Mood disorders

Binge Drinking, Smoking Are Risk Factors Alcohol-use disorders and depression commonly coexist, presenting unique challenges for both individuals who suffer from this comorbidity as well as their treatment providers.

Mental illness is wide-spread and often undiagnosed, with the World Health Organisation estimating that 450-million people worldwide suffer mental illness.

The sudden move by medical aid schemes to deny chronic medication benefits for various mental illnesses has been condemned as the biggest disaster to hit psychiatric care in South Africa in the last 10 years. The arbitrary and unilateral move, which could endanger the lives of thousands of sufferers across the country, has drawn widespread criticism from leading groups involved in mental healthcare including the SA Depression and Anxiety Group (SADAG) and the healthcare consumer watchdog, Rights Education and Activism for Consumer Healthcare (REACH). People suffering from (BMD, previously known as manic depression) and depression are particularly at risk, says Zane Wilson, founder of SADAG. Sufferers of bipolar mood disorder ( BMD) and depression can and do function as productive contributors to the economy and highly capable members of society at large. But this is only possible with continued proper medication and monitoring. Otherwise they risk regression with resultant personal setbacks and even hospitalisation, but more dire consequences including suicide and even violent attacks says,Wilson. Outraged patients, many of them successful business leaders and heads of families and whose conditions have stabilised under consistent treatment, have inundated SADAG and REACH with complaints. The decision of the Council for Medical Schemes is based on the lack of published guidelines for the treatment of BMD and lack of registeration gfor most of the medications used. This does not take into account the thousands of patients who are stabilised on current medication, says Khan., the REACH national co-ordinator. It is understandable that treatment guidelines need to be structured on solid evidence-based data. One needs to take into account that, even though certain medications might not be registered in SA, they are however registered abroad. The consequences of the slow registration process for medicines in SA are being borne by patients here. Although BMD has been included in the list of so-called '25 prescribed minimum benefits (PMB)' conditions for chronic medication, individual schemes are refusing to cover costs on the grounds that no treatment protocol exists for BMD. REACH approached the Council of Medical Schemes to assist in drawing up guidelines regarding mental healthcare benefits, only to told that their inputs were not neeed. In a bizarre twist, these illnesses, including BMD, are still recognised as chronic diseases - just not funded any more. Medical schemes are not legally bound to reimburse patients for medications for BMD. There should be very specific guidelines underpinning the lack of a protocol for the treatment of BMD. For example, patients stabilised for a specific period of time should be reimbursed by their medical scheme. Depression is acknowledged as the world's second biggest cause of adult deaths, and BMD causes violent mood swings, ranging from feelings of BMD sufferers may fall into a manic state resulting in extreme violence and even homicide if their condition is untreated. this creates a set back on important advances in bringing mental illness out of the closet for example in addressing the crisis of the growing number of teen suicides and a successful nationwide focus on the mental health issues on 10 October - World Mental Health Day. Hostile environment alienates sufferers In addition to the spectre of having to spend hours in queues at state hospitals, thousands of people on chronic medication now have to thread their way through a veritable labyrinth of different interpretations, conditions and sub-conditions and a host of products within individual medical schemes. We will pursue every means available to get them to reconsider, say Wilson and Kahn. – ( Source: SAPA 27 October 2003).