03 May 2006

Denial costs mentally ill dearly

Only 45% of South African patients with mental health problems seek help timeously, reports a new study.

Only 45% of South African patients with mental health problems seek help within the first year of experiencing symptoms says a consumer study conducted by Cat Communications during 2005.

The research was done in collaboration with the SA Depression & Anxiety Group (SADAG) and the SA Bipolar Association, and sponsored by AstraZeneca, Eli Lilly and Solvay Pharma. It comprised 331 respondents, all diagnosed with a psychiatric illness.

Why do people with mental health problems delay getting help? Half the survey respondents “thought they would get over their problems” and “didn’t know that they had a disorder known to doctors,” says researcher, Linda Trump.

“Ignorance about mental illness and delayed help seeking costs patients dearly,” says Trump. The 2005 research study shows that 19% of respondents became unemployed during the course of their illness; 26% separated from their partners or divorced, and half experienced problems in dealing with immediate family members.”

“When mental illness is compounded by unemployment, divorce, and family and financial problems, this is an unstoppable downward spiral,” says Zane Wilson, CEO of the SADAG. “Statistics also show that when people with depression are left untreated, 15% will actually commit suicide,” says psychiatrist, Dr. Dora Wynchank.

Unfortunately, delays in seeking help were compounded by the fact that it took more than a year for 55% of the respondents to get a correct diagnosis. Seven out of ten respondents also needed to see two or more caregivers before receiving a correct diagnosis. “With 74% of respondents having received their diagnosis eventually from a psychiatrist, the study identified that South African GPs, psychologists and social workers need further psychiatric education,” says Trump.

Discontinuing medication
Despite the significant problems caused by mental illness in respondents’ lives, the research showed that 69% of respondents discontinued taking medication at some point in their illness. Primary reasons were the mistaken belief that they could handle the problem on their own, that they did not want to become dependent on drugs (even though most psychiatric drugs are not addictive), and that they did not like the side-effects of the meds they were taking.

Financial limitations also led to 23% of respondents stopping their medication, and to 46% stopping psychotherapy. One out of four respondents receiving psychotherapy said that the funds available from their medical schemes for psychotherapy were insufficient. Thirteen percent of respondents discontinued taking prescribed medication due to medical scheme limits.

“Sadly, patients with chronic conditions like bipolar mood disorder, and those who have been clinically depressed more than once, inevitably relapse when they stop taking their meds,” says Wynchank.

“Despite the reluctance of many respondents to take medication, surprisingly 47% of them used alcohol while mentally ill, 34% moderately or a lot,” says Trump. “Another disturbing finding was that one out of ten respondents reported using alcohol or another substance to ‘boost the effects of prescribed medication’.”

Diet and exercise
Although a healthy, balanced diet and regular exercise are essential ingredients for mental wellness, only 34% of respondents claimed to eat well, with even less (27%) doing regular exercise.

“The study clearly showed the extent to which mental illness affected respondents’ daily functioning,” says Trump. “Only 19% of respondents said they could work adequately while ill and 77% took sick leave, 33% for more than a month. One out of two respondents also said that their illness negatively affected relationships with parents, siblings and children.”

Mental illness is unfortunately not a cold. It rarely goes away unless properly treated. The prognosis, however, is good for mentally ill people who attend to their symptoms promptly. Recovery can be as high as 80% with a combination of medication, therapy and support group attendance. “Through a process of trying various other medications, effective treatments are also eventually found for the other 20%,” says Wynchank.

Patients have a lot to gain from support groups. Three out of ten respondents said that support group members had been a valuable resource for them, with the same number reporting that they had gained friends while ill. In all likelihood, these were probably other support group members.

May 2006


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