SA, we have a problem: the link between mental health and substance abuse – and what can help

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South Africa has been fighting more than just the Covid pandemic for the past few years. The country has been trying to stem a rising tide of mental health issues and substance abuse. New research has found that more than a quarter of South Africans suffer from probable depression and anxiety – higher than other countries, including the US, Australia and Brazil – but that the majority are not receiving help or treatment.

Many turn to familiar crutches like cigarettes, alcohol and marijuana, or more illicit drugs like methamphetamine, opiates, and cocaine. Substance abuse in Africa has consistently and steadily increased, and the problem has intensified because of the uncertainty, disruptions and ongoing impact of the pandemic.

High levels of substance abuse

South Africa again outperforms its global peers: the lifetime prevalence of substance abuse of South Africans is an estimated 13.3% for at least one substance – more than twice the worldwide average of 5%. Alcohol is the most abused substance in the country, with the rates of heavy drinking the highest in the world. Tobacco and cannabis follow as the second and third most used substances respectively.

Substance abuse does not occur in a vacuum – it’s been found to go hand-in-hand with mental health conditions. A UCT study showed that patients with disorders such as schizophrenia and bipolar are more likely to abuse substances, but it also found a link between substance abuse and people with anxiety symptoms, disorders and high levels of post-traumatic stress.

The study found that people with mental health conditions use substances, especially alcohol, as a coping mechanism and form of self-medication. However, while having a few drinks or smoking some marijuana may initially seem to help with feelings of uncertainty or stress about the future or to numb memories of traumatic events, it can quickly become a habit that people can’t go without, and which starts to impact daily living and behaviour.

Providing access to critical support

There are warning signs that people can look out for. Sleep disorders such as insomnia, which interfere with the amount and quality of sleep and impact physical and mental functioning during the day; heightened impulsivity or aggression, and other patterns of addiction, such as shopping, gambling, caffeine, or nicotine.

It’s also important to consider family history and recent traumatic events that may have a compounding effect on the usage of substances. It is never too soon to seek help and talk to a health professional to deal with grief, trauma, anxiety, depression, or substance abuse. And the good news is that there are resources – including professionals, programmes, platforms, and apps – that provide access to a support network.

Many companies today have programmes and resources in place for their people’s health and wellbeing. The evidence shows that these types of programmes are highly effective. We see a marked difference where employers offer employees access to wellness resources and where they are committed to putting people first in the workplace.

Access to awareness programmes with information around substance abuse and mental health conditions can help people recognise symptoms and signs of trauma and addiction. Further access to resources and support networks such as call centres and apps – like Hello Doctor – with trained counsellors and professionals, can assist people in the short, medium and long-term by teaching them resilience exercises and prevention strategies to manage their mental health and wellbeing.

Connection, support structures and self-care are the key to managing mental health and preventing substance abuse. They help people know they are not alone, and that help is available. The health system and professionals who work in it are trained and geared towards supporting people who are struggling. The earlier a person reaches out for support; the sooner they will get the help they may
need.

Margot Brews is the Head of Health Risk Management Strategy at Momentum Health Solutions

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