South African Psychiatry - February 2019

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REPORT T H I R D NATIONAL PUBLIC MENTAL HEALTH F O R U M ( P M H F ) Richard J. Nichol This forum took place on the 21 st of September 2018 at the conference venue of the Council of Scientific and Industrial Research (CSIR) in Pretoria. It was organized by the Department of Psychiatry, School of Health Sciences, of the University of the Free State (UFS) in collaboration with the Psychiatry Department of the School of Health Sciences of the University of Pretoria (UP). MORE THAN TWENTY PSYCHIATRY REGISTRARS IN THEIR THIRD YEAR FROM ALL THE MEDICAL SCHOOLS IN SOUTH AFRICA, WERE INVITED TO ATTEND THE FORUM WHICH INTERFACED WITH THE 19 TH NATIONAL CONGRESS OF THE SOUTH AFRICAN SOCIETY OF PSYCHIATRISTS HELD AT THE SAME VENUE. A NUMBER OF HIGHLIGHTS OF THIS FORUM ARE PRESENTED. During his opening address Prof Christopher Paul Szabo (Academic Head – University of the Witwatersrand) alluded to the theme of the forum: Public Mental Health; Here, there and everywhere. He thanked the sponsors of the forum, Mr. Greg Sinovich on behalf of Sanofi Pharmaceuticals, SASOP and the Colleges of Medicine of South Africa (Psychiatry). Prof Szabo continued with a presentation ‘Introduction to Public Mental Health’. He related how the first PMHF came into being in 2015 after he realised that most psychiatric curricula of the various medical schools in South Africa lacked adequate teaching on Public Mental Health. Subsequently the second PMHF took place in 2017 in Stellenbosch. Dr Andre Rose, a consultant in Richard J. Nichol Community Medicine and currently the Chairman of the Public Health Association of South Africa (PHASA), discussed Mental Health Economics. (The world population was estimated to be 7,7 billion people in December 2018). Quoting WHO statistics, published in 2018 he informed the audience of the numbers of people affected globally (Table I). Table I: Burden of mental illness: Disease Depression Anxiety Disorders Bipolar affective disorders Dementia Schizophrenia and other psychoses Source: WHO, 2018 Number of people affected globally 300 million 275 million 60 million 50 million 23 million 48 * SOUTH AFRICAN PSYCHIATRY ISSUE 18 2019
REPORT THIRD NATIONAL PMHF The 2016 Institute for Health Metrics and Evaluation, (IHME) statistics concerning ‘the prevalence by mental and substance use disorder’ internationally, are noted in Table II. Table II: Share of the population with a given mental health or substance use disorder in 2016 Disorder Prevalence Anxiety Disorders 3.83 % Depression 3.77% Alcohol Use Disorders 1.37% Drug Use Disorders 0,85% Bipolar Disorder 0.61% Schizophrenia 0.29 % Eating Disorders 0.14% Source: http://ghdx.healthdata.org/gbd-results-tool. THE FIGURES ATTEMPT TO PROVIDE A TRUE ESTIMATE OF THE FINDINGS, GOING BEYOND REPORTED DIAGNOSIS, OF DISORDER BASED ON MEDICAL, EPIDEMIOLOGICAL DATA SURVEYS AND MET-REGRESSION MODELLING. DR. ROSE WENT ON TO EXPLAIN THAT IN 2014 A PERSON HAVING DEPRESSION AND ANXIETY FACED A REDUCTION OF PERSONAL INCOME OF $ 4798, (PER ADULT ANNUALLY) RESULTING IN A $3.6 BILLION ANNUAL NATIONAL LOSS IN SOUTH AFRICA. IN CONTRAST A NIGERIAN STUDY ESTIMATED THE NATIONAL LOSS TO BE $166.2 MILLION ANNUALLY. THE ANNUAL PRODUCTIVITY LOSS IN KENYA WAS $453 MILLION. IN GHANA PSYCHOLOGICAL STRESS WAS ASSOCIATED WITH A 6.8% LOSS IN GDP. A consultant in Psychiatry at the University of Pretoria, Dr Funeka Sokudela, discussed the role of stigma in mental health. She highlighted the fact that many Mental Health Care Users are still being discriminated against for a number of reasons including their mental illnesses, gender, ethnic background and sexual orientation. She stressed the importance of psychiatrists taking responsibility for combating this stigma. Dr Lesley Robertson, a community psychiatrist affiliated to the University of the Witwatersrand, discussed studies related to the Global Burden of Disease and their relevance to mental health in South Africa (see Feature article in this issue). Dr Michelle Nel of the Department of Psychiatry at the University of the Free State addressed the topic “The Mental Health of Refugees”. The population of our world is over 7,7 billion people of which tens of millions have been forced to flee their homes due to violent conflict. THE OFFICE OF THE UNITED NATIONS HIGH COMMISSIONER FOR REFUGEES (UNHC) CLAIMS THE WORLD IS CURRENTLY FACING ONE OF THE HIGHEST LEVELS OF DISPLACEMENT EVER IN HISTORY. ACCORDING TO UN STATISTICS, AN UNPRECEDENTED 65.3 MILLION PEOPLE HAVE BEEN FORCED FROM THEIR HOMES BY WAR, INTERNAL CONFLICTS, DROUGHT OR POOR ECONOMICS. AMONG THESE ARE 21.3 MILLION REFUGEES, OVER HALF OF WHOM ARE UNDER THE AGE OF 18; THE REST ARE ECONOMIC MIGRANTS AND INTERNALLY DISPLACED PERSONS. THE MENTAL CONDITIONS FACING REFUGEES INCLUDE MAJOR DEPRESSION, POST-TRAUMATIC STRESS DISORDER, ADJUSTMENT DISORDERS, ANXIETY DISORDERS, PSYCHOTIC DISORDERS AND GRIEF AND BEREAVEMENT. THERE IS COMPELLING EVIDENCE THAT SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS ARE MORE PREVALENT AMONGST REFUGEES RESETTLED IN HIGH-INCOME COUNTRIES, COMPARED TO OTHER IMMIGRANTS AND HOST POPULATIONS. Dr Carla Kotze, consultant in Psychiatry at the University of Pretoria concluded the forum by thanking all the speakers and everyone who made it possible. It is anticipated that the Public Mental Health Forum for senior registrars will continue annually or at least bi-annually in future. Richard J. Nichol is an Associate Professor and a Principal Specialist (Head: Childand Adolescent Psychiatry) in the Department of Psychiatry, University of the Free State, Bloemfontein, South Africa.Correspondence: NicholR@fshealth.gov.za SOUTH AFRICAN PSYCHIATRY ISSUE 18 2019 * 49
Page 1 and 2: ISSN 2409-5699 ABOUT the discipline
Page 3 and 4: Features THE GLOBAL BURDEN 7 OF DIS
Page 5 and 6: FROM THE EDITOR Dear Reader, Welcom
Page 7 and 8: FEATURE THE GLOBAL BURDEN OF DISEAS
Page 9 and 10: FEATURE YEARS LIVED WITH DISABILITY
Page 11 and 12: FEATURE FACTORS AFFECTING BURDEN OF
Page 13 and 14: FEATURE Kristiansen CB, Munk-Jorgen
Page 15 and 16: Young Psychiatrist Leadership and P
Page 17 and 18: FEATURE DEADLY MEDICINE: PAYING THE
Page 19 and 20: FEATURE Neurosis, Freud argues, is
Page 21 and 22: FEATURE Nevertheless, failure to in
Page 23 and 24: FEATURE IT STRIKES ME THAT WHAT FRE
Page 25 and 26: FEATURE THE 2018 OXFORD DICTIONARY
Page 27 and 28: FEATURE PHARMACOGENOMIC T E S T I N
Page 29 and 30: FEATURE Table II provides an exampl
Page 31 and 32: Biological Psychiatry Congress 2019
Page 34 and 35: FEATURE THE CHALLENGES OF PERINATAL
Page 36 and 37: FEATURE that empowered mothers lay
Page 38 and 39: NEWS VISITING PROFESSOR - SEMINAR C
Page 40 and 41: NEWS ADDICTION PSYCHIATRY - NEW HEA
Page 42 and 43: NEWS THE PERINATAL MENTAL HEALTH PR
Page 44 and 45: Specialised dementia care in luxuri
Page 46 and 47: UPDATE Corlia Schutte, occupational
Page 50 and 51: REPORT FEEDBACK FROM THE ROYAL COLL
Page 53 and 54: REPORT CELLULAR NEUROSCIENCE OF PSY
Page 55 and 56: 10 “How beautifully leaves grow o
Page 57 and 58: UPDATE “ALSO REMEMBER THAT IF YOU
Page 59 and 60: UPDATE Theresa Partington, a clinic
Page 61 and 62: PERSPECTIVE THE IMPACT OF CLINICAL
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Page 65 and 66: PERSPECTIVE reduce distress caused
Page 67 and 68: in Mental Health
Page 69 and 70: BOOK REVIEW POIGNANTLY, EMSLEY FORC
Page 71 and 72: CULINARY CORNER atrium of a large t
Page 73 and 74: CULINARY CORNER As expected, the EX
Page 75 and 76: WINE FORUM Rewind Raats; does it ma
Page 77 and 78: MOVIE REVIEW THE WIFE broadcast the
Page 79 and 80: SASOP HEADLINE FEBRUARY 2019 EDITOR
Page 81 and 82: SASOP HEADLINE Esidimeni tragedy; a
Page 83 and 84: SASOP HEADLINE errors, as well as a
Page 85 and 86: INSTRUCTIONS TO AUTHORS South Afric
Page 87 and 88: The fine art of mental health treat

South African Psychiatry - February 2019

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