The Role of Counselling in Mental Health: A Practitioner’s Perspective
Drugs are not always the answer to our mental issues
The Role of Counselling in Mental Health: A Practitioner’s Perspective
Dr E V Rapiti
Cape Town, June 25, 2025
Having offered mental health services for over 35 years as a family physician with a qualification in mental health, I discovered that the majority of my patients suffering from depression and anxiety recovered significantly better through counselling and guidance—without the long-term use of psychotropic medication.
I wish to share a small sample of cases from my practice that demonstrate how individuals, even with severe emotional distress, managed to recover and thrive through psychotherapy, education, and emotional support alone.
Case 1: A 40-Year-Old Woman with Chronic Depression
A housewife in her forties requested a repeat prescription for fluoxetine, which she had been taking intermittently for 20 years. Despite long-term use, she hadn’t experienced meaningful improvement...
Six months later, she returned with life-changing news—she had divorced her husband, stopped all medication after our initial session, joined a running club, and was visibly thriving.
Case 2: Grieving Young Mother Turned Entrepreneur
A young mother of two teenage boys presented with depression following a miscarriage. She had never received counselling for the loss and began abusing alcohol to cope...
She later told me that conversation changed her life. Over the next five years, she earned a qualification, ran a business, and became a sought-after photographer—entirely free from depression or medication.
Case 3: Suicidal 20-Year-Old Male Reclaims Purpose
A father brought his son to me after two suicide attempts. The young man had been unemployed since finishing high school and felt hopeless...
By the end of our 40-minute session, he was smiling, motivated, and committed to change.
Case 4: Severely Medicated Male Returns to Life
A long-standing patient in his 40s was placed on six psychotropic drugs by a psychiatrist. He felt sedated, unproductive, and hopeless...
He addressed his core life challenges, returned to work, and even managed a major family tragedy—without relapsing into medication.
Case 5: Executive Overcomes Suicidal Depression
A financial consultant, overwhelmed after his wife left him, attempted suicide and was hospitalized for two weeks...
He came off the antidepressant and has remained stable and happy for over a decade.
Case 6: 11-Year-old Traumatized by Abusive Teacher
An eleven-year-old boy refused to go to school after suffering repeated abuse from a female teacher. I intervened, escalating the matter to the Department of Education...
The child was moved to another class and began to thrive academically and socially.
Anxiety Disorders and Non-Drug Therapy
Over the years, I have treated many children and adults for anxiety and panic disorders without resorting to medication. Techniques such as breathing exercises, meditation, and affirmations have yielded lasting results...
Children as young as 4 have successfully overcome phobias and separation anxiety without any medication.
Conclusion
These cases represent a small fraction of my 42-years of being in practice. They demonstrate that even the most severe mental health challenges can be effectively managed through compassion, deep listening, practical guidance, and empowering therapy.
Medication may have a place, but it should not be the default. It is far more powerful to equip patients with the tools, understanding, and support they need to face life’s challenges with dignity and resilience.
Dr Rapiti is a family physician with over 42 years experience working in the low income suburb of Mitchells Plain, which has a population of 1.5 million people. He has a keen interest in mental health and social issues apart from lifestyle medicine. He successfully treated over 4000 patients with COVID achieving a 99.97% success rate. He has given several talks on a number of independent platforms internationally and in South Africa about his successful protocols.
Dear Dr. Rapiti. I am so glad to have found your substack. I first found you when I was reading about the tragic story of Dr Jackie Stone. Your tribute was so genuine and so very touching. I just want you to know that your patients are so truly blessed to have you as their doctor. I only wish I could find a doctor that had half of your qualities. You are a true blessing on this earth!
Dear Dr. Rapiti: Thank you so much for sharing your clinical experiences of helping your patients through engagement, listening and understand with empathy and guidance. Are you aware of my husband, Peter Breggin, MD's work in the same arena? (website is breggin.com) Your professional experience is so informative as it demonstrates that non-drug therapy is effective across cultures. We would love to have a conversation with you on our radio show if we can arrange it. Would you please write to me at psychiatricdrugfacts@hotmail.com Very best, Ginger Breggin