How to Access State and NGO Mental Health Services in South Africa - Part Two

If you have reached the point where you know you need help, but you can't access private health care and aren't sure where to turn next, then this series is for you.

Part one: What brings people to counselling and other mental health services? What if you are not ready to meet with a mental health professional?

Part two: What to do if you are ready to start meeting regularly? How does the public health system work? How do you find nearby services?

Part three: This is an emergency; what should you do? What if a family member or friend refuses to go to the hospital?

Part Two

In part one, we looked at options for people who aren't quite ready to meet a counsellor or mental health professional in an ongoing way. Now we turn to what do now that you are ready.

I'm ready to see someone. Now what?

This is good news! Yes, telephonic, text, and even email support are all valuable. Still, none are quite the same as starting an ongoing journey with a mental health professional and meeting regularly with the professional offers you a better chance to get to know each other. It also makes it easier for the professional to assess and help you.

South Africa's community service program makes it far easier to access medical doctors and psychologists than before, especially around cities. However, to maximise your chances, it is essential to understand how the public health system works and to follow the procedures carefully.

Important point #1: The South African health system prioritises community-based care.

Unless you face an emergency, your healthcare journey starts with a visit to the community clinic nearest to your home. Hospitals do not offer superior care to our clinics; instead, they aim to address more specific problems and refer back to community clinics.

Most people needing counselling, or other mental health services, are not facing an emergency. They are ordinary people (like you and me) having difficulty.

Life throws up challenges. Some we manage alone, others with help from loved ones (if we are lucky enough to have some). Then some problems require expert hands, either because special skills are needed or because they can overburden our relationships.

How to find clinics and services

The internet offers an excellent tool for locating clinics and other services. Unfortunately, many sites (including Google) hold outdated clinic contact details. These two websites are better than most.

HealthSites ( https://www.healthsites.org.za/ ): is a list of all health facilities in South Africa. The website can be overwhelming, but it is comprehensive.

TherapyRoute ( https://www.therapyroute.com/ ): a user-friendly option that automatically displays nearby mental health services like community clinics, hospitals, NGO's, and private facilities.

What if the phone rings or the number is wrong?

If you can't get through by phone, visit the clinic and talk to the staff. Prepare by asking yourself the following questions…

• Can you describe the issue that brings you to visit the clinic?
  
• What do you want to see change?
  
• When did this all start?
  
• Why do you think it is happening?
• Do you have troubling symptoms, e.g. can't sleep, no energy, bad dreams?
• Do you want medicine, to talk to someone, or both?
  
• Has this happened before? What helped?

If you do get to see someone, it will most likely be a medical officer or a nurse. They will assess your situation and either give an appointment, put you on a waiting list, or refer you to another clinic or hospital.

Important point #2: Clinics are medical spaces.

The person assessing you will likely prioritise ruling out medical conditions. It is possible that counselling is not on top of their minds. If you would like to see a counsellor, you should ask to. Be polite and direct, e.g. "I would like to speak with a psychologist or counsellor. Please can you refer me to one?"

If possible, it can help to arrive with a letter from a private GP supporting the need for counselling.

Treating professionals will use their expertise to decide how best to proceed. They might decide that counselling is unnecessary or that they don't have access to enough resources to provide it. Still, there is no harm in asking. It's also worth asking if another clinic (or NGO) could help.

How to get the most from counselling

• Be open and honest. No sense in pretending things are better than they are.
• Focus on how you can change rather than on what others are doing wrong.
  
• Commit to the process. You will probably need to go more than once.
• Keep working between sessions by noting what to talk about the next time you meet and whether the last talk was helpful.
• Feel proud of yourself!

What's next?

We have examined how to access in-person mental health care in non-emergency situations and situations. But what should you do in an emergency or if you (or someone) need to go to the hospital?

Click here for part three .