ABSTRACT
As the COVID-19 pandemic unfolded during 2020, there was growing cognizance of the short-, medium-, and long-term impacts of the event on individuals and communities globally. This was felt both directly (e.g. people affected by the illness and recovery associated with COVID-19) and indirectly (e.g. caring for people falling ill, the medium- to long-term socioeconomic effects of the pandemic such as joblessness, poverty, and substance abuse). In South Africa, the mental health burden of the pandemic was identified relatively early, where a substantial mental health burden was identified under stages 3 and 4 of the country’s lockdown measures. Collective trauma and psychological distress were experienced by many communities, in tandem with widespread uncertainty and socioeconomic pressures, and severe restrictions in personal freedoms. Importantly, the contexts of infection prevention and control catalysed virtual support platforms, and this was exemplified by provincial health departments who worked with academic and technical partners to develop psychoeducational materials (audio-visual and print materials promoting COVID-19-related mental health literacy and help-seeking among healthcare workers (HCWs) and in communities) as well as a wellness training course for HCWs. The South African Federation for Mental Health, the South African Depression and Anxiety Group, and several others offered free telephonic counselling, while grassroots mobilisation like the development of Community Action Networks helped to rally community resources to support the basic needs of the vulnerable, which included looking after their mental health needs. While promising, many of these responses are at best reactive, emergency procedures, and not illustrative of a quality, people-centred health system. Time will tell how well the South African health system dealt with the multilevel, increasingly complex mental health challenges presented by COVID-19 (especially against the background of widespread socioeconomic inequities and growing systemic challenges faced by the poor and marginalised). Its deficiencies in optimally preventing and managing mental ill-health are well documented, including inadequate funding mechanisms and under-developed data monitoring systems. While the pandemic exposed deep and persistent health system challenges, there are promising, if isolated, partnerships that focus on comprehensive health system strengthening.
