The following are the key interventions that the National Department of Health has implemented:
1. Guidelines issued on Mental Health Interventions during the Covid-19 disaster dated 02 April 2020
The National Department of Health developed and provided guidelines on mental health interventions that should be implemented during the Covid-19 disaster. These were made available for implementation to the Heads of Health Departments in all nine provinces; Facility Managers of designated facilities in terms of the Mental Health Care Act, 2002; Psychiatric Hospitals, Care and Rehabilitation Centres; Residential Mental Health Facilities run by Non-Governmental Organizations; Private Psychiatric Hospitals and Contracted Mental Health Facilities; Health District Chief Directors; Health Care Providers (Public and private); and Mental Health Review Boards (MHRBs).
The objectives of the Guidelines are to:
- 1.1 Provide information to promote and protect the mental well-being of the population, and to raise awareness about mental disorders and mental health problems that may arise due to the Covid-19 outbreak;
- 1.2 Direct Heads of Health Establishments, Mental Health Facility Managers, Health Care Providers, Multi-Disciplinary Specialist Mental Health Teams, and informal caregivers, on actions to be taken to identify and manage mental health problems and mental disorders arising out of the Covid-19 disaster;
- 1.3 Ensure that psychiatric/mental facilities comply with measures that have already being prescribed to manage the Covid-19 outbreak;
- 1.4 Provide directives for Mental Health Review Boards to ensure that there is continuity in their oversight functions with regards to assisted and involuntary mental health care and rehabilitation; and
- 1.5 Provide directives for inpatient mental health care, treatment and rehabilitation services, outpatient and primary health care services.
2. Psychosocial support for health workers during the Covid-19 pandemic
Interventions on mental health and emotional support (Psychosocial support) for healthcare workers is a requirement as prescribed by the Occupational Health and Safety Act, 1993 (Act No. 85 of 1993), the Department of Labour Occupational Health Policy of 2005, and the International Instruments underpinning Employee Health and Wellness Management. In the public services environment these interventions are provided according to the Department of Public Service Employee Health and Wellness Strategic Framework for the Public Service (2019).
As a response to the Covid-19 pandemic the following interventions, among others, have been undertaken by the National Department of Health:
- The Occupational Health and Safety (OHS) Work-Stream was established to provide guidance and interventions on “Psychosocial Support for Health Workers” during the Covid-19 pandemic. This work-stream has representation from academic departments of occupational medicine, professional societies, trade unions, and key stakeholder government departments such as the Departments for the Public Service and Administration (DPSA), of Employment and Labour and the National Institute for Occupational Health (NICD);
- Similar work-streams were established in all nine provinces to facilitate and oversee the implementation of the Occupational Health and Safety interventions;
- Guidelines on Psychosocial Support for Health Workers during the Covid-19 were developed by the mental health sub-group in the OHS work-stream and distributed to health and social service workers. The guide provides evidence-based integrated interventions on prevention of anxiety and stress related problems, management of these problems at the frontline by managers, stress inoculation and psycho-education strategies, mental health support and treatment interventions;
- Employees that have been identified to have developed a mental condition are identified and referred to professional mental health practitioners;
- Health Professional Associations, Psychiatrists, Psychologists, Medical Practitioners and Social Workers have offered psychological support services throughout the Country and have been organized in a Health Workers Network to offer free telephonic and online services across public and private sectors. These services have augmented the existing National Crisis Line that the Department contracted to Lifeline, the professional mental health services available in public facilities as well as Employee Health and Wellness Programmes that were available at each workplace. The South African Depression and Anxiety Group (SADAG) has also offered mental health and counseling support to healthcare professionals; and
- About 1200 Unemployed Social Workers are being recruited and will be deployed to provinces to augment the Covid-19 response and the Employee Health and Wellness Programmes with funding from the Health and Welfare SETA.
3. Mental Health and well-being for those in quarantine and isolation
The guidelines for quarantine and isolation in relation to Covid-19 exposure and infection that were published on 05 May 2020 provide for the emotional health aspects during isolation or quarantine.