Londiwe Buthelezi
20 July 2026
Noma ubani ofuna usizo lwezempilo yengqondo eNingizimu Afrika kungenzeka ukuthi useke wahlangana nala magama amabili wazibuza ukuthi asho into efanayo yini. Awasho into efananyo. Nakuba bobabili odokotela bengqondo besebenzela ukusiza abantu ukuthi baphathe kahle impilo yabo yengqondo nemizwa, ukuqeqeshwa kwabo, amathuluzi abawasebenzisayo, kanye nohlobo lokunakekelwa abalunikezayo luhluke kakhulu. Ukuqonda lo mehluko kungakwenza kube lula kakhulu ukwazi ukuthi ubona bani, futhi nini, kungakhetheki ukuthi usebenzisa uhlelo lwezempilo likahulumeni, umshwalense wezempilo (medical aid), noma umtholampilo wangasese.
Umehluko ocacile phakathi kwalezi zinhlobo zombili zodokotela kuqala ngemfundo, futhi bobabili balawulwa eNingizimu Afrika yi-Health Professions Council of South Africa (HPCSA), okusho ukuthi ochwepheshe ababhalisiwe kuphela abangasebenzisa lesi sikhundla ngokomthetho.
I-psychiatrist ingudokotela wezempilo. ENingizimu Afrika lokhu kusho ukuqedela iziqu ze-MBChB (ngokuvamile iminyaka eyisithupha) esikoleni sezokwelapha esiyingcweti njenge-UCT, i-Wits, i-Stellenbosch, noma i-UKZN, kulandele inkonzo yomphakathi (community service), bese kuba iminyaka eminingana yokuqeqeshwa okuyingcweti ngaphansi kwe-Colleges of Medicine of South Africa ukuze bathole iziqu ze-FCPsych(SA) noma i-MMed kwezengqondo. Ngoba baqeqeshwa njengodokotela kuqala, ama-psychiatrist afunda umzimba wonke, hhayi ingqondo kuphela, ngaphambi kokugxila ekunakekeleni impilo yengqondo. Lesi sisekelo sezempilo yisona esibavumela ukuthi baqonde ukuthi izimo zomzimba, imithi, kanye ne-biology kuxhumana kanjani nokugula kwengqondo.
I-psychologist, ngokwehlukile, uqedela iziqu zokuqala kwezenhlalakahle yengqondo (psychology), kulandele izifundo eziphakeme, ngokuvamile iziqu ze-Honours, bese kuba iziqu ze-Master’s ohlwini oluthile lokubhaliswa (Clinical, Counselling, Educational, Research, noma Industrial Psychology), okuhlanganisa nokuqeqeshwa okuphathelene nokusebenza ngaphansi kokuqondiswa (supervised internship). Abanye baqhubeka bathole ne-PhD. Ukuqeqeshwa kwabo kugxile ekufundeni ngengqondo nangokuziphatha komuntu, kanye nezifundo ezinzulu kanye nokuqeqeshwa okuqondisiwe kwezokwelulekwa ngengqondo (psychotherapy) nokuhlolwa kwengqondo. Ama-psychologist kumele nawo abhalise ne-HPCSA ngaphansi kohlu abakulo, kodwa akubona odokotela bezempilo futhi abayi esikoleni sezokwelapha.
Ama-psychiatrist avame ukugxila kakhulu ohlangothini lwe-biological nolwezokwelapha lwempilo yengqondo. Ngenxa yokuthi bangabhalela imithi, iningi lomsebenzi wabo uhlanganisa ukuxilonga ukugula kwengqondo, ukubhalela nokuphatha imithi efana ne-antidepressant, i-mood stabilizer, noma i-antipsychotic, kanye nokuqapha ukuthi isiguli sisabela kanjani ekwelashweni ngokuhamba kwesikhathi. Amanye ama-psychiatrist nawo anikeza ukwelulekwa ngokukhuluma (talk therapy), kodwa amaningi amaappointment, ikakhulukazi emkhakheni kahulumeni lapho izinga leziguli liphezulu khona, mafushane futhi agxile kakhulu ekuphatheni imithi, ukwelulekwa kudluliselwa ku-psychologist, umeluleki obhalisiwe (registered counsellor), noma wezenhlalakahle (social worker).
Ama-psychologist aqeqeshelwe ukwelulekwa ngengqondo (psychotherapy), okuvame ukubizwa ngokuthi ukwelulekwa ngokukhuluma noma ukweluleka (counselling). Basebenzisa izindlela ezihlelekile, ezisekelwe ebufakazini, njengokwelashwa kokucabanga nokuziphatha (cognitive behavioural therapy – CBT), ukwelashwa kwe-psychodynamic, noma ukwelashwa kokwamukela nokuzibophezela, ukuze basize abantu ukuthi banqobe izinkinga ezifana nokukhathazeka, ukudangala, ingcindezi yengqondo (trauma), izinkinga zobudlelwano, noma izinselelo zokuziphatha. Ama-psychologist nawo yiwona avame ukuqeqeshelwa ukwenza ukuhlolwa kwengqondo, njengokuhlolwa kwe-IQ, ukuhlolwa kobuntu, noma ukuhlolwa kokuxilongwa kwezimo ezifana ne-ADHD noma ubunzima bokufunda, umsebenzi ovame ukudingeka ekufakweni ezikoleni, ekuhlolweni endaweni yomsebenzi, noma ezindabeni zomthetho.
Kubalulekile futhi ukwazi ukuthi iNingizimu Afrika inezinye izigaba ezibhalisiwe zempilo yengqondo ezihamba nalezi zimbili: abeluleki ababhalisiwe (registered counsellors) kanye nabahloli bengqondo (psychometrists), abasebenza ngaphansi kwesikhala esincane somsebenzi, nabezenhlalakahle (social workers), abavame ukunikeza nokweluleka, ikakhulukazi ngezinhlangano ezingekho ngaphansi kukahulumeni (NGOs) nasezindaweni zezempilo zomphakathi.
Lo ngomunye womehluko omkhulu osebenzayo. Ama-psychiatrist, njengodokotela bezempilo, angabhalela imithi. Ama-psychologist eNingizimu Afrika awakwazi ukubhalela imithi ngaphansi kwazo zonke izimo, lesi akusona isigaba esinemibandela evumela ukubhalela imithi njengoba kunjalo kwamanye amazwe. Njengomthetho, ukuphathwa kwemithi kungaphansi kwe-psychiatrist, nakuba udokotela wemvelo (GP) naye engabhalela futhi aphathe eminingi imithi ejwayelekile yengqondo, futhi ivame ukuba yindawo yokuqala yokuxhumana.
Ukukhetha okufanele kuvame ukuncika kulokho obhekene nakho:
Bona i-psychiatrist uma ucabanga ukuthi kungenzeka udinge imithi, unesimo esinzima noma esiyinkimbinkimbi sempilo yengqondo (njenge-bipolar disorder, i-schizophrenia, noma ukudangala okukhulu), noma usuvele uthatha imithi yengqondo futhi udinga ukuqashwa okuqhubekayo.
Bona i-psychologist uma ufuna ukukhuluma ngenkinga, obhekene nayo nokukhathazeka, ingcindezi, usizi, izinkinga zobudlelwano, noma ingcindezi yengqondo (trauma), noma udinga ukuhlolwa kwengqondo ukuze uxilongwe.
Kuvamile futhi kuncomeka ukuthi abantu babone bobabili. I-psychiatrist ingaphatha imithi kuyilapho i-psychologist inikeza izigcawu zokwelulekwa ezijwayelekile, bobabili ochwepheshe basebenzisana ekunakekeleni konke komuntu.
Ukufinyelela eNingizimu Afrika ngokuvamile kwehlukaniswa kabili:
Ezempilo Zikahulumeni: Izibhedlela zezifundazwe kanye nemitholampilo yomphakathi zinikeza izinsizakalo ze-psychiatric ne-psychological ngentengo ephansi noma mahhala, nakuba isidingo siphezulu futhi izikhathi zokulinda zingaba zinde, ikakhulukazi ezimeni ezingezona eziphuthumayo. Ukudluliselwa kuvame ukuba ngomtholampilo noma isibhedlela sendawo.
Ezempilo Zangasese: Amaningi amasikimu omshwalense wezempilo (medical aid) asibekela inani elithile lokubonana ne-psychologist ne-psychiatrist unyaka nonyaka ngaphansi kwe-Prescribed Minimum Benefits (PMBs), esebenza ezimweni ezithile zokuxilongwa kwengqondo kungakhathaleki ukuthi ukuluphi uhlelo. Kufanele uhlole imithetho yesikimu sakho ngokuqondile, njengoba izinkokhelo ezengeziwe (co-payments), umkhawulo wezigcawu, kanye nemvume edingekayo kuyahluka kakhulu phakathi kwezikimu nezinhlelo.
Iningi lama-psychiatrist nama-psychologist angasese adinga ukudluliselwa okuvela ku-GP ukuze izicelo zomshwalense wezempilo zicutshungulwe kalula, ngakho ukuqala ngo-GP wakho kuvame ukuba isinyathelo esisebenzayo kunazo zonke izikhathi.
Ama-psychiatrist nama-psychologist akusiyona imisebenzi encintisanayo, kodwa iyahambisana. Ama-psychiatrist aletha ulwazi lwezempilo kanye namandla okubhalela imithi, kuyilapho ama-psychologist eletha ukuqeqeshwa okujulile kwezokwelulekwa nokuhlolwa kwengqondo. Ukwazi umehluko akuwona nje ulwazi lwesikole, kungakusiza ukuthi uthole usizo olufanele ngokushesha futhi uhambe kalula nomshwalense wezempilo noma uhlelo lukahulumeni.
Uma ungaqiniseki ukuthi udinga bani, indawo enhle yokuqala ukuvakashela u-GP wakho, ongakuhlola futhi akudlulisele ngendlela efanele, noma uxhumane nohlelo lokusiza lwezengqondo lwesikimu sakho somshwalense wezempilo uma unalo. Izinhlangano ezifana ne-South African Depression and Anxiety Group (SADAG) nazo zinikeza inombolo yocingo yamahhala engakusiza ukukuqondisa ohlotsheni olufanele lokunakekelwa.
