Frequently Asked Questions
Frequently Asked Questions
Frequently Asked Questions
WHAT'S THE DIFFERENCE BETWEEN A PSYCHIATRIST AND A PSYCHOLOGIST? A psychiatrist is a qualified medical doctor (MBChB, MBBCh) with a Master’s degree and/or Fellowship in Psychiatry (MMed Psych, FC Psych). They are qualified to diagnose psychopathology and conduct a physical examination, and treats through prescribing medication and giving psychotherapy (talk therapy). Specialist areas include -Adult Psychiatry -Addiction Psychiatry -Child and Adolescent Psychiatry -Consultation-liaison Psychiatry -Forensic Psychiatry -Geriatric Psychiatry -Neuro Psychiatry -Perinatal and Infant Psychiatry A psychologist has a Masters and/or Doctorate degree in Psychology (MPsych, DPsych) There six categories of psychologists registered with HPCSA: -Clinical Psychologist -Counselling Psychologist -Educational Psychologist -Industrial and Organizational Psychologist -Neuropsychologist -Research Psychologist Clinical Psychologists are qualified to diagnose and treat mental and emotional disorders in the clinical setting. They use different psychotherapy approaches to manage complex psychopathology and provide services mainly in the clinical settings such as hospitals, clinics and private practice. Counselling Psychologists focuses on promoting and helping individuals and groups to improve their personal and interpersonal functioning.They provide services in private practice, universities, organisations, counselling centers and hospitals). Educational Psychologist diagnoses and manages learning disorders and provide services in schools and universities. Industrial Psychologists provide services to organisations addressing the behaviour of employees in the workplace, offering training and reviewing of performance measurements. Neuro Psychologist works mainly with people who have experienced a brain injury through trauma, illness, or dementia to understand how their diagnosis impacts their behaviour. A Clinical Psychologist with an additional qualification in Neuropsychology, has a wider scope of practice. Research Psychologists mainly work in the academic setting of a university designing and monitoring study hypothesis, and publishing their results to expand industry knowledge.
WHAT SHOULD I EXPECT DURING MY FIRST PSYCHIATRIST VISIT? Before seeing your psychiatrist, you will need to complete several documents to open a file with the doctor such as personal information, consent documents and payment arrangements. Your first consultation will take between 60-90 minutes and the psychiatrist will thoroughly review your family and childhood history, past psychiatric and medical history, and discuss your symptoms. A physical examination and blood tests may be conducted. A provisional diagnosis may be given with treatment options and if necessary, a prescription.
CAN I SEE A PSYCHIATRIST WITHOUT A REFERRAL FROM MY GP? Yes you can, however, some medical aids specify that you may only see a specialist if you are referred to one by your GP so best to check beforehand. In addition, waiting lists to see a psychiatrist may be very long (up to 3 months) hence consulting a GP in the interim may be a quicker option. GPs are also equipped to assess and treat uncomplicated psychiatric conditions and will refer you to a psychiatrist should the need arise.
CAN LIFESTYLE CHANGES IMPROVE MY MENTAL HEALTH? Whilst lifestyle changes cannot replace psychiatric medication in certain psychiatric conditions, they certainly play an important and complementary role. The following lifestyle changes have been shown to be beneficial: •Regular, structured schedule with sleeping, and waking times, regular meals and a strict medication regime •Good sleep hygiene habits especially if there is difficulty sleeping. No caffeine-containing drinks after 6pm, regular sleep schedule, regular exercise, a warm shower/bath before bedtime, only sleeping in bed (not on a couch or in front of the television), switching off electronic devices at least 2 hours before bedtime, light reading before bedtime if indicated, avoid daily alcohol to assist with sleep •Regular exercise assists with anxiety and depressive symptoms •Regular, healthy diet without the exclusion of major food groups unless indicated •A good work/life balance that includes boundaries about when to switch off from work-related activities, opting for spending quality time with friends and family and engaging in hobbies that you enjoy once work-related activities have been stopped •Social interaction regularly rather that social isolation
DO I NEED MEDICATION FOR LIFE? This would depend entirely on your psychiatric diagnosis, response to medication and following a comprehensive discussion with your treating doctor. In most mild illness cases doctors will guide you on how long you should be on medication. Only once you are completely symptom-free and fully functional, a trial of reducing medication under supervision may then begin to gauge your response. It is best to refrain from discontinuing medication prematurely, suddenly stopping medication or without prior discussion with your treating doctor as all psychiatric illnesses and individual responses to medication differ from person to person.
DO I QUALIFY FOR A SASSA GRANT? Only certain conditions qualify for SASSA grants. These are usually conditions that are irreversible, not fully treatable and cause the sufferer to be unable to be employed in any sector (formal or informal). Your treating psychiatrist will inform you if you meet these conditions and criteria. The final decision, however, remains in the hands and desecration of the assessing doctor at SASSA, and not with your treating psychiatrist or GP.
HOW DO I SUPPORT A FAMILY MEMBER WITH MENTAL ILLNESS? Its great that you want to acknowledge and support your family member. So many people with mental illness lack family support. Start by acknowledging to your family member that you recognize that they are ill and that you would like to support them. Ask them what support they need. Everybody needs a different type of support be it practical emotional or financial. Ask whats needed and work with your family member to support them as best as possible
HOW IS THE RIGHT TREATMENT DETERMINED? The first step is to make an accurate diagnosis. Based on that diagnosis, there are treatment protocol psychiatrists follow. Treatment is holistic and may include medication, psychotherapy, lifestyle changes and work interventions. Your psychiatrist will choose the right treatment package for you. Then, depending on how you respond your psychiatrist will modify your treatment to produce the best outcome for you. Your psychiatrist will look at your response as well as any side effects to decide on your treatment.
HOW LONG WILL I NEED TO BE ON MEDICATION? The amount of time you will need to be on medication will depend on your diagnosis, the severity of your illness, your response to treatment and the number of times you have been ill. In general for a first episode of depression you will need 6-12 months of treatment from the time you get well. This is to prevent relapse, as though you may feel well, brain healing takes time to be complete. For second episodes of depression you will need about 2 years and for 3 more episodes 5 years to possibly lifelong treatment. Anxiety disorders take longer to respond – first episode need about a year to 18 months of treatment, subsequent episode 3-5 years or even lifelong treatment if you have had multiple episodes. If you have schizophrenia or bipolar mood disorder, it is likely that you will need some form of treatment for life, though as you become more well the number of treatments may be reduced.
HOW OFTEN DO I NEED TO SEE A PSYCHIATRIST OR THERAPIST? How often you see a psychiatrist is determined by the severity and type of your illness, as well as your response to medication. In general you will initially see your psychiatrist every few weeks. If you are admitted your psychiatrist will see you every few days. Once you get better you may see your psychiatrist every 3 to 6 months. You need to have seen your psychiatrist in the last 6 months for he/she to be able to prescribe medication. This is a HPCSA requirement. Therapists usually see you weekly and once the therapy process is more established this can be extended to once every 2 weeks or monthly.
WHAT IS VOLUNTARY, ASSISTED, OR INVOLUNTARY CARE? To decide on the individual’s level of care, we are guided by the Mental Health Care Act,17 of 2002 •Voluntary care: Admission (treatment and rehabilitation) is offered to a mental health user who is voluntary and who is capable of making informed decisions. •Assisted care: Admission (treatment and rehabilitation) is offered to a mental health user who is voluntary but not capable of making informed decisions due to their mental health condition. This mental health user requires health interventions for their own protection or the protection of others. •Involuntary care: Admission (treatment and rehabilitation) offered to a mental health user who refuses treatment and is not capable of making informed decisions due to their mental health condition. This mental health user requires health interventions for their own protection or the protection of others.
WHAT DO I DO TO GET MY FAMILY MEMBER TO THE HOSPITAL IF THEY ARE MENTALLY ILL AND ARE REFUSING TREATMENT? •In case of emergency, or where you suspect the individual might refuse treatment, go to the nearest emergency unit •If the individual refuses to go to the emergency unit or consult with a general practitioner, psychologist, or psychiatrist, you should contact the South African Police Services or a medical emergency response service. •As required by the Mental Health Care Act, a spouse, next of kin, partner, associate or gaurdian of the user may submit the application for admission. If no such person is available, a mental health professional (doctor, nurse or social worker) can also complete the application documents.
HOW TO ARRANGE VOLUNTARY, INVOLUNTARY, OR ASSISTED ADMISSION? •For admission, the friend or loved one should display signs of mental illness and their behaviour is harmful to themselves and/or others •If the individual cooperates, you can consult a general practitioner, psychologist, or psychiatrist. •For assisted or involuntary admission, a medical professional should consult the mental health user. If the mental health user refuses to go to the emergency rooms the hospital, emergency medical response (ambulance) service and/ or South African Police Services should be contacted. •The medical professional should contact the nearest facility with a license to accommodate assisted and involuntary patients. •For admission to a private hospital, the authorisation from the medical aid is obtained by the family or the referring practitioner’s rooms. •Confirmation of bed availability and admission date will be communicated for admission to both private and public hospitals.
WHICH FORMS DO I COMPLETE TO HAVE A FAMILY MEMBER ADMITTED TO THE HOSPITAL AS AN INVOLUNTARY PATIENT? For emergency involuntary admissions: •MHCA 01: completed for an emergency admission or treatment without consent. This form is completed by the medical professional working at the establishment that provides care, treatment, and rehabilitation services to involuntary patients •MHCA 22: If the mental health user was brought to the emergency room by the SAPS, this form must be completed For an involuntary admission that is not an emergency: •MHCA 04: completed for assisted admissions by the spouse, next of kin, partner, associate, guardian, or parent •MHCA 05: completed by two medical practitioners after they examined the mental health user
WHAT ARE THE SIDE EFFECTS OF PSYCHOTROPIC MEDICATION? Different types of Psychotropic medications are used to treat many Psychiatric conditions. Prescribed medication is determined by the individual’s presenting symptoms, medical history and preference. People react differently to different medications, so side effects will differ from person to person. Psychiatric medications may interact with other chronic medications and you may have to avoid certain psychiatric medications if you are suffering from certain medical conditions. •Common side effects include: -Anxiety -Blurred vision -Diarrhea/Constipation -Dizziness -Drowsiness -Dry mouth -Headache -Nausea/Vomiting -Sleep problems -Sexual dysfunction -Tremors -Weight gain/Weight loss Certain medications carry a black box warning as they may have a risk of dangerous adverse effects.
WHAT SHOULD I DO IF I EXPERIENCE A CRISIS OR SEVERE SIDE EFFECT? Even though your doctor may warn you about potential side effects, the severity can sometimes be unpredictable. Should you experience a crisis: 1.Call your doctor’s office 2.Call the emergency line (082911) 3.Go to your nearest Emergency Department
HOW DO I ACCESS MENTAL HEALTH SERVICES IN SOUTH AFRICA WITHOUT MEDICAL AID? 1.Free and Low-Cost Counselling Services Many non-profit organizations provide free or low-cost mental health services across South Africa, including: o South African Depression and Anxiety Group (SADAG) o LifeLine South Africa o SA Federation for Mental Health (Randburg) o Cape Mental Health (Cape Town) o Hope House (Cape Town) o Community Keepers (Stellenbosch) 2.Free Telephone Counselling Hotlines Several organizations offer free 24/7 telephone counselling: • SADAG Helpline: 0800 12 13 14 (substance abuse) 0800 457 567 (suicide helpline) • Lifeline South Africa: 0861 322 322 • Adcock Ingram Depression and Anxiety Helpline: 0800 70 80 90 • CIPLA chat line: 076 882 2775 • Maybelline Brave Together: 087 163 2030 3.Public Health Facilities Mental health services are available through public clinics and hospitals. While long wait times may exist, these services are low or free. 4.Online Resources • SADAG offers free online resources and support groups. • Miss South Africa Shufhadzo Musida hosts free weekly "Mindfulness Mondays" on Instagram, providing mental health education. 5.Other Options • Some employers offer Employee Assistance Programs with free counselling. • Universities often provide free mental health services for students. • Consider joining free support groups in your community.
IS MENTAL ILLNESS CURABLE? Mental illness is generally not considered "curable" in the traditional sense, but it is treatable and manageable. Here are the key points: 1. Most mental illnesses require lifelong management rather than being curable. A "cure" for mental illness typically means symptoms are being successfully managed through treatment, not that the condition goes away permanently. 2. Treatment, rather than cure, is the focus for most mental health conditions. Effective treatments include medications, psychotherapy, lifestyle changes, and other interventions. 3. People with mental illnesses can recover and live long, healthy lives with proper treatment and management of their condition. 4. A few specific mental health conditions may be "curable" in the traditional sense, such as drug-induced mania, brief psychotic disorder, and some cases of postpartum depression/anxiety. 5. For most mental illnesses, the goal is symptom reduction, improved functioning, and recovery rather than a complete cure. Recovery means different things for different people but generally involves managing symptoms effectively. 6. Treatment success rates can be pretty good. For example, data showed that about half of people completing a course of treatment for conditions like depression and anxiety recovered from their condition.
WHAT ARE THE DIFFERENT TYPES OF THERAPY? There are several main types of psychotherapy: 1. Cognitive Behavioural Therapy (CBT): • Short-term, goal-oriented therapy focusing on changing negative thought patterns and behaviours • Often used for anxiety, depression, stress, phobias, and addictions • It involves identifying and challenging unhelpful thoughts and developing more productive responses 2. Psychodynamic Therapy: • Emphasizes how past experiences and relationships affect current feelings and behaviours • Aims to resolve internal psychological conflicts and improve self-esteem and relationships • It involves exploring unconscious thoughts and past experiences 3. Dialectical Behaviour Therapy (DBT): • Combines cognitive-behavioural techniques with mindfulness practices • Teaches skills like emotional regulation, distress tolerance, and interpersonal effectiveness • Often used for borderline personality disorder but effective across many conditions 4. Humanistic/Experiential Therapy: • Takes a holistic approach focused on self-actualization and growth • Includes techniques like Gestalt therapy and client-centred therapy • Emphasizes present experiences and emotions rather than past causes 5. Interpersonal Therapy: • Focuses on improving interpersonal relationships and social functioning • Often used for depression related to life changes or relationship issues 6. Depth Therapy: • Based on Freudian theories (psychoanalysis) or Jungian theories (psychoanalytic psychotherapy) about unconscious motivations • It involves analyzing dreams, free association, and exploring childhood experiences 7. Family/Couples Therapy: • Treats relationship issues by working with multiple family members together 8. Group Therapy: • It involves meeting with a therapist and a group of people with similar issues The choice of therapy depends on the individual's needs, the condition being treated, and personal preferences. Many therapists use an integrative approach, combining multiple techniques. The therapeutic relationship between client and therapist is also considered crucial across different modalities.
WHAT ARE THE PRESCRIBED MINIMUM BENEFITS (PMBs) FOR MENTAL HEALTH CONDITIONS IN SOUTH AFRICA? Based on the search results, here are the key points about prescribed minimum benefits (PMBs) for mental health coverage by medical aids in South Africa: 1. All registered medical schemes in South Africa are legally required to cover PMBs, which include certain mental health conditions, regardless of the member's plan type. 2. The PMBs for mental health include: o Emergency medical conditions o A defined set of 271 diagnoses, which includes some mental health conditions o 27 chronic conditions, including schizophrenia and bipolar mood disorder 3. Specific mental health conditions covered under PMBs include: o Major affective disorders (including unipolar and bipolar depression) o Schizophrenic and paranoid delusional disorders o Alcohol and substance abuse/dependence o Anorexia nervosa and bulimia nervosa o Attempted suicide o Brief reactive psychosis 4. For these conditions, medical schemes must cover: o Hospital-based management for up to 3 weeks per year for most conditions o Up to 15 outpatient psychotherapy/counseling contacts per year for some conditions o Medication for chronic conditions like schizophrenia and bipolar disorder 5. To access PMB benefits for mental health: o The condition must qualify and be on the list of defined PMB conditions o Proper diagnosis and test results must be submitted to the scheme o Members need to register their condition with the scheme 6. While PMBs ensure a minimum level of coverage, many schemes offer additional mental health benefits beyond the PMBs, especially on more comprehensive plan options. 7. The Council for Medical Schemes (CMS) oversees the implementation of PMBs and can assist members if they have issues accessing their entitled benefits. It's important to note that specific coverage may vary between medical schemes and plan options, so members should consult their scheme's documentation for exact details of their mental health coverage.