A systematic review of online depression screening tools for use in the South African context.

BACKGROUND: According to the World Health Organization, the alarming increase in rates of depression globally has become a serious concern. In 2010, the prevalence rate of depression in South Africa was 4.6%. Given the context of South Africa where the majority of the population have limited access to healthcare facilities and 59.3% of the population have access to the Internet, an online depression screening tool would have much to offer. OBJECTIVE: To determine whether online depression screening tools would be suitable for use in South Africa. METHODS: This study presents a systematic review of online depression screening tools to determine whether one would be suitable for use in South Africa. Articles were accessed from seven electronic databases from 1970 to 2018. All articles included in the review were critically appraised. RESULTS: A total of 17 articles met the inclusion criteria. From the results, there was only one screening tool available on an open access platform for use by the general population. The most common depression online screening tools were the Beck Depression Inventory-II (BDI-II), the Center for Epidemiology Studies Depression Scale (CES-D) and the Patient Health Questionnaire (PHQ-9). It was also evident that there were negligible differences in the psychometric properties of online versus paper versions of the online screening tools. Furthermore, there were very few studies that considered the African or South African population and no online screening tools for major depressive disorder (MDD) developed in these contexts. CONCLUSION: There appears to be a need for a depression screening tool to be adapted for online usage in South Africa. It is recommended that the online screening tool should be adapted from the three commonly used online depression screening tools: PHQ-9, CES-D and BDI-II.

South African Hindu psychologists' perceptions of mental illness.

Conceptualisations of mental illness are not universally applicable, as culture shapes the expression, perceptions and treatment preferences thereof. By focusing on the perceptions of Hindu psychologists regarding mental illness, this study aimed to provide a deeper understanding of the impact that religious beliefs have on such conceptualisations. Semi-structured interviews were conducted with six Hindu psychologists around the Johannesburg area, South Africa. Responses were analysed using thematic content analysis. From the findings, it was evident that religion plays a critical role in the understanding and treatment of mental illness. Hindu beliefs around psychological disturbances were salient. Additionally, it was found that a tension existed between psychologists' awareness of the influential function of religion, particularly amongst collectivistic communities such as the Hindu community, and their occupational understandings and practices, which are deeply rooted in Western thought. Furthermore, it was suggested that the fear of stigma prevented Hindu clients from reaping the benefits of seeking help from culturally competent psychologists.

In the Wake of COVID-19: The Developmental and Mental Health Fallout Amongst South African University Students.

Multiple studies have noted the impacts on student mental health of the COVID-19 pandemic, associated national lockdowns and emergency remote teaching. In light of COVID-19 shifting from pandemic to endemic status, this study investigates the developmental and mental health consequences of the pandemic for a group of South African undergraduate students. A qualitative design allowed for the thematic analysis of the narratives of 140 humanities students, gathered through an online survey. This paper presents the 'voices' of this group to convey the intensity of their COVID-19 experience. The results suggest a loss of a sense of freedom and opportunities to explore and experiment, high levels of depression with a notable sense of hopelessness regarding the future and decreased motivation, and significant reports of social anxiety related to delays in the development of social skills due to social isolation, particular to the first-year cohort.

Evaluating the Efficacy of Ethical Guidelines for Online Screening of Mental Health in South Africa.

Despite the rapid growth in digital mental health options, a systematic review conducted on the ethics of developing online mental health screening instruments highlighted that there were no formal guidelines in this area. This lack of formal guidelines and the results of the systematic review led to the development of formal guidelines for online mental health screening tools in South Africa. This study aimed to explore the efficacy of these draft guidelines using a qualitative design with two samples of individuals recognised as experts in the field of mental health. Sample one consisted of a purposive sample of 15 experts who commented on the appropriateness of the draft guidelines. The second sample consisted of 9 experts who completed the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument to assess the guidelines. Both samples were in agreement on the relevance of the core content areas in the guidelines, namely purpose and scope, modes of testing, psychometric properties, informed consent, ensuring minimal risk to participants, feedback as well as data security. There was also agreement on the appropriateness of the methods used to develop the guidelines. The use of the guidelines was supported with the suggestion that issues of risk and suicidality be explored further.

Preventing suicide, promoting resilience: Is this achievable from a global perspective?

Suicide continues to be a major health concern globally despite many initiatives to identify risk factors and methods for suicide prevention. We have carried out a detailed narrative review of the literature from 2016 to 2019 using the headings of Personal resilience (P1), People (P2), Places (P3), Prevention (P4), Promoting collaboration (P5), and Promoting research (P6) in order to support an integrated approach to suicide prevention and the promotion of personal and population resilience. We have made 10 key recommendations on how this can be moved forward.

South African Muslim Faith Healers perceptions of mental illness: understanding, aetiology and treatment.

The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession--all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.

Personality and behavior prediction and consistency across cultures: A multimethod study of Blacks and Whites in South Africa.

The cross-cultural universality of behavior's consistency and predictability from personality, assumed in trait models though challenged in cultural psychological models, has usually been operationalized in terms of beliefs and perceptions, and assessed using single-instance self-reports. In a multimethod study of actual behavior across a range of situations, we examined predictability and consistency in participants from the more collectivistic Black ethnic group and the more individualistic White group in South Africa. Participants completed personality questionnaires before the behavior measurements. In Study 1, 107 Black and 241 White students kept diaries for 21 days, recording their behaviors and the situations in which they had occurred. In Study 2, 57 Black and 52 White students were video-recorded in 12 situations in laboratory settings, and external observers scored their behaviors. Across both studies, behavior was predicted by personality on average equally well in the 2 groups, and equally well when using trait-adjective- and behavior-based personality measures. The few cultural differences in situational variability were not in line with individualism-collectivism; however, subjective perceptions of variability, operationalized as dialectical beliefs, were more in line with individualism-collectivism: Blacks viewed their behavior as more variable than Whites. We propose drawing a distinction between subjective beliefs and objective behavior in the study of personality and culture. Larger cultural differences can be expected in beliefs and perceptions than in the links between personality and actual behavior. (PsycINFO Database Record

When There Are Only Minorities: Identity and In-Group / Out-Group Orientations of Emerging Adults in Four South African Ethnocultural Groups.

Intergroup relation perspectives stem from research in Western contexts with clear distinctions between the dominant and nondominant groups. In South Africa, with at least 13 different cultural groups and 11 official languages, no group is dominant in all life spheres. We examine the relationship between identity and in-/out-group orientation across Black-Zulu, Coloured (mixed racial ancestry), Indian, and White-Afrikaans emerging adults (N = 390; 75% females, Mage = 19.97 years, SD = 2.44). Results indicate that personal identity for all groups and ethnic identity for Black-Zulu, Indian, and White-Afrikaans emerging adults were important for intergroup relations. Black-Zulu, Coloured, and Indian emerging adults distinguish themselves less from others, whereas White-Afrikaans emerging adults are less open to others. Ultimately, the complexity of intergroup relations in South Africa has implications for the effective transformation interventions needed to counter experiences of threat and make group boundaries more flexible for emerging adults.

Perceptions of mental illness among Muslim general practitioners in South Africa.

BACKGROUND: Mental health literacy on the part of medical practitioners is an important component of mental healthcare. General practitioners (GPs) are typically the first doctors consulted by a person who is ill. Exploration of their perceptions regarding mental illness, aetiological issues and treatment is important. OBJECTIVE: To investigate perceptions of mental illness in a sample of ten South African Muslim GPs (five male, five female) in the Lenasia area (Johannesburg, South Africa). METHODS: Using a qualitative approach, semi-structured interviews were conducted with each GP. The questionnaire encompassed 37 questions relating to the context in which the GPs practised, perceptions of mental illness, understanding of religion and culture, and treatment of mental illness (including aspects of spiritual illness). Thematic content analysis was used to analyse the data. RESULTS: Six dominant themes were identified, namely GPs' understanding of mental illness and its causation; stigma, secrecy and somatisation; the beneficial effects of religion in mental illnesses; perceptions of spiritual illnesses; collaboration with traditional healers; and collaboration with psychiatrists and psychologists. CONCLUSION: Greater awareness regarding the stigmatisation of mental illness is needed. Furthermore, it is important that healthcare professionals have an understanding of religious and cultural taxonomies of illness as well as the use of traditional healing as a mode of treatment. Participants identified a need for increased collaboration between healthcare professionals, including traditional healers.

Exploring foundation phase school teachers' perceptions of learning difficulties in two Johannesburg schools.

OBJECTIVES: According to the 2001 census (StatsSA 2001), approximately 12% of the population in South Africa are intellectually disabled and 7% of the population have a communication disability. Early diagnosis and intervention is vital for optimum functioning in later life yet most children are not identified until well into their schooling. Since foundation phase teachers are amongst the first to encounter these difficulties, this research explored foundation phase teachers' perceptions of learners with learning difficulties (LD) in two inner city public schools in Johannesburg. METHODS: Eight teachers were interviewed using a semi-structured interview schedule. The challenges associated with dealing with children who have a LD together with issues of stigma and parents responses were explored. Thematic content analysis was used to analyse the results. RESULTS: Seven themes were identified, namely understanding of LD, symptoms of LD, aetiology of LD, impact LD has on a learner, stigmatisation of learners with LD, parental denial and inclusive education. CONCLUSION: From the results, it was evident that LD needs a more contextually appropriate definition in South Africa for teachers to correctly identify these learners. Furthermore, teachers require more training for them to effectively cope with learners with LD.