Opening rural conversations about mental health

Helping caregivers and community members understand the difficulties their children experience, and what they can do to help.

Thulisa May, facilitator of UNICEF’s Check Connect Care project in the Eastern Cape
community members sitting in hall listening to a speaker
UNICEF South Africa/2023
Community members listen attentively during the mental health dialogue at Lungelo Junior Secondary School in Lusikisiki, Eastern Cape.
29 November 2023

In every area I have visited people asked for a second visit: they say being part of the awareness and community dialogues on Mental Health is therapeutic.

“I grew up in a society, where men are perceived as strong according to our cultural belief, and under a popular phrase “Men do not cry” which also promotes, patriarchy. It has not been easy to navigate through their cultural beliefs and emotions on mental health. This society  believes that psychological services are meant for women only. If you are a man and you are advised to go for counselling, the society perceives you as weak and therefore you don’t qualify to be called a man.

To attest to that, the Mental health awareness dialogues that I conducted in the school communities, were dominated by female participants. However, the few males that attended those meetings would cry. To balance female dominance in the meetings, I organized meetings at the tribal authorities, where men dominated.  

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community members looking through resources
UNICEF South Africa/2023
UNICEF’s Check, Connect Care resources were eagerly received by community members.

The studies reveal that men are less likely to seek help when they are not feeling well.  It’s even worse for Xhosa men who go to the mountain for initiation. Most men in our society neglect their children and are not involved in their lives. The Lusikisiki area has been number one for reported crimes of rape in South Africa according to the stats in 2020/2021.  The criminal behaviors are connected to mental health problems. Gender based violence and femicide is also on the rise currently in Lusikisiki.

Based on my experience, 99.9% of individuals perceive the term “Mental health” as mental illness. Educators are not exempted from this definition, hence I have been working with school communities. Furthermore, they associate mental health with rich and educated individuals.

Symptoms of depression are associated with ancestral calling and those who commit suicide were labelled as bewitched.

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ZAF-Thuli-award
Thuli’s efforts to champion mental wellness were recognized by the Eastern Cape MEC for Health.

Doing Mental Health at grass root level has helped me to explore ways on how to create awareness and address the stereotypes using the layman language. In as much as UNICEFs main objective was to create awareness on stress, anxiety and depression, different symptoms of other mental health problems emerged, namely schizophrenia, dementia, personality disorders substance and drug abuse. Most elderly women who show dementia symptoms are brutally killed because they are accused of practicing witchcraft. Symptoms of depression are associated with ancestral calling and those who commit suicide are labelled as bewitched. Each community differs from each other, therefore there is no one size fits all strategy in creating awareness on mental health.

As much as I thought I was doing passion work for UNICEF, I realized that I am doing the necessary work for the community. This opened a slot for me to speak on Mental Health Awareness on a local community radio station and I was also an award winner for 2nd runner up for Mental Health in rural communities. The benefit of the radio slot is to reach out to thousands of listeners at once, but the challenge is that you don’t see their emotions. I receive more calls after the program, of individuals who suffer from Mental Health problems. 

The services that I provide are the following:  

  • Conduct community dialogues Mental Health in rural, namely, tribal authorities, religious and school communities.
  • Create awareness and promote Mental Health in rural communities.
  • Address stereotypes on Mental Health
  • Provide counselling.
  • Conduct training on Mental Health
  • To advocate and refer vulnerable groups.
  • Promote good parenting skills.

Mental Health is equally needed in rural communities the way it’s needed in urban areas.

Mental Health is equally needed in rural communities the way it’s needed in urban areas. The working class in rural communities do not utilize the psychological services even though they have medical aids. The reason is that psychologists are very far from them and are in urban areas. Moreover, when people make appointments, they get dates that are far from when the problem has escalated.

Lack of psychological services has led to lack of understanding in Mental Health among the professionals in the rural communities. Mental health is not gender based nor biased, neither for the rich nor for the poor - it does not discriminate, it affects everyone.

In every area I have visited people asked for a second visit: they say being part of the awareness and community dialogues on Mental Health is therapeutic.  I get a lot of invitations to schools and community since I started doing Mental health, but the challenges are that there is lack of resources in reaching out to those communities.”

“Go to the people. Live with them. Learn from them. Love them. Start with what they know. Build with what they have. But with the best leaders, when the work is done, the task accomplished, the people will say 'We have done this ourselves.”

Lao Tzu
Thulisa May is an award-winning champion of mental health in rural Eastern Cape, her passion ignited  by facilitating mental health dialogues with parents at schools around Lusikisiki and Flagstaf, under UNICEF’s Covered, Clean and Caring COVID-19 Prevention Programme.  A psychology honours graduate, studying towards her Masters degree in Public Health, Thuli is helping to fill the critical gap in rural psychosocial support services.  

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