Half of all mental health illnesses begin around the age of 14, with most cases going undetected and untreated. Picture: Supplied
Half of all mental health illnesses begin around the age of 14, with most cases going undetected and untreated. Picture: Supplied

World Mental Health Day: Mental health for all in South Africa is key

By Viwe Ndongeni-Ntlebi Time of article published Oct 10, 2020

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The past few months have brought many challenges for all of us and taking care of our mental health is crucial during a time when our daily lives have changed considerably as a result of the Covid-19 pandemic.

Saturday is World Mental Health Day, and experts say there is no better time for everyone to focus on mental health care.

Mental illness is classified by a combination of abnormal thoughts, emotions, behaviours and relationships with others. Examples are schizophrenia, depression, intellectual disabilities and disorders caused by substance abuse.

“Mental illness is more common than we think – it can affect anyone at any time, and is treatable,” says Sally Baker, social worker and member of The South African Association of Social Workers in Private Practice (Saaswipp).

One in three South African adults will experience mental illness in their lifetimes, but the quest for equal access to better mental health for all is hampered by a severe lack of treatment facilities and mental health professionals, with only 1 000 psychiatrists to serve the country’s almost 60 million people.

President-elect of South African Society of Psychiatrists, Dr Sebolelo Seape, says, with the availability of psychiatrists at 0.5 per 100 000 people, well below the global average of 1.3 psychiatrists per 100 000 people, a ratio that varies widely from 0.51 in low-income countries to 12 in high-income nations.

Graphic: ANA Pics

She says the lack of professionals was worsened by structural barriers to achieving universal mental health coverage, including treatment costs and limited medical aid cover for mental illness, while a lack of public sector treatment facilities and professionals is felt in both high-density urban areas and South Africa’s more rural provinces.

“This indicates that from the get-go, South Africa is not in a position to deliver services adequately to its population.

“The 2020 World Mental Health Day theme is ‘Mental health for all – Greater Investment, Greater Access. For Everyone. Everywhere.’ This is a noble principle which we should all strive hard to achieve and sustain but, sadly, there are serious barriers to achieving this in South Africa,” Seape says.

Despite the high prevalence, mental illnesses remain largely unknown and unrecognised as medical conditions, leaving the afflicted undiagnosed and untreated, to the distress of family and community. The reasons for this are as diverse as the economic, cultural and social landscape of South Africa.

Seape says a lack of knowledge of mental health, social stigma and a belief that mental illness is a sign of weakness, as well as the risk of discrimination in the workplace by disclosing a mental health disorder, were among the attitudinal barriers to achieving good mental health for all.

A South African study has shown that the majority of people did not perceive that they needed treatment for mental health conditions, or else they believed they could manage without help, that the problem would “go away on its own” or that treatment wasn’t effective.

“This is tied to a lack of knowledge and understanding of the causes of mental health conditions and the appropriate treatment for these conditions – what we call mental health literacy. Culture and traditional beliefs also play a role in South Africa, and solutions to addressing barriers to seeking treatment for mental health conditions need to take these into account.

“It is clear that all these barriers will need to be overcome to improve mental health service provision in South Africa,” says Seape.

Treatment dropout is a further concern, Seape says, due to negative interactions with mental health-care providers, lack of personal or medical aid funding for maintenance or follow-up care, and lack of support from employers in allowing employees the time to seek help and complete treatment.

If someone you know shows signs of mental illness, or you need help, the South African Depression and Anxiety Group (Sadag) is Africa's largest mental health support and advocacy group and is committed to quality counselling, outreach and capacity-building work throughout the country. Sadag also helps people access other resources.


  • To contact a counsellor from 8am – 8pm, Monday to Sunday, call 011 234 4837 / fax: 011 234 8182.
  • For a suicidal emergency call us on 0800 567 567.
  • 24-hour helpline: 0800 456 789.
  • If you suspect that you have a substance abuse problem or someone you know needs help, call the SA National Council on Alcoholism and Drug Dependence (Sanca) on 011 892 3829.


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