Building an effective mental health defence force to serve SA communities

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Left unchecked, endemic trauma, deprivation, violence and a wide range of abuses seriously drain the well-being in our country, and ultimately impact negatively on our collective day-to-day experience of life in South Africa.

Like any other healthcare situation, the old adage ‘prevention is better than cure’ holds true. While there may be some resources directed at clinical and medical treatment for mental health issues, the question is what are we doing when it comes to the proactive prevention and the promotion of mental health at the community level?

Untapped resources

Private educational institutions, such as SACAP (the South African College of Applied Psychology), and other stakeholders are raising awareness of registered counsellors as an untapped resource when it comes to prevention and the promotion of well-being in communities. “To build an effective mental health defence force, a multi-pronged strategy needs to be implemented that involves greater public awareness of the role of registered counsellors and a concerted boost for employment opportunities, especially in under-served communities,” says Dr Laura Fisher PhD, the director of Academic Affairs at SACAP.

Fisher argues that the current Scope of Practice set out by the Health Professions Council of South Africa (HPCSA) falls short of effectively illuminating the potential of the registered counsellor category within the country’s psychology profession. “By positioning registered counsellors relative to [[http://www.sacap.edu.za/blog/counselling/clinical-psychologist/ clinical psychologists, the role has been bound to a clinical/medical psychology discourse of abnormality-, dysfunction- and individually-oriented treatments,” she says.

The problem with this is that it is not aligned with the vision of training up a strong cohort of registered counsellors to create a groundswell for scaling up access to and delivery of mental healthcare services nationally. The primary role of a registered counsellor is aimed at providing psychological interventions for prevention and mental health promotion and wellness. They are trained and well-positioned to specifically provide community-based psychological services, including supportive counselling, the promotion of mental health and well-being, psychological screening and assessment, as well as psycho-education.

Yet, when it comes to their current, real-life work situation, the majority of proper career opportunities arise in the clinical treatment environment instead of in the community.

Creating viable employment opportunities for registered counsellors

Fisher highlights the consequences of this: “We have many NGO's and government departments desperately in need of access to mental healthcare services for their communities, but they cannot afford them. Then, we have many mental healthcare workers longing to serve in under-resourced and disadvantaged communities. These are registered counsellors who trained with the passion for playing their role in making counselling services and psychological interventions accessible to the communities in South Africa who need them the most.

But, so often, all that they can do to realise their career aspirations and life’s purpose is to volunteer or accept a vastly suboptimal salary or stipend that then forces them to supplement their income in private practice for their basic survival. In essence, we need these mental health foot soldiers so badly, but when we do deploy them, we aren’t looking after them properly and enabling their services to be sustainable.”

This is why institutions such as SACAP and others, are strongly advocating for the psychology profession to unite and engage with both local, provincial and national government to create viable employment opportunities for registered counsellors where the country needs them most. “Just think how we can turn things around if the Departments of Health, Social Development, Education, Correctional Services and Youth Development across the country created the positions for the mental healthcare workers that they truly need. If these jobs were opened up, there would be tremendous upliftment benefits,” concludes Fisher.