes. Each type presents with different brain function issues, which cause different symptoms, and require specialised treatment protocols. Our infographic summarises these types and their presenting symptomology.

The impact of ADHD: Insights into the South African prevalence rates are limited, but estimated to be between 2-16% in children (Boshomane, Pillay, & Meyer, 2020; Botha & Schoeman, 2023). Adult estimates are somewhat lower, at 2.5-4.2% prevalence (Schoeman & Leibenberg, 2017), although it has been noted that 60 – 70% of children diagnosed with ADHD continue to have symptoms in adulthood (Belanger et al., 2018).

Possible causes for this larger estimated range in children include overdiagnosis in younger populations (and underdiagnosis in older groups), varying methodologies and assessment practices employed to make diagnoses, and limited expertise from practitioners (Schellack & Meyer, 2016). Given the life-changing impact of an ADHD diagnosis on an individual and their families, it should not be a diagnosis that is made in haste. Rather, practitioners should be careful in ensuring that they’re obtaining as holistic a view of their client as possible, before assigning the “ADHD label”.

Having untreated ADHD affects nearly every aspect of a person’s life and has been associated with school underachievement, family conflict, drug abuse, legal difficulties and poor work performance. Additionally, even though ADHD does not cause other psychological problems, it is common that other disorders (such as mood, anxiety, substance abuse, and learning disorders) occur alongside it, making diagnosis and treatment more challenging. Stimulant medications, such as Ritalin or Adderall, are often prescribed to manage ADHD symptoms in both children and adults. However, before medicating a client, it is important to identify their specific ADHD presentation type, as stimulants can make some forms of ADHD worse, as indicated above as well. Sometimes medicinal reactions can be extreme, causing hallucinations, violent outbursts, volatile temperaments, psychosis and suicidal behaviour. Alternatively, engaging in some form of sport or art form (for example, music) has been shown to improve or reduce the frequency of ADHD symptoms.

PLEASE do not use this article as a diagnostic resource; it is meant for informative purposes only. The South African Depression and Anxiety Group (SADAG) has a toll-free ADHD helpline (0800 55 44 33), please reach out to them if you are concerned that you or a loved one may have undiagnosed or misdiagnosed ADHD.

Mandela Day – 18 July 2024

Mandela Day – 18 July 2024

What would Nelson Mandela say in 2024?

Written by Prof. Anthony Pillay 

As we commemorate Nelson Mandela Day and celebrate his life, we cannot help wondering what he would say about the state of the nation that he and others fought so hard to free; or what he would say about global affairs. We are reminded of his quest for justice, human rights and equality, his love of children, and his outspokenness on injustice worldwide. As a global statesman he made it his duty to argue for the rights of all, and the oppression of none. We can, therefore, assume that he would be disappointed at the continuing inequity, poverty, violence and corruption that engulf our country three decades after his inauguration as South Africa’s first democratically elected President. The maladministration, increasing unemployment, poverty and the multiple social ills that befall our communities would be troubling to him, as they should be to all of us.

There is also reason to believe that our former President would be incredibly saddened by the levels of oppression, violence and atrocity being meted out against marginalised groups across the globe. With war and violence spreading through numerous countries, these are disturbing times, and we long for a Mandela to rescue us – but Psychology has taught us and those we serve, that we have to learn self-reliance. We need to put up our hands, take responsibility, and do the job, as difficult as it may be. As we were advised by our former leader, “It always seems impossible until it’s done”.

Following our freedom as a nation, President Mandela made a point of reminding us that “…our freedom is incomplete without the freedom of the Palestinians”. With the current war on Gaza in its 10th month, and more than 35 000 Palestinians killed, he would have been really troubled at the continuing violence and oppression. That women and children accounted for more than half of those killings would have been deeply disturbing. Wars elsewhere in the world are also wreaking havoc on civilians, with death, destruction and displacement of communities proliferating on a daily basis. The recent missile attack on Ukraine’s largest children’s hospital would have struck a nerve for our former President given his devotion to the well-being of children, which was embodied in his sentiment that “The true character of a society is revealed in how it treats its children”. On his home continent, the plight of civilians in several countries with armed conflict will, no doubt, have been a worry. The conflicts in Sudan, The Democratic Republic of Congo, Burkina Faso, Mali, and elsewhere, would distress the great man, as it should the rest of us.

All things considered, it is likely that Mandela would lament the state of our country, the poverty, inequality and governance, as well as the wars, oppression and killing of innocent civilians, including women and children, and the many social ills prevailing elsewhere in the world. However, among his parting words, he said to us, “It is in your hands” – so we need to step up and continue the struggle work that he and many others did. This time, we have to conquer the enemies of corruption, inequality, poverty, greed, and oppression, among other national and global evils.

The Psychological Society of South Africa (PsySSA) joins the global community in celebrating Nelson Mandela International Day and honouring the life of our great leader.

For all that you did for us, and for all that you taught us, we salute you, Mr President!

SANCA Drug Awareness Week 2024: 24 June – 30 June

SANCA Drug Awareness Week 2024: 24 June – 30 June

Dr Elron Fouten

Dr Elron Fouten holds a Ph.D. in Psychology from the Psychology Department at Rhodes University, where he is also a lecturer. For his PhD, he applied structural equation modelling (SEM) to test which individual, contextual, and social risk factors best predict substance abuse amongst a sample of substance abusers. Using SEM allowed him to demonstrate which paths and interactions amongst the risk factors are the most likely contributing factors making individuals susceptible to substance abuse. Dr Fouten’s other research interests are community psychology, the psychology of men and masculinities, gangsterism and violence, and complex traumatic stress disorder.

Risk Profiles and Multi-Level Predictors of Substance Abuse in South Africa

Substance abuse levels in South Africa have continued to rise, with the age of first experimentation with drugs reported as being 10 years. Several studies have shown that substance abuse has an adverse impact on users, their families and their communities, resulting in a number of social, psychological and economic struggles. Moreover, substance abuse places an increased psychological, social and financial burden on the individual and the family, as it has been related to the destabilisation of the nuclear and extended family units, permeating every area of life and affecting the very social fabric of society.

Since the South African government recognized the need for effective policies and strategies to mitigate substance abuse they established the Central Drug Authority to oversee the implementation of the National Drug Master Plan (NDMP). The NDMP focuses on a multi-pronged approach to mitigate substance abuse, including prevention, treatment, and rehabilitation. The plan also aligns with the global shift towards harm reduction and individualized care, as highlighted in the 2022 National Drug Control Strategy in the United States. The main targets of substance abuse awareness promotion and harm reduction strategies in South Africa are diverse, including the general population, the workforce, and specific groups such as Nyaope users.

A recent study, using the South African Substance Use Contextual Risk Instrument (SASUCRI), sought to determine the magnitude, strength and direction of the interaction of the individual and contextual risk factors (as measured by the SASUCRI) in predicting substance abuse. This study thus applied structural equation modelling (SEM) to data collected from 1094 individuals seeking either inpatient or outpatient treatment for substance abuse in the Eastern Cape and Western Cape.

This study identified 10 risk profiles (see figure below) that interact in the prediction of substance abuse; these are: individuals with low self-esteem (SE), who perceive their family as lacking or having low intra-family communication (IFC), who lack positive peer support (PPS), who perceive criminal behaviours as normal (AACB), who feel a strong need to fit in (FI), who are less religious (REL), who have easy access to drugs (PTD), who lack a sense of community traditions and belonging (CTB), who see public displays of substance use (PDSU) as normal, and who lack concern for the future(CFF), are at 59% greater risk of substance abuse. It is important to note that the micro level factors (low SE, PPS, IFC) and meso-level factors (AACB, FI, REL) do not significantly predict substance abuse, rather, they significantly interact with factors further from the individual that they predict substance abuse. Thus, it is only when they interact with factors located in the other systems (exosystem, macrosystem and chronosystem) that they become significant predictors of substance abuse. Conversely, exosystem (APTD), macrosystem (CTB, PDSU), and chronosystem factors (CFF), independently are significant predictors of substance abuse.

This finding highlights the need for collaboration between community stakeholders and government in engaging community residents, particularly disadvantaged groups, to identify any of the 10 risk profiles to promote health and well-being at a community level.

Warren Cornelius

As someone with lived experience, I am deeply passionate and committed to working with people who have substance use disorders and other addictions. Professionally, I lead the ITTC SA substance use prevention, advocacy, and recovery programming. Additionally, I serve as the deputy country coordinator for the South African Chapter of the International Consortium of Universities for Drug Demand Reduction (ICUDDR). During my free time, I focus on community-based projects aimed at coordinating and facilitating substance use prevention, treatment, recovery, and other social development initiatives. I am actively involved in the organizing committee for the Recovery Walk Cape Town and am advancing the Inclusive Recovery Cities (IRC) model in South Africa. I particularly enjoy mobilizing grassroots individuals and organizations and uniting people from diverse backgrounds. I hold Postgraduate Diplomas in Addictions Care and Public Mental Health from the University of Cape Town and I am currently pursuing an Mphil in Public Mental Health.

Harmful substance use is a growing problem in South Africa. It has a profound impact on almost every aspect of our society, including the social, physical, spiritual, and mental well-being of individuals, as well as on families, communities, public health, social welfare, education, and criminal justice services. To this end, Drug Awareness Week aims to raise awareness of the harmful effects of substance use. However, many of the most common strategies being used by well-meaning advocates have been shown to be ineffective. Some have even caused harm by unintentionally reinforcing pro-use attitudes, behaviours and norms by, for example, using scare tactics. Some strategies may seem like a good idea on the surface, but our obligation is to employ evidence-based effective strategies that maximize our limited resources.

The early detection of harmful substance use is key in preventing and treating substance use disorders (SUDs). Consequently, the International Technology Transfer Center South Africa (ITTC SA), has developed the World Health Organization (WHO) The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into an online web app ASSIST version. The web app ASSIST is anonymized and asks about recent substance use over the past 3 months and assesses lifetime use risks. It provides (i) a level of risk for each substance used; (ii) information for the Brief Intervention (BI) component; (iii) information and feedback about the risks and harms associated with each substance; and (iv) feedback on physical, medical, and psychological risks of regular substance use, it also screens and provides information on injection drug use. Members of the public can use the self-screen pathway, and there is also a pathway for practitioners to screen clients. High-risk screening scores will lead to further assessment and a referral to specialized treatment. Usually, a small proportion (5%) of the using population will be at high risk. The rest of the individuals can be treated via a BI.

Whist mental health promotion and substance use prevention are fundamental along the continuum of care, accessibility and availability of evidence-based treatment services are vital. Members of the public are encouraged to only use treatment facilities that are registered with the Department of Social Development (DoSD). You may visit the Substance Use Treatment Directory at https://sudservices.uct.ac.za/, developed by the ITTC SA, to locate a treatment service provider nearest to you. For better treatment outcomes, substance use treatment providers should be trained in the latest evidence-based treatment approaches. The University of Cape Town and Stellenbosch University’s Postgraduate Diploma in Addictions Care are the only two specialized addiction science programmes offered in the country (Kader et al., 2023). These postgrad diplomas are offered online and are accessible to addiction practitioners across the country.

While addiction has been characterised as a chronic relapsing condition, multiple studies have shown that stable recovery is not only possible but that it is probable (Sheedy and Whitter, 2009). It is widely recognised that recovery is a journey that can be measured in terms of growth of recovery capital (Granfield and Cloud, 1999) which includes three primary domains – personal, social and community capital. Recovery success relies not only on personal efforts and capabilities but also on social networks and access to the resources in the community. The recovery focus should, therefore, be aimed at community facets that are capable of hindering or promoting recovery success. Essential to this are community-based events and activities led by community members consisting of people in recovery, people who are allies of recovery, and grassroots organizations, in partnership with civic leadership and addiction treatment services.

The Recovery Walk Cape Town (RWCT) is one such event, which:

  • Challenges stigma and social exclusion by demonstrating the positive successes and achievements of recovery.
  • Creates a visible and accessible recovery community that is inclusive and welcoming and that actively engages the general public.
  • Ensures that the event is inclusive in terms of the diversity of participants including but not restricted to ethnicity, gender and gender identity.
  • Creates pathways to a diverse range of community resources and builds meaningful partnerships with these resources.
  • Champions and celebrates the contribution the recovery community makes to the communities and city in which it is located.

The RWCT is the start of a bigger objective of establishing Cape Town as an Inclusive Recovery City (IRC). However, the IRC model aims to have a network of linked cities across SA engaging in innovative grassroots practices to increase awareness of and acceptance of recovery in communities while engaging in a diverse range of public-facing activities that benefit the recovery community, other marginalised and vulnerable groups and communities and creates opportunities for active citizenship for people affected by drug and alcohol problems. The fundamental premise of the IRC model is about creating networks and hope through public celebration events that are open and accessible, first to increase connectedness for people affected by addictions and second to increase collective efficacy and civic participation across a wide range of excluded and marginalised groups. Please contact me if you are interested in learning more about the RWCT or the IRC model – it would be a joy to assist and support you in starting these in your communities and towns.

Links:

Web app ASSIST: https://assistscreening.uct.ac.za/

Substance Use Treatment Directory:  https://sudservices.uct.ac.za/

Recovery Walk Cape Town:  www.recoverywalk.co.za

References

Granfield, R., & Cloud, W. (1999). Coming clean: Overcoming addiction without treatment. NYU press.

Kader, R., Govender, R., Cornelius, W., Abrahams, L., Ashburner, F., Tisaker, N., Miovský, M., & Harker, N. (2023). Needs assessment and preparatory work for addiction science programs at universities: experiences of universities in South Africa. Journal of Substance Use, 1-6.

Sheedy, C. K., & Whitter, M. (2009). Guiding principles and elements of recovery-oriented systems of care: What do we know from the research? HHS Publication No.(SMA) 09-4439. Rockville, MD: Center for Substance Abuse Treatment. Substance Abuse and Mental Health Services Administration.

Men’s Health Month – June 2024

Men’s Health Month – June 2024

Men’s Health Month – June 2024

Men’s Health Month – A Contribution from the CaSP Division

“The objective of Men’s Health Month is to heighten awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. This month allows healthcare providers, public policymakers, the media, and individuals to encourage men and boys to seek regular medical advice and prompt treatment for disease and injury. The response has been overwhelming with thousands of awareness activities around the globe.”

Breaking the binds of a broken man- Men and Mental Health
By Christo Muller

I want to preface this article with a story. This is not a story of triumph or even a love story. This story starts with a young boy. Not much after his 10th birthday in fact. He met a wise man who used to be a very powerful warrior. He used to regale the children of his village with heroic stories of battle and facing many monsters that he encountered along the way. All the other children wanted to be like this great man, except this boy. The man was intrigued by this boy as he never marveled at the battles with the sea monsters or the trolls in the mountain but rather he showed interest in why the man chose to face these challenges. One day the boy saw the aged warrior sitting under a tree overlooking the valley. Cautiously the boy approached him, “Sir, do you mind if I join you?” He asked. “Certainly my boy!” He replied enthusiastically, as if his loneliness spoke on his behalf. The boy sat down in silence next to the retired warrior.

After a short while the man asks “Do you want to hear some of my stories? The great battles? The powerful monsters?”. “Yes sir, but I don’t want to hear the stories you tell the other children in the village.” Responded the boy while picking little blades of grass. “No? Which stories do you want to hear?” The man asked surprisingly. “I want to hear the story of why you went on these adventures. Why do you never tell us about the failures or the friends you had? I know all of the stories of what you had done but you never told us what scared you or anything other than what you think we want to see when we think of you.” the boy said in a very kind manner. The old warrior was silent, clearly taken aback by this. “What do you mean boy? My stories are the ones that will carry my name into history and songs, like all the warriors before me. That is the way of the great warriors.” He retorted almost gleefully.

“That is the thing that I do not understand sir, you want to be remembered for all your great deeds and heroic labours to inspire others to be like you, but you don’t want others to know who you were as a person.” The boy countered. “Who I am does not matter as much as what I accomplished to those who seek to be like me, little boy, the person I am may just break down the legacy I am meant to leave behind.” The old man says honestly. “Oh, can I ask you a question? To you, not to the warrior you are meant to be.” The boy says while taking the time away from his meticulous grass picking. The old man nodded. “What is the hardest thing you have ever done?” The boy asked. “Admitting to my fellow warriors that I am scared of facing the monster that we are sent to slay.” The old man said. “What scares you the most?” The boy asked while moving closer to the old man. As a tear ran down his war battered cheek the old man said: “Asking for help”…

The purpose of this story is not to take away from those who seem to have conquered all but rather to share the idea of how society has influenced the stigma of men’s mental health. You never know what those around you may be going through. From the automated responses of “Im fine” to the isolated patterns of emotional acting. The newest war that the world is facing is the mental health war. Traditional masculinity which is supposedly influenced by the Stoic philosophy has created a battlefield the requires the hiding of wounds in fear of appearing weak. The reluctance to seek help, the fear of societal judgement and rejection has resulted in men falling into the abyss of addiction and suicidality.

Treatment of physical illness or injury is not frowned upon as to live a key requirement is to have a healthy body. When it comes to mental illness, so many of today’s men are bound by the painfully heavy bonds of masculinity. Emotions are for the weak. Everyone has issues and this is my burden to carry. Those who love me would rather see me die on the battlefield than see me fall off my horse. If Stoicism has taught us anything, reality needs to be accepted for what it is, not what we wish it to be. Acceptance is not approval but rather acknowledgement of fact.

Ask your male friends how they are doing. Check in on them and be honest with them how you are doing. Don’t fear not being fine. The actions, attitudes and thoughts you hang on to can be of value to you and others or they can be the whip that inflicts pain onto you.

Sometimes the bravest thing anyone can do is ask for help.

Mental Health Help Resources

https://www.groundup.org.za/article/how-accesspublic-mental-health-services

https://www.globalcitizen.org/en/content/ways-southafricans-take-care-of-mental-health/J

Start or join a support group / support group: www.sadag.org.

 

Men’s Health Month – A Contribution from the DRM Division
by Mr Omphile Rammopo

Men’s Health Month in June focuses on raising awareness about the health challenges confronting men and advocating for early detection and treatment of diseases. In South Africa, this initiative holds significant relevance due to the distinctive health issues men encounter. These include high rates of HIV/AIDS, tuberculosis (TB), and the escalating burden of non-communicable diseases (NCDs) like hypertension and diabetes, making men’s health a pressing public health concern demanding urgent attention (van Heerden et al., 2017).

A foremost concern in South Africa is the heightened prevalence of HIV/AIDS among men. Men exhibit lower rates of HIV testing and tend to seek healthcare only at advanced disease stages (Sileo  et al., 2018). This delay not only compromises their health outcomes but also elevates the risk of transmission to others, necessitating concerted efforts to promote regular HIV testing and early treatment.

Mental health emerges as another critical area necessitating attention. South African men often grapple with societal expectations to suppress emotions and avoid discussing mental health issues, potentially leading to adverse outcomes such as elevated suicide rates (Rammopo, 2021). Moreover, suppressed emotions may serve as a risk factor for functional neurological disorder, predisposing men to various physical health complications, including hypertension, diabetes, cerebrovascular accidents, and seizures. Facilitating open dialogues about mental health and ensuring accessibility to mental health services are crucial steps in addressing this issue effectively.

Additionally, substance abuse, particularly alcohol consumption, represents a significant concern among South African men (Lawana & Booysen, 2018; Mohale & Mokwena, 2020). This behaviour is associated with diverse health ramifications, including liver disease, cardiovascular complications, cerebrovascular disease, diabetes, and hypertension (Parry et al., 2011), and heightened risks of accidents and violence. Hence, public health campaigns aimed at curtailing alcohol consumption and advocating healthier lifestyles play a pivotal role in mitigating this issue.

Addressing lifestyle factors such as poor dietary habits, sedentary lifestyles, and smoking is also crucial in mitigating men’s health conditions in South Africa and globally. Encouraging regular health check-ups, promoting healthier dietary practices, and advocating for increased physical activity can play a significant role in alleviating the burden of NCDs among men.

Men’s Health Month serves as a poignant reminder of the imperative to address the unique health challenges confronting men in South Africa. Through concerted efforts encompassing awareness-raising, early detection and treatment initiatives, and promotion of healthy behaviours, tangible strides can be made toward enhancing health outcomes and reducing the burden of preventable diseases among men.

Reference List

Lawana, N., & Booysen, F. (2018). Decomposing socioeconomic inequalities in alcohol use by men living in South African urban informal settlements. BMC Public Health18, 1-9.

Mohale, D., & Mokwena, K. E. (2020). Substance use amongst high school learners in the south of Johannesburg: Is this the new norm?. South African Family Practice62(4), , e1–e6. https://doi.org/10.4102/safp.v62i1.5122

Parry, C. D., Patra, J., & Rehm, J. (2011). Alcohol consumption and non‐communicable diseases: epidemiology and policy implications. Addiction106(10), 1718-1724.

Rammopo, O. (2021). Constructions of Depression from Black Men Residing in Mabopane [Master’s thesis, University of Johannesburg]. UJ Content. https://hdl.handle.net/10210/501592

Sileo, K. M., Fielding-Miller, R., Dworkin, S. L., & Fleming, P. J. (2018). What role do masculine norms play in men’s HIV testing in sub-Saharan Africa?: a scoping review. AIDS and Behavior22, 2468-2479. https://doi.org/10.1007/s10461-018-2160-z

van Heerden, A., Barnabas, R. V., Norris, S. A., Micklesfield, L. K., van Rooyen, H., & Celum, C. (2017). High prevalence of HIV and non‐communicable disease (NCD) risk factors in rural KwaZulu‐Natal, South Africa. African Journal of Reproduction and Gynaecological Endoscopy20(2), e25012. https://doi.org/10.1002/jia2.25012.

Men’s Health Month – A Contribution from the PiPS Division

The South African National Integrated Men’s Health Strategy 2020-2025 (the Strategy) is a framework for action to work towards the goal that Every South African man and boy is supported to live a long and healthy life. South African men generally have poor healthseeking behaviours and are less likely than women to engage health services across the care cascade, resulting in adverse clinical outcomes for many preventable illnesses. In addition, the health system misses key opportunities to engage with men who do seek services by not offering comprehensive and integrated services to those men who access services for specific conditions.

The Strategy aims to deliver a comprehensive and integrated package of care for men and boys across the life course. The overarching aim of the Strategy is to improve the overall health and wellbeing of South African men and boys. At the heart of the Strategy are four core objectives and associated actions that are designed to drive meaningful progress towards the Strategy’s overarching goal. These include a clear commitment to:

  • Empower and support men and boys to optimise their own and each other’s health and wellbeing.
  • Strengthen the capacity of the health system to provide quality appropriate preventative care for men and boys.
  • Ensure that men and boys receive treatment, care and support services for chronic conditions, as needed.
  • Build the evidence base for improving men’s health.

The Strategy advocates for a life-course approach in tailoring interventions to engage and support South Africa’s diverse men and boys across all stages of their lives, with a focus on adolescents (10-19 years); young adults (20-35 years); older men (above the ages of 35); and aging men (above the age of 50) as well as high risk men and boys.

Health is influenced by a complex range of factors, or health determinants. Targeted actions are identified to meet the Strategy’s goal and objectives – actions that require the engagement and collaboration of a wide range of stakeholders from across South Africa. They include all levels of government, the health sector, other sectors, with non-government organisations (NGOs), community-based organisations (CBOs) and faith-based organisations (FBOs), researchers and experts, and, of course, with men and boys themselves.

Critical to the success of this Strategy is a clear commitment to implementation planning and to taking an active approach to evaluating, monitoring and communicating progress over time. By providing a framework for gender-focused health, this Strategy highlights South Africa’s commitment to taking collective action to create a healthier future for men and boys.

The Strategy identifies seven key priority health issues which have been identified as key causes of morbidity and mortality for all South African men:

  1. Mental health
  2. HIV and AIDS
  3. TB
  4. Sexual Health
  5. Chronic conditions (diabetes, hypertension, high cholesterol)
  6. Cardiovascular disease
  7. Prostate and testicular cancers

The following platforms are available for men, or those close to men who need mental health support:
Department of Social Development Substance Abuse Helpline: 0800 12 13 14, SMS to 32312

South African Depression and Anxiety Group (SADAG): 011 234 4837 or  0800 21 22 23 or 0800 12 13 14 (24Hrs) SMS to 31393, http://www.sadag.org

Suicide Crisis Helpline: 0800 567 567

References:

Welcome Ngwenya, M., & Olivia Sumbane, G. (2023). The Urgency of Access to Men-Centered Mental Healthcare Services to Address Men’s Sensitive Issues in the Communities of South Africa. IntechOpen. doi: 10.5772/intechopen.108493 (https://www.intechopen.com/chapters/84694)

The South African National Integrated Men’s Health Strategy 2020-2025 (https://knowledgehub.health.gov.za/system/files/elibdownloads/2023-04/Men%2526%2523039%253Bs%2520Health%2520Strategy.pdf)

Child Protection Week

Child Protection Week

26 May – 2 June 2024

Alexa Russell Matthews

Alexa Russell Matthews – BSS in Social Work (UCT), MA in Play Therapy (UP) – is a registered Social Worker who works for Arise Family – an NGO based in the Western Cape whose mission it is to see every child in a thriving family, regardless of who constitutes that family.  Arise works to preserve and strengthen families through programmes written and developed in South Africa, but which have reached a training cohort in the Global South as part of their training and consulting suite of services.

Child Protection Week helps remind us of the vulnerability of children within society. South Africa’s children are vulnerable for a myriad of reasons – from the economic hardships, under resourcing in communities most at risk and vulnerability to continuous and complex trauma, the challenges for mental health professionals supporting children and families are real.  In addition to this, it is recognised that over 50% of South African’s children, i.e. over 10 million children do not live with a biological parent.  They may live with an extended family member or alternative caregiver – some of which is formalised in the alternative care system, but for many children, this is not.

Children are said to need three things to succeed in life and break out of the poverty trap: i) a good enough education, ii) a consistent relationship with a primary caregiver and iii) support for that caregiver.  As psychologists, the role of support for children in the education sphere as well as within their families and communities is important.  An opportunity to partner or collaborate with other role players while advocating for children to have the best possible foundation exists.  Role players may be social workers, educators, health care professionals and community-based organizations relevant to the child’s context all matter in offering a family care and support.

The purpose of the South African Children’s Act of 2005 act is to establish what is needed for the protection of children to flourish and thrive, ideally within their families of origin wherever possible.  What this means is that should there be a suspicion of risk (neglect, abuse including sexual, physical, emotional, and psychological) as well as medical and educational neglect is that this renders that person responsible who has been made aware of this to report.  Any person working with children is accountable and held liable to the act. As mandatory reporters, self-awareness of personal fears and biases matter – without this there is often a reluctance to report or fear of disruption of family units that then do not lead to any further intervention. 

Themes and trends emerging within the greater child protection landscape currently include an increase in sexual abuse disclosure, anxiety & depression, and self-harm (including increased substance use and anti-social behaviours). The expected risks to children following the Covid pandemic lockdown are being noted.

Developing good working relationships with the relevant child protection organisations and Forensic & Child Sexual Offences officers within your local SAPS are helpful ways of building broader support networks for psychologists to refer and consult with, as well as continue to strengthen services for children in need of care.

The adage that it takes a village to raise a child remains equally true for the protection of children. Not only to raise them but to protect them also.

Nasiphi Matshaya

Social Work manager for Child Welfare SA Grahamstown.

The Role of Child Welfare and Social Work

During Child Protection Week, the South African Association of Counselling Psychology (SAACP) wish to draw attention to the important role Child Welfare and our Social Work colleagues play in the protection of our children. Nasiphi Matshaya, Social Work Manager, Child Welfare Makhanda, shares her thoughts:

As a child protection organization, our work is guided and governed by the Children’s Act, (Act 38/2005) working to ensure that the best interests of the child is always served. Most of the cases reported to our office are as a result of child abuse (sexual, emotional and physical), neglect, substance abuse by the parents, poor/inadequate parenting skills, domestic violence between parents etc. Our social workers work with two types of cases, each managing over 120 cases. We have statutory cases, where children have been removed from their parent’s care due to dire circumstances at home and are placed in foster care or registered Child and Youth Care Centres (CYCC) via Court Orders. Our other focus is on prevention cases where we work intensively with families in order to keep children within the family system.

Contrary to many people’s beliefs, the focus of our work is NOT to remove children from their families, but to do whatever we can to keep children in their homes and with their biological parents if at all possible. Obviously, there are times when we have no other choice but to remove children via Form 36 (which is the form used to legally remove children) from their parents as their safety would be at risk if left in their care. This process is done in Court and the approval of removal is endorsed by the Presiding Officer.

On a typical day, our social workers will be involved in family meetings, investigating children’s home circumstances, interviewing parents and family members, teachers, counselling children and their family members, report writing for children’s courts, appearing in court for foster care reviews, and referring children for therapy.  This work requires considerable commitment, endurance and skills as social workers face challenges every single day in their work including child abuse, neglect, domestic violence, inadequate living conditions.

Our staff respond to children in crisis, operating within a highly pressurized work environment. It therefore requires experienced and caring staff members who are able to think on their feet in crisis situations. As the Child Protection Week approaches, our social workers will be going around to schools and communities creating awareness on child protection.

Zakiyah Hoosen

Vice Chair for the Registered Counselling and Psychometry (RCP) Division at PsySSA

Call to Develop Child Protection Policies for Social Media

In South Africa, National Child Protection Week (CPW) is observed annually to raise awareness of children’s rights as per the Children’s Act of 2005. The campaign strives to ensure safety, care, and protection for all children in various forms, including health, education, community, and social development. South Africa faces alarming rates of violence against children, and this is an overwhelming challenge to be tackled. Despite focused and progressive laws, policies, and actions to prevent and reduce violence against children, it remains a severe issue.

A targeted manner to address this issue could be through creating and enforcing child protection rights on digital platforms and social media. This article is inspired by a recent scandal exposed on Twitter, a popular social media platform. A young girl approximately aged 16/17 years was observed to be groomed by a pastor within her community. Sadly, these are all too common scandals in our communities, with increasing statistics of sexual violence and gender-based violence. Allegedly, the girl hailed from a poor, marginalized community and was spoiled by the pastor with luxuries such as takeout food, clothing, jewellery and a brand-new iPhone. Social media users observed this and were able to determine that the girl was still in high school, and the pastor was well-known and married within his community. While some adult social media users were wise and handled the situation with thought and consideration for the child in question, many ridiculed and mocked the child and her choices. Videos of the child and her high school uniform soon flooded platforms and many attempted to showcase the “poor” choices of this child. Over-exposure to social media platforms that are mixed with a variety of users across all ages, ethnicities and genders may prove concerning. Unfortunately, this could also lead to this child being a victim of cyber-bullying.

As the world develops, children are being introduced to smart technology from younger ages compared to before. We know children to be vulnerable and curious, and earlier exposure to social media may have detrimental effects on many levels. The young girl from this scandal may have been a victim of grooming, and then faced further ridicule whilst also having her face and high school plastered on an open social media platform. Cyber-bullying refers to bullying, threats or intimidation that occurs on electronic platforms. It may have severe psychological impacts on an individual, including negative self-esteem, low mood, antisocial actions and may even lead to suicidal ideation and thoughts (Albikawi, 2023).

The use of technology has permeated every area of our lives, and the creation of Artificial Intelligence (AI) may soon surpass limits of protection. While AI has become a recent advancement in technology, social media has been present for long enough to warrant child protection policies. Deliberate exposure of minors, their faces and potential locations is extremely dangerous. Whilst every effort is focused on prevention and reduction of crimes against children, including violence and abuse, there is a growing need for stringent measures of child protection on social media platforms. The responsibility for child protection in both actual and on digital environments lies upon the community. As the world advances into the wonders of smart technology, our responsibility to extend protection and guidance must progress all the same.

References:

Albikawi Z. F. (2023). Anxiety, Depression, Self-Esteem, Internet Addiction and Predictors of Cyberbullying and Cybervictimization among Female Nursing University Students: A Cross Sectional Study. International journal of environmental research and public health20(5), 4293. https://doi.org/10.3390/ijerph20054293

Dr Narainsami (Anand) Chetty

Vice Chair for the Society for Educational Psychology of South Africa (SEPSA) Division at PsySSA.

A Minority Perspective

Child Protection Week is an opportune time for concerned colleagues to Refresh, Rewind and Restart on critical issues regarding Children.  We have been accustomed to focusing on macro issues like Child Abuse, Bullying, Gender-based and the like. This is wholly justified as there are mounting studies that confirm the escalation of violence against children in its various forms.

As complex society further complicates innocent children again become the most affected party. A vulnerable sub-population that receives scant attention from the professional community is the Children of Divorced parents. While international literature is replete on this topic local literature is limited. It appears confined mostly to academic pursuits with little influence and cross-pollination over policy and practice.

Children of Divorce present with a unique set of dynamics mostly that go unnoticed or misunderstood.  Hence it warrants appropriate awareness,  growing attention and proverbial protection. Child Protection Week is a convenient time to bring this susceptible population into the main frame. It is reported that almost one in three marriages end in divorce. This equates to about nineteen thousand couples who dissolve their marriages annually. Further, the biggest casualties of a failed marriage are the children and at a conservative estimate this is between thirty-eight to fifty-seven thousand every year. From a statistical perspective, it may not appear significant. In psychological terms, if left unnoticed it has the potential to grow into unmanageable proportions.

Divorce involves the spouse, the children and the extended family as well as a chain of official personnel including, the opposing attorneys, Social Workers, Psychologists, the Office of the Family Advocate and the presiding Judge in Court. As expected spouses are usually engaged in an acrimonious dispute, children are confused and torn between the opposing parents and the extended family playing the blame game. While matters concerning the welfare of the children are predicated in the Children’s Act 38 of 2005 and subsequent amendments, it is moot whether the paramount principle of “Best Interests of the Child” is followed through to the letter. This becomes particularly pertinent when considering the traumatic overt and covert psychological constructs that children in particular experience. This ranges from adjustment problems, loss, grief, anxiety, depression, sadness and suicidal ideation.  In addition, children start performing poorly academically, lose interest in social activity, have difficulty adapting to change, are emotionally sensitive, have anger/irritability,  feelings of guilt, destructive behaviour, increase in health problems and loss of faith in the family unit.

Thus adversarial lawyers, template-following social workers, and forensic psychologists,  work according to the regulations OFA and the learned judges have to “dig deep into the Pierian Spring” of psychology before they make an informed decision on reluctant children caught up in the divorce maze of their parents’ divorce.

Hospice Week: 5-11 May 2024

Hospice Week: 5-11 May 2024

Hospice Week honours the compassionate care and support provided to individuals and families facing life-limiting illnesses. It’s a time to recognize the dedication of hospice workers, volunteers, and caregivers who offer comfort, dignity, and respect during one of life’s most challenging journeys. Let’s celebrate their invaluable contributions