Industry News

POOR MENTAL HEALTH

14 October 2008

In Categories: Industry News , Industry News > General , Industry News > Patients

By Lucas Malambe

OCTOBER IS MENTAL HEALTH MONTH and once again the concept of mental illness becomes trendy. We are reading and hearing more about mental health and the illnesses and stigma attached to it. For many the news whizzes past like a fighter jet. Its just all sound and fury signifying nothing but something that happens to others. But the reality is much closer to home. Me too can be nuts tomorrow, and will I be adequately covered by my medical aid scheme.

MENTAL illnesses account for a frightening eight percent of all Disability Adjusted Life Years (DALY), found the World Health Organisation in the World Health Report of 2001. It may be seven years but no one is taking this seriously, that is, if you look at the benefit packages regarding mental health coverage. 

DALY is a health gap measure that extends the concept of potential years of life lost due to premature death including equivalent years of “healthy” life lost by virtue of being in states of poor health or disability. Think of a DALY as one lost year of “healthy” life and the burden of disease as a measurement of the gap between current health status and an ideal situation where everyone lives into old age free of disease and disability. Now think of alcohol and you will realise this is something that may trigger a psychological or behavioural pattern that may cause distress or disability thus tinkering with your DALY.

What is really a mental illness? Is abusing drugs or alcohol a mental health condition? Maybe. What about administering corporal punishment to your child? Think of walking around town in the nude. I have just mentioned a few behavioural patterns that may be considered normal in one setting and a bit odd in another.

Nevertheless, in mental health not every mental or behavioural chaos constitutes illness even if such demeanour deviates to the expected conduct - as part of “normal” culture. It is something more onerous than that. Perhaps an insidious mental process entrapping one to a fantasy world rendering him/her dysfunctional. Maybe a bodily condition in which there is a disturbance of normal functioning as a result of what goes on in one’s brain or mind. This may include the response to such mental turmoil, uneasiness or cause to be worried or alarmed.

Of course, the above is not a true definition of mental health illness. People do feel emotionally patchy now and again as a result of the relationships we have with our immediate world and significant others. Think of the irritating traffic jams one had to negotiate every peak hour travel, massaging egos of colleagues and the intense sorrow caused by loss of a loved one (especially by death).

Our bodies are largely equipped to deal with these emotional and psychological upheavals most of the time. But in some cases we just can’t cope with these everyday stressors and slip into mental illness. These seemingly everyday stressors are responsible for eight percent of all DALYs according to the World Health Organisation. This is not scrimpy considering HIV/Aids accounts for 13% of all DALYs.

Despite this frightening observation, mental illness still gets the end of the stick. Look no further than your medical aid benefit package. The least benefits belong to psychological illnesses. But why is mental illness treated like a poor cousin of the healthcare industry if it causes so much pain?

A University of the Free State nursing academic Dr I Venter write in the October installment of HASA NEWS that it is a combination of a lack of understanding of the impact of mental health on society because of the way public health statistics have been formulated and presented in the past. Until recently, says Venter, health statistics have focused on mortality rather than morbidity or dysfunction. Deaths have been ascribed to their direct causes with no reference to the underlying behaviours or disease. For example, alcohol-induced liver failure is attributed to a liver condition. No mention of substance abuse which is the underlying cause.

These methods of communication render mental illness almost invisible though its impact on DALYs is more than heart diseases and cerebrovasuclar conditions combined (3%). Furthermore, behaviour-related illnesses make up a staggering 34% according to the same WHO report.

Perhaps it is time for our medical aid benefit packages to start reflecting on these surveys, and respond positively to the plight of those suffering from mental illness. The alternative is death man walking presenting to hospitals. No doubt the man abusing alcohol and his liver eventually access medical aid benefits for his liver condition. But it is usually too late, or the recovery period may be longer and extremely expensive. The same may be said with obesity and other pychological disorders. With good mental illness benefits these patients may turn their DALYs around before they develop more debilitating physical symptoms because of their mental problems. 

Dealing with mental health effectively may save the system a lot of money by strengthening the future quality of life. As medical aid schemes are busy reviewing benefit packages for the near future, here is an opportunity to reduce DALYs - by some eight percent. Who knows how much of the health rand we can save by dealing with mental cases decisively? Nip it in the bud and save the system millions of rands.