Historical under-investment in mental health services in South Africa has been compounded by an increase in insurance incapacity claims for mental health issues, compounded by long Covid health conditions.
Alexforbes Health Management Solutions (HMS), a health risk manager within the employee wellbeing space, has seen up to a 40% increase in such incapacity cases over the past year.
According to Gareth Friedlander, Discovery Life Deputy Chief Executive, the insurer was concerned about the growing prevalence of claims related to mental health conditions. Liberty reported a spike in mental health claims from its clients during 2021, particularly among working people between 35 and 54 years. This is largely attributed to the stresses brought on by the pandemic.
“Some individuals suffering from long Covid symptoms do not realise it, which increases anxiety and mental health conditions,” says Alexforbes HMS head, Myrna Sachs.
Long Covid is defined as Covid‐19‐related symptoms that are present 28 days or more after the onset of acute infection and can last months. Symptoms can be physical and psychological.
Impact of pandemic highlights need for more awareness
Long Covid is not the only driving force increasing mental health issues. The actual impact of the pandemic (financial and psychological) for those affected and infected has also highlighted the need for more awareness and support, says Sachs.
Mental health conditions are a cause of incapacity, disability and exclusion. They affect people’s ability to contribute to their workplace and families. The World Bank considers mental illness to be the greatest thief of productive economic life. Yearly global costs from mental, neurological and substance use disorders are estimated at between $2.5 and $8.5 trillion dollars a year, projected to double by 2030.
“The impact of poor mental health among employees therefore has highly apparent and direct repercussions for employers,” Sachs says.
An article on mental health in Africa published in The Lancet Global Health journal notes that “there are 1.4 mental health workers per 100 000 people, compared with a global average of nine per 100 000”.
“In South Africa, access to psychologists and counsellors is limited to the wealthy, and even then, you can wait weeks for an appointment. Government hospitals and clinics do not have the capacity or professional staff to deal with the increase in mental health,” says Sachs.
“This is not a new problem. Mental health has always been ‘neglected’ and this is now exacerbated by the current situation. Therefore, an opportunity exists for employers to fill this gap by offering access to professional counsellors.”
Mental health under-reported because of stigma attached
Sachs notes that mental health conditions are generally under-reported due to the attached stigma.
“Employees don’t want to divulge that they have a problem, or they are not aware that they have a problem. They just relate their symptoms to something physical, so they don’t get treated timeously. Employees are still scared they will lose their job if they disclose; they feel they will be ostracised and they feel vulnerable.”
Sachs says employers play an important role in breaking the stigma around mental health by conducting education sessions and having employee wellness programmes in place. Employees need supportive, open communication and an empathic approach from management.
“The onus is on employers to create an environment which is more conducive to dealing with mental health illness. They should have policies in place which look after the wellbeing of employees by monitoring absenteeism, as this is one of the early warning signs of poor mental health.”
Poor mental health of an employee affects business, resulting in poor productivity and low morale, as well as affecting other employees.
“There are bottom-line losses due to productivity, as well as direct and indirect costs of absenteeism,” says Sachs.
Sachs says employees needed to be empowered to know how to access mental health support and champion this, “as mental health challenges are also a major contributor to physical health and general wellness”.