Aside from the courage it takes to begin your journey towards mental wellness, cost is a significant consideration when it comes to accessing mental health care - particularly in the South African context.
We find ourselves in something of a predicament. Psychologists and psychiatrists can be financially out of reach for many South Africans, with access often dependent on having medical aid or sufficient disposable income to cover private healthcare costs.
The facts
Only around 14-15% of the population has medical aid, depending on the statistics and source used.
The public mental healthcare system plays an essential role, and there are many dedicated, compassionate and service-driven practitioners working within it. However, these services are often under considerable pressure, with limited resources and high patient volumes making it difficult to provide the level of individualised care that people deserve.
This is, in part, where I believe the role of the counsellor becomes increasingly pertinent.
Counsellors do not provide medical diagnoses in the way that psychologists or psychiatrists do. Instead, counselling can offer a space to work with the person as a whole, rather than focusing solely on a diagnosis.I like to say: I work with the person, not the diagnosis. In fact, many people who seek support do not necessarily need a medical diagnosis or meet the criteria for a mental disorder. They may simply be struggling with a difficult period of life, navigating a relationship, experiencing stress or burnout, processing a loss, or trying to better understand themselves and their experiences.
What I have found in my own practice is that, more often than not, people need somewhere they can speak openly, without judgement, and feel genuinely heard. They need someone to sit with them in what they are experiencing and respond with empathy and kindness. It is remarkable how often this fundamental human need goes unmet — and even more remarkable is the impact that being truly listened to can have.
Counselling can also provide a more financially accessible point of entry into mental health support. Counsellors' fees are often considerably lower than those of psychologists and psychiatrists, making professional support more attainable for people who may otherwise struggle to access it.
There are, of course, also NGOs and community-based organisations doing invaluable work. However, many operate with limited resources and are frequently at capacity. I take my hat off to the social workers, counsellors and other professionals working tirelessly within these services to support their communities.
So, where does this leave the person who knows they need someone to talk to, but cannot afford — or does not necessarily need — the level of care provided by a psychologist or psychiatrist? This is where counselling can play an important role.
It offers a space somewhere in the middle: professional, supportive and accessible mental health care for the everyday person.