By Nomfundo Mogapi
Our starting point: psychological depletion
South Africa’s population was critically psychologically depleted even before Covid-19 dropped a pall of fear, stress and confusion over the country.
Reports note that somewhere between one in four and one in six South Africans suffers from some form of mental disorder during their lifetime, with only 15-25% of affected individuals seeking and receiving help. According to the South African Depression and Anxiety Group (SADAG), untreated mental disorders cost the South African economy more than R35 billion in lost working days each year.
THE CAPITALS BEING ERODED BY THE PANDEMIC
Human capital is the stock of habits, knowledge, social and personality attributes (including creativity) embodied in the ability to perform labour so as to produce economic value.
Social capital is our capacity to function together in social groups. It speaks to interpersonal relationships, a shared identity, a shared understanding, shared norms, shared values, trust, cooperation and reciprocity. It has been used to explain improved and superior performance, the growth of entrepreneurial firms, enhanced supply chain relations, the value derived from strategic alliances, and the evolution of communities.
Mental wellness practitioners have for many years – in fact, from as early as 2008 – warned that there is a crisis looming in our continent. Africa has extremely high levels of what we call woundedness. From individuals to families, large numbers of people have experienced significant trauma and psychic pain. Mental health practitioners have been calling for a paradigm shift in business as well as in society in relation to their investment in mental health, noting that business has underestimated the extent of the impact that mental health has on the bottom line.
It’s not only the business world that has overlooked the damaging implications of our nation’s trauma and psychic pain. As individuals, families and communities, we have largely been asleep to how wounded we are; and we take this wounding into how we are in our families, in our institutions and in our societies – and, importantly, how we are as leaders.
The outcome of wounded individuals and families is that our institutions are wounded – and they are themselves wounding. People have long noted that, for instance, when they go to public hospitals they experience their dignity as being stripped; the relationship with the police is also toxic – and so further fragmentation happens, at a societal level and at a community level. The very social fabric that is needed to heal and rebuild this wounded society is being eroded by the very same untreated wounds.
What mental wellness practitioners have further been saying is that when we operate in a wounded context, we can have two types of leaders:
Those who are peace carriers: people who are awake to themselves and to their own emotional experience, who allow themselves to be vulnerable. These have the capacity also to contain other people’s emotional reaction and – most importantly during this COVID period – they have the capacity to tolerate rapid and traumatic change; and
Those who are trauma carriers: asleep to their wounds, not self-aware and have limited capacity to be fully present. Unfortunately, this is the majority of those in leadership positions. When these people have to deal with a crisis situation, they can make things even more unbearable – because they tend to be fully engaged in the unresolved trauma; thus, any vision of rebuilding takes the back seat and the wound takes the front seat.
Where the pandemic has taken us
Predictably, as this is a profoundly traumatic event, we are finding that COVID-19 has exacerbated South Africa’s already dismal mental wellness situation. We have not fully appreciated the level of psychological damage taking place in our society now, and what it will cost us when we move forward. Even necessary measures – quarantine and social distancing – have consequences in that we thrive through human contact, so the very thing that we need to protect us from the virus is the same thing that can hurt us. To protect our physical health, we must do that which is detrimental to our mental health; loneliness and isolation inevitably follow.
A number of measures have had disastrous impacts. For example, the curfew and bringing the military into communities. A number of communities have told us that this triggers fear, anxiety and trauma from the past. Those tasked with enforcement – soldiers and the police – experience, too, their own level of trauma and grief.
South Africans have also reported high levels of anxiety related to food insecurity, skyrocketing unemployment and increased domestic violence – increased inequality is a direct contributor to violence – as well as fear of illness. This is putting a huge strain on families and radically eroding the social capital needed to build emotional resilience. Employees will inevitably carry this stress as they return to the workplace.
The very real trauma associated with loss of income is obvious. We all know they are speaking their truth when community members break the lockdown rules to seek money in whatever way they can: either we will be killed by COVID, they say, or we will be killed by poverty.
For the around 40% of youth in South Africa who are yet to find their first secure job, the economic contraction is somewhat of a death knell to their hopes. Unemployment is itself a mental health risk, associated as it is with loss of hope, a sense of unworthiness and a lack of dignity.
The fault lines in our society are deepening. We are finding that levels of distrust are increasing within communities, along with stigmatisation and othering. It plays out in social media all day, every day. COVID-19 is exposing fault lines and driving the deterioration of the very same social compact that we need to recover.
Leadership – especially those who have been in the forefront of making COVID-19 decisions – have their own level of trauma and stress as they try to navigate something the world has not seen before, and for which there may be no “right” answers. Like Cabinet’s COVID task force, everyone in a leadership position is faced with difficult choices.
When we think about leaders, we also need to think about teachers. Already in a storm of political stress and taxed by resource constraints, teachers now have to also consider how to protect their health while they hold the boundaries and the inevitably high levels of anxiety in the classroom.
I have mentioned that increased inequality is causally linked to violence, and we know that frustration is boiling over in communities. Existing indignities are compounded by the humiliation of standing in line for food parcels. Existing anxiety is stoked by losing – or fearing the loss of – a job. The wounding is daily being exacerbated.
It is critically important that we deal not only with the physical health and economic aspects of COVID-19 but also with the mental health dimension. Mental wellbeing is at the core of human and social capital; and this is the capital we need to (re)build our country and its economy.
These mental health responses must include interventions at leadership, institutional and individual levels.
Most leaders and managers stepped up to the frontlines of the COVID-19 response right from the beginning, and have been operating in survival mode. They are at high risk of burnout, compassion fatigue and other stress-related illnesses – meaning that the human capital most needed to rebuild the economy is already being worn out. Unattended, this risk will manifest in high levels of stress-related illness, resulting in absenteeism and poor performance, in a context in which the workforce is likely to be significantly depleted. For those who persist in working through burnout, increased workplace conflict and inability to contain and support the workforce is likely to ensue.
As the economic crisis escalates, we will see at an institutional level similar levels of overwork and high stress.
Work wellness issues regarded as nice-to-haves are going to be crucial, or must-haves, in a post-COVID-19 environment. Leadership debriefing, coaching and mentorship must be an integral part of COVID-19 responses and recovery, as must investing in a positive and supportive workplace climate and psychologically informed change management processes. Parenting, couple, family interventions and individual counselling will be critical to support families being hubs of building social capital rather than further stressors.
If we don’t do anything, we’re going to end up with wounded frontline workers with high levels of compassion fatigue and moral injury. We will have leaders who are completely burned out. How will they be able to lead and show the way in wellness and safety when they themselves are broken? When we make wounded decisions, there’s a high likelihood that there’s going to be an increase in conflict and further strain on interpersonal relationships – all in an environment in which we are not able to touch one other.
But if we begin to look at how we integrate mental wellness in our COVID responses, then we could begin to rebuild some resilience in our human and social capital. To have the society we need, it is imperative that we scale up the existing good work that is being done in the realm of mental wellness, and extend it from individual to family, to community, and to leadership. There are insufficient leadership interventions in South Africa to deal with the level of trauma to which our leaders are exposed.
In closing, I would like to ask the reader: as a leader, what have you been doing to take care of yourself? What is your mental state, and how are you going to treat those who work with and for you, who are traumatised?
And I want to appeal to all of us to begin to be advocates of mental wellness. Engage on this with those with whom you interact; speak about COVID as a mental health issue, as well as a physical health and economic issue. Just as much as we invest in physical health and economic recovery, we need to invest in mental recovery.
The greatest resource that we have in Africa is the people of Africa, but this resource is being depleted by mental challenges. We need to invest in this resource, we need to invest in our people, we need to invest in us, in repairing our brokenness and in healing our woundedness.