MHM Magazine

Issue 5 | 2022 | MENTAL HEALTH MATTERS | 43 MHM problems can evolve. Sometimes the structural change that is needed is pro-active, to prevent mental illness and not simply react to mental illnesses care after the fact. Be innovative: Why not screen whole communities? The Kessler 10-item Psychological Distress Scale is used as a screening tool by mental health professionals to work out how much of a risk an individual patient has of developing anxiety or depression. Researchers are also allowed to use this scale, in order to create aggregate data. When looking at aggregates or averages, it becomes possible to take the pulse of a community. In the case of this survey, the data set is large but not representative, thus we cannot draw firm conclusions about the populations of both townships. However, we can begin to develop a sense of what to measure in future and how to begin to help those community members who took part in the survey. Analysis of survey responses to the questions posed in the Kessler 10-item Psychological Distress Scale) indicated that township dwellers tend more towards depression than anxiety. With 20% reporting that they felt depressed, 16% feeling worthless, and 14% feeling so sad that nothing could cheer them up, low mood dominated. When looking at average scores across townships, it was noted that depression screening items were more often reported in Diepsloot, and anxiety items appeared more prevalent in the Ivory Park survey cohort. That said, survey data also suggests the presence of a depression-anxiety continuum across both township survey cohorts. For example, a moderate positive correlation was discerned between inexplicable tiredness and feeling slightly nervous. Similarly, extreme nervousness was statistically associated with reports of deep and persistent sadness. Any township based mental health professional would do well to anticipate complex presentations of mental health challenges. Moreover, a mental health scorecard should, ideally, not be over-simplified for use in poorer communities. Scoring the stressors – context is critical It was also possible to find statistical associations between the main challenges, per community and average levels of psychological distress. For example unemployment was reported more often by Diepsloot residents than by those who lived in Ivory Park. People who cited unemployment as a community challenge were more likely to report elevated feelings of worthlessness than their peers, and worthlessness is a key depression screening item. Here we can see a clear connection between a community challenge (unemployment) and community mental health (depression) in Diepsloot. Using aggregate data in this manner allows SADAG to sensitise counselling specialists in each community, building towards treatment goals needed to create a scorecard. Moreover, material support can also be given to people in order to take preventative action. Mental health challenges that may develop in response to hardship might then be averted. In this way, the ideal mental health scorecard developed for townships, will contain more than indicators pertaining to access to medical care.    Know what mental health means to community members Nearly 150 definitions of mental