Deploying more ‘mental health foot soldiers’ in SA communities

Mental health issues are not just staggeringly prevalent, but have been on the rise across South African communities for quite some time. Unchecked, endemic trauma, deprivation, violence and a wide range of abuses seriously drain the well-being in our country, and ultimately impact negatively on our collective day-to-day experience of life in South Africa. But it’s not just a problem of having an overwhelming need – we also have a shortage of skills in the psychology profession.

Like any other healthcare situation, the old adage ‘prevention is better than cure’ holds true. While there may be some resources directed at clinical and medical treatment for mental health issues, the question is what are we doing when it comes to the proactive prevention and the promotion of mental health at the community level?

Private educational institutions, such as SACAP (the South African College of Applied Psychology), and other stakeholders are raising awareness of Registered Counsellors as an untapped resource when it comes to prevention and the promotion of well-being in communities. “To build an effective mental health defense force, a multi-pronged strategy needs to be implemented that involves greater public awareness of the role of Registered Counsellors and a concerted boost for employment opportunities, especially in under-served communities,” says Dr Laura Fisher PhD, the Director of Academic Affairs at SACAP.

Dr Fisher argues that the current Scope of Practice set out by the Health Professions Council of South Africa (HPCSA) falls short of effectively illuminating the potential of the Registered Counsellor category within the country’s psychology profession. “By positioning Registered Counsellors relative to clinical psychologists, the role has been bound to a clinical/medical psychology discourse of abnormality-, dysfunction- and individually-oriented treatments,” she says.

The problem with this, is that it is not aligned to the vision of training up a strong cohort of Registered Counsellors to create a groundswell for scaling up access to and delivery of mental healthcare services nationally. The primary role of a Registered Counsellor is aimed at providing psychological interventions for prevention and mental health promotion and wellness.

They are trained and well-positioned to specifically provide community-based psychological services, including supportive counselling, the promotion of mental health and well-being, psychological screening and assessment, as well as psycho-education. Yet, when it comes to their current, real-life work situation, the majority of proper career opportunities arise in the clinical treatment environment instead of in the community.