By Leigh Andrews

Meyers said on the show: "The conference is organised for South African journalists by the South African Depression and Anxiety Group (SADAG) and the Carter Centre Mental Health Programme, based in Atlanta, Georgia.” Meyers explained on the radio show that the Carter Centre encourages journalists to explore and write about mental health issues, to gain understanding of the technical issues involved with mental health issues and that he would raise questions at the conference on how journalists make sense of the often very technical information provided by doctors, psychiatrists and psychologists.

I attended the second day of the conference, held at the Pfizer building in Sandton on Monday, 4 and Tuesday, 5 April. The second day of the seminar kicked off with a welcome by the Master of Ceremonies, Marion Scher, who is a freelance journalist and a Carter Fellow. She stated that there is a lack of knowledge out there, and that as a result, mental disease becomes “a silent illness”. It is not perceived as serious, and we need to get this awareness out there through the media.

SADAG’s founder, Zane Wilson, introduced the day’s first speaker, Dr Leigh Janet, who deals with “some of South Africa’s most difficult, treatment-resistant patients”. He is a psychiatrist, psychopharmacologist and expert in Bipolar Mood Disorder, who presented on ‘Riding the emotional rollercoaster – understanding Bipolar Mood Disorder’. He likened Bipolar Mood Disorder to the ‘emotional rollercoaster’ you would ride if we were to win the soccer, cricket and rugby world cups on the same day – then to find out a loved one has been booked into hospital and since died. He said, “Now imagine your mood moving like that for no reason,” calling Bipolar the most interesting disorder on the planet as one can have periods of ‘normal mood’ for years, and other conditions can co-occur with the disorder. He added that the mood swings, which range from depression to mania, “don’t feel abnormal to the person at the time.” It is also one of the top disorders associated with suicide and depression, and is linked to strong feelings of guilt. Interestingly, ECT, or electric shock therapy, is often used as treatment in an attempt to imitate a series of epileptic fits, which can be seen to cure depression.

This was followed by an off-the-record case study of a patient who lives with Bipolar Mood Disorder, where she described the prejudices she has faced in the workplace and within her own family, along with the difficulty she has had in convincing people that a mood disorder is as real a disease as diabetes or cancer. It’s a fight to get people to listen. She added that this is made worse by the fact that “government is interested in AIDS and TB, not mental illness.”

Next, Dr Shadi Motlana, Director of Psychiatry M Powered, took to the podium. As the head of Psychiatry at Tara Psychiatric Hospital, she elaborated on mental health patients’ rights and the Mental Health Care Act. She feels that Tara is misunderstood, particularly in the way it screens its patients. In explaining the rights of the mentally ill in South Africa, Motlana stated that the many abuses of government during the Apartheid era were redressed with 2002’s Mental Health Care Act, which sought to bring our practices in line with those of the World Health Organisation (WHO) and the African Banjul Charter. Mental Health Care Users (MCHU) of today have the right to respect, protection from unfair discrimination, and the right to intimate adult relationships, as well as knowledge of their rights and the right to appeal. Care treatment and rehabilitation must therefore not be used as punishment or for the convenience of others. Motlana added that the workplace should be made aware of any mental illness as there are reasonable protections in place by the law. She stated, “Silence causes more problems down the line.” She added that certain terminology is problematic, and that there is lots of discriminatory thinking regarding mental health issues. “The obligation lies with reporters to watch how they report on stories and to not exaggerate the facts or ostracise anyone,” Motlana said. Responsible reporting on mental health can destigamatise and raise awareness of mental health issues, getting people comfortable with the topic, so that they realise, “This doesn’t have to be your destiny” – it can be treated. She applauded SADAG for its role in making mental health issues visible to the public eye in terms of raising awareness. Wilson added that it would cost roughly R20 000 per month to run a 24-hour suicide line – the group can currently only afford to run the line from 08:00 to 20:00.

We then heard from Peter Matlhaela, the Siyabuswa Support Group Leader, who discussed the complications of getting patients’ care in a rural community, in an interview session with SADAG’s Operations Director, Cassey Chambers. He described his ordeal in dealing with panic attacks following his involvement in a taxi accident, and highlighted the fact that there is lots of stigma or lack of knowledge concerning mental health problems in the rural areas, adding that many people in these areas are illiterate and needed support groups so as to reach the people and educate them in the way they would understand. He said a key issue affecting understanding is that some African cultures lack separate words for depression and panic attacks, lumping them all together as ’madness’ – and if there’s no word for it, how would they understand it? Matlhaela gets around this problem by getting support group attendees to act out how they feel.

Following a tea break, Kevin Bolon, a clinical psychologist and Cognitive Behavioral Therapy (CBT) expert who has developed a course for the fear of flying, spoke about how obsession and compulsion go hand in hand, offering an insight into Obsessive Compulsive Disorder (OCD). He explained that many psychological terms have become popular and are now in everyday use, such as ‘depression’ and ‘panic attack’ – he stated that mental disorders are debilitating and should not be treated lightly – much in the way that anyone with a runny nose and sore throat claims to have the flu, which is actually a serious, potentially fatal illness. He mentioned that washing and counting are among the most common compulsions, and that prayer often gets hijacked into compulsion, in that we feel a need to pray when we think a ‘bad thought’ – the act of praying works to ease our anxiety. He added that the compulsions are targeted in treatment, so that eventually the patient is less likely to feel a need to react a certain way when a certain thought crosses their mind, because they are associating a consequence with a certain unrelated behaviour – this is known as ‘magical thinking’ as people connect a cluster of ‘what ifs’ to reach an unlikely outcome. It is also known as the ‘doubting disease’ because of this. The compulsion only results in a temporary release of anxiety as it reloads. Bolon reassured attendees that “we all have bits of OCD behaviour”, but actual diagnosis is based on the amount of time spent on the compulsions, as well as the level of impairment or interference caused in day-to-day functioning. He added that there is a risk of misdiagnosis and that people are becoming more aware of the disorder due to it receiving greater coverage in articles and TV shows. It is not treated with Cognitive Behavioural Therapy, which aims to change thoughts during the behaviour – instead, an ‘exposure and response prevention’ method is used, where the patient is made to face their obsession trigger and resist the compulsion. The thoughts get weaker and weaker as treatment goes on. OCD only gets worse if it is not treated as it acts as an addiction. Traditional therapy is also not effective in treatment of OCD as going through past traumas can make OCD worse. Antidepressants are also used to boost levels of serotonin – but not because there is a lack of serotonin or the person is depressed. Bolon explained this is similar to the fact that Panado is used to cure a headache even though a lack of Panado is not the cause of the headache. He asserted that mental health issues are often misrepresented in the media, and that there is no such thing as ‘compulsive’ shopping or gambling, as these are based on impulses.

SADAG Counsellor, Shai Friedland, then gave a personal account of living with OCD, titled, ‘When worry hijacks the brain: An OCD patient takes back his life.’ He shared his typical obsessive thought processes and explained that anyone who suffers from mental health issues is “not a freak – it’s a disorder”. To this, Bolon added, “These people are not weird or strange – they are as normal as you and me. They are normal people dealing with abnormal situations.” SADAG’s Project Manager, Roshni Parbhoo-Seetha, spoke about creating mental health awareness and developing successful school outreach programmes. SADAG promotes several mental health awareness days to raise awareness, as well as school prevention programmes, such as ‘Suicide shouldn’t be a secret’ and ‘When death impacts your school’ in order to discuss the warning signs in a safe environment, as teenagers don’t seem to understand the permanence of the act and it is sometimes seen as a way to attract attention. Wilson interjected that SADAG has revamped its website (www.sadag.org), which is a valuable resource for mental health journalists as it includes local and international articles on many topics. She also provided surprising statistics from a survey taken the previous day that proved 30% of the journalists attending the conference suffer from mild depression, 25% from major depression, with one so high that the person might be verging on suicide. A definite sign that there’s a need for better education on the topic!


After a lunch break, Clinical Psychologist, Robyn Rosin, spoke on the topic of ‘Flashbacks: when the worst thing that ever happened to you keeps happening everyday’ in the sense of treating Post-Traumatic Stress Disorder (PTSD). She stated that the media has a great role to play in terms of getting factual information out there and breaking the stigma of mental health disorders. She said knowledge of PTSD is especially important to field reporters who are at the scene of horrible accidents and violence, often taking horrific images as photojournalists, which continue to haunt them for years. It is also known as vicarious or secondary traumatisation if journalists hear traumatic stories and need to recount them. She added that we like to feel our world is safe and predictable, and we think that “bad things happen to other people” – this is why it is such a shock when something bad happens to us. For the first 24 to 48 hours after experiencing a traumatic event, the typical reaction is to feel numbness and disbelief as we try to make sense of what has happened – debriefing is often essential to put the event into perspective. This involves education and ‘normalising’ the symptoms in order to redress the trauma experiences and put them into perspective, understanding that the symptoms are normal. PTSD is only diagnosed if symptoms persist for a month after the event which triggered the symptoms and is easy to trace. Rosin echoed Bolon’s words, that mental illness is “a normal reaction to an abnormal set of circumstances.” Treatment revolves around getting the person back to their normal state of functioning as soon as possible.

Meyers then presented the final session of the day, on ‘Presenting to editors, producers and supervisors: how to portray your story’. This was a workshop brainstorming session where attendees broke into small groups to discuss possible article ideas based on the topics that had been presented for the day. He spoke of the importance of using a common/ neutral language that does not make mental health patients sound deficient in any way, adding that standards differ greatly among different media, ad that there has been a “coarsening of civil dialogue,” which is why so many newspapers lead with shocking images of bodies splattered on the ground and graphic images of violence.

Rebecca Palpant, Assistant Director of the Rosalynn Carter Fellowships for Mental Health Journalism, concluded the session by stating, “This is just the beginning for mental health journalism in South Africa,”adding that personal stories are so powerful – stories about mental health should not quote numbers, they should speak of the singular self that is affected. Scher interjected that interested parties should enter the Pfizer Awards for mental Health Journalism through the SADAG website, which results in two awards of R25 000 for mental health journalists.

Attendees received a certificate following completion of the seminar, and the enthusiasm sparked in all, whether they catered to print, broadcast or online journalism, was evident in each and every one. All in all, a most informative day, especially as it brought my love of journalism and mental health together. For more information, visit www.sadag.org.