The outbreak of COVID-19 is likely to cause serious challenges for mental health services. In any epidemic it is common for individuals to feel stressed and worried, and there are specific stressors particular to the COVID-19 pandemic. Mental health practitioners are anticipating spikes in incidences of fear, anxiety, stress, post-traumatic stress, depression, substance abuse, aggression, regression, family and gender-based violence, anxiety about finances and various other forms of psychological issues during and in response to the lockdown. Separation from loved ones, loss of freedom, uncertainty over disease status and boredom will dramatically affect some individuals.
Educational psychologists, as essential service providers, have moved swiftly to adapt to new and demanding circumstances brought about by the COVID-19 outbreak. Many educational psychologists have skilled themselves in online therapy, are providing pro bono services to some families and to some frontline health workers, and/or are offering public advice and opinions that have reportedly influenced key decision makers during the period of lockdown.
Educational psychologists, perhaps more than any other category of registered psychologist, have been involved in community interventions, in schools and in diverse fields of practice. They are extensively trained and many have skills in the areas of assessment, psychotherapy (including individual, family, parental, couples, marital, and group therapy), systemic interventions and research.
The Educational Psychology Association of South Africa (EPASSA) is dismayed to note that some medical schemes are continuing to refuse to pay for educational psychology services at a time when South Africa needs them most and when our country is in any event severely underserviced in terms of mental healthcare workers, particularly within the government and community health systems. Schemes that have refused to pay for the services of educational psychologists and/or counselling psychologists, and who continue to do so at a time of national need, include, but may not be limited to Medihelp, Profmed, GEMS (administered by Medscheme), Polmed (administered by Medscheme) and KeyHealth. CAMAF and Bonitas have also in some ways been inconsistent in their funding of educational psychology services.
Although the largest private medical scheme, Discovery Health, does not discriminate when it comes to paying clinical, counselling or educational psychologists, some of the aforementioned schemes have refused to pay educational psychologists based on misconceptions as to the role, function and scope of practice of educational psychologists. The High Court declared as invalid a regulation that these schemes happened to be misinterpreting and the Professional Board for Psychology of the Health Professions Council of South Africa (HPCSA) advised the Minister of Health not to introduce a new regulation. Moreover, the regulator of medical schemes, the Council for Medical Schemes (CMS), has acknowledged that the regulation defining a differential scope of practice has fallen away and that service providers should be funded.
At a time when some medical schemes are professing to champion mental health needs, EPASSA calls on them to be more transparent. Schemes cannot make such claims while they withhold funding and, thereby, limit access to certain categories of mental health practitioners. Their claims are particularly offensive in the present climate.