The Covid-19 coronavirus pandemic has a nasty, debilitating side effect that health care professionals are calling as dangerous as the virus itself. Depression, anxiety and issues relating to mental well-being have seen a sharp spike in frequency.
South Africans, like citizens around the globe, are anxious and afraid about contracting the deadly virus, losing their jobs in a tanking economy and facing financial hardship. The uncertainty has resulted in a widespread sense of helplessness and unease.
Among the most vulnerable groups affected are some members of the LGBTQI+ community, where isolation and the enforced sharing of hostile, emotionally challenging spaces is leading to despondency.
It is an area that the newly opened Queer Wellness Centre (QWC) – a clinic in Illovo Johannesburg that serves the specific needs of the LGBTQI+ community – has identified, and is fully equipped to deal with.
Malan Van Der Walt, a 34-year-old educational psychologist attached to the QWC, says this lockdown has been particularly difficult for some members of these often marginalised communities.
“I would like to get the message out: You do not have to deal with this on your own. We at the QWC are open for business and help is a phone call away. I urge people to call in and make an appointment.”
He added that there were trained professionals available at QWC to help those in need, either in person or on social media platforms like Zoom. Van Der Walt said that there were certain anxiety causing situations that were specific to particular groups within the LGBTQI+ community.
“Let’s take someone transitioning, socially or physically, into the gender with which they identify, who has not yet had the gender changed on an identity document. There is the constant fear of being stopped by police who find the gender does not match that on the ID.
“It would cause anxiety at any time, but being stopped when you are out during this time of lockdown is much more likely, and therefore much more anxiety-producing.”
In another example of a stress inducing situation, Van Der Walt used the analogy of victims of domestic violence who are trapped with their abuser at this time of self-isolation.
“Likewise, because of the lockdown time spent in close proximity to others in a confined space, Queer people who have not revealed their sexual or gender identity to those around them may fear harassment or abuse should those they live with not be affirming or accepting.
“Often that fear stems from possible rejection, humiliation or, in a worst case scenario, ejection from the family home.”
He said transphobia and homophobia was still prevalent in parts of society and the attached stigma creates feelings of deep anxiety for vulnerable groups.
The educational psychologist has extensive experience working in the field of sexual and gender diversity. After graduating from the University of Cape Town, he spent four years teaching English in Taiwan.
Van Der Walt served as a Project Manager for The Equality Unit at the Centre for Student Counselling and Development, doing HIV testing with Men who have Sex with Men (MSM), running support groups, organising community dialogues and offering gender and sexual diversity sensitisation training to campus health officials, academics and Campus Security.
He also trained Stellenbosch University students to be HIV counsellors and testers, and has worked tirelessly to reduce stigma and prejudice experienced in the health sector of the LGBTQI+ community.
He believes that it is critically important to be culturally aware when dealing with sensitive issues such as race, sexuality and identity, and strives to cultivate a multicultural orientation (a humble, respectful, and open approach to addressing culture in therapy). Van der Walt is also acutely aware of how mental healthcare needs intersect with socio-economic status, and acknowledges that socio-economic situations may exacerbate mental health self-care.
In short, he says, there is no “one size fits all” in a country struggling with such massive income inequality and that is as diverse as South Africa. Van der Walt cautions that any generalised mental healthcare tips that he shares in this article should not replace the individual assessment and treatment plan that a qualified mental healthcare professional can provide.
He co-facilitates a parallel support group for trans youth and the parents of trans youth, and says that vulnerability, and therefore the possibility of fear, anxiety, hopelessness, anxiety and depression, comes in a host of different shapes and sizes.
“Queer people, who might be functioning well on the surface, could have difficult or traumatic experiences - being unacknowledged and dealing with issues of abandonment and rejection – triggered by the solitariness of self-isolation.
“Isolation can play tricks on the mind, irrespective of one’s gender and sexual identity, particularly if you have a history of depression. I encourage clients to practice self-compassion, and not to deny or suppress difficult emotions. Rather, during a particularly bad period, setting small, achievable goals, can be a victory: like getting out of bed, brushing your teeth, showering and getting dressed.”
He said that there were practical things people who were depressed or anxious could do.
“Reach out to a person you can trust, who has consistently shown up for you in the past, someone you can confide in. Nurturing that relationship with a person who is caring, trustworthy, and reliable, may already make a big difference.
“Monitor your sleep patterns: establish a sleeping routine about an hour before bedtime, and aim to do about 30 minutes of light exercise 3 times a week (walking in the morning, for instance).
“Mental health is something that has to be maintained; it’s something you manage. You learn to understand that there is an ebb and flow, and practicing good mental healthcare hygiene during the good times builds resilience for the times when you are not feeling that well.” Van der Walt urges all members of the public to contact a qualified mental healthcare professional when they are feeling completely overwhelmed and unable to cope.
He suggests that mental healthcare apps might be useful during lockdown, such as an app called Youper.
"While not a substitute for in-person therapy, Youper does provide emotional assistance by helping you monitor emotional states, and offers helpful ways to mitigate stress and anxiety, such as practicing gratitude or mindfulness.”
Despite the human rights of members of the LGBTQI+ community being enshrined in the constitution and the law, prejudice within the medical fraternity remains a challenge.
“This often leads to the shaming and humiliation of members of the LGBTQI+ community seeking medical help. “At the QWC, people can come to us with medical problems that are common, or unique to members within the community and receive treatment in a safe, welcoming, and non judgemental environment.”
FACT FILE:
WHAT: Queer Wellness Centre, one of five queer-friendly clinics in SA specialising in specifically queer community health needs such as, anoscopies and kidney-related issues around PrEP treatment. The QWC also offers counselling and psychiatric services tailored to queer communities.
WHERE: Illovo Johannesburg. (First Floor, Illovo Muse, 198 Oxford Road)
QWC SERVICES:
Helps fast track transgender affirmation therapy
Provides endocrinology services for hormone therapy
Connects patients with surgical specialists to plan and perform transition surgery.
Anoscopy technology provides “papsmear for your anus” to prevent anal cancer.
Provides psychological counselling
Psychiatric availability
Pre-exposure prophylaxis (PreP) available
HISTORY: Founded by Dr Claudia Do Vale and Dr Ryan van der Merwe to provide unbiased, personalised care while offering state of the art medical services specific to the needs of the LGBTQI+ community.
COMMITMENT: To provide a place of compassion and targeted, specialist (stigma-free) health care; to have meaningful impact on the lives of members of the LGBTQI+ community.
