28 November 2011

HIV patients prone to mental illness

The global community will commemorate World Aids Day on Thursday amid warnings from some South African psychologists that mental illness in HIV-positive people need more attention.


The global community will commemorate World Aids Day on Thursday amid warnings from some South African psychologists that mental illness in HIV-positive people is not getting the attention it deserves.

As a result, mental illness has reached alarming levels and several studies have shown that there is a strong link between mental illness and HIV.

The government is expected to announce drastic changes on Thursday to the way healthcare facilities deal with such concerns.

City Press understands the changes include creating health screening tools at all healthcare facilities to assist nurses in assessing the mental condition of HIV-positive people.

Mental health screenings

While mental health screening is part of HIV treatment guidelines, it’s often overlooked. Dr Jan Chabalala, a psychiatrist specialising in HIV/Aids, said the high rate of mental disorders in HIV-positive people in SA was cause for concern.

“It has reached a point where some people on antiretroviral (ARV) treatment are using the life-prolonging drugs to commit suicide,” Chabalala said.

“In the past few years, we have seen an increase in the number of people who overdose on ARVs.

“Patients are educated about how and when to take ARVs, and there is no way they could swallow more than they are supposed to unless they are trying to kill themselves.”

He said in most cases people who overdose on ARVs have severe depression or are at a stage where they can’t think clearly because the HI virus has affected their brains.

A recent study conducted by the University of Cape Town has revealed that almost half of the 5.6 million people living with HIV and Aids in the country have some kind of mental disorder.

Depression, anxiety

The study found that the prevalence of mental illness, especially depression and anxiety, among people living with HIV is 43.7%.

It also found that depression and anxiety were much higher in pregnant women who had recently learnt about their HIV status.

Nonhlanhla Dlamini, a team leader for counsellors at the Thembalethu Aids clinic at Helen Joseph Hospital in Joburg, agreed with the findings.

She said depression was very common in pregnant women who discovered they were HIV- positive.

Dlamini recently counselled a 26-year-old woman who tried to kill herself three times after she found out she was HIV-positive.

“She had severe depression and felt like her life was over,” she said.

“Her family and boyfriend had abandoned her, and the thought of knowing she was living with HIV pushed her over the edge.”

The National Association of People Living with HIV and Aids blamed the increasing number of HIV-positive people with mental illness on “under-diagnosis”.

“Mental health screening is part of the HIV treatment guidelines, but healthcare workers routinely fail to screen people,” said the association’s secretary-general, Mluleki Zazini.

“I am not sure if they are not skilled enough to identify mental illness or are merely overworked and don’t have enough time to spend with patients.”

But perhaps this is set to change soon – the new five-year national strategic plan for HIV and Aids, sexually transmitted infections and tuberculosis comes into effect next year.

- Zinhle Mapumulo, City Press  

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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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