Unpacking the invisible
Mental health is a vital part of overall wellbeing and therefore an international public health priority – not just a trending topic. Dr Nkateko Msimeki and the Medscheme Health Policy Unit’s latest newsletter unpacks details about the current mental-health landscape in South Africa.
In our country, where many face daily challenges such as financial hardship, social and economic inequality, as well as limited access to healthcare, mental-health struggles are common yet often overlooked. While challenges persist, South Africa’s mental-health burden calls for systemic reform and individual action to ensure accessible, effective support.
The state of mental health in SA
According to the South African Depression and Anxiety Group (SADAG) and the South African Stress and Health (SASH) study (2022), up to one in six individuals are affected by anxiety, depression, or substance use disorder. Alarmingly, nearly 30% of adults experience a common mental disorder in their lifetime. Due to underreporting, the situation might be even worse as these figures likely underestimate the reality.
Several barriers fuel underdiagnosis and lack of treatment, including poor integration of mental health into primary healthcare, limited public awareness, high costs, and general stigma. Only 27% of people with severe mental illness receive treatment, with rural and township areas particularly underserved, having just 0,28 public-sector psychiatrists per 100 000 people.
The effects of untreated mental illness ripple across all aspects of life. It is linked to substance abuse, gender-based violence, and poor workplace productivity, the latter costing SA over R61 billion a year in lost earnings. Suicide claims approximately 23 lives daily.
Despite its heavy toll, mental health care receives only 5% of the public health budget, largely directed to psychiatric hospitals, leaving community services underfunded. If community-based care could be expanded, as indicated in the National Investment Case for Mental Health (2023–2030), it could restore up to R117,7 billion in productivity over 15 years.
The private healthcare sector also faces challenges. Conditions such as schizophrenia and bipolar disorder fall under Prescribed Minimum Benefits (PMBs), ensuring more comprehensive coverage. However, common conditions such as major depressive disorder often receive limited benefits. For instance, in-hospital treatments are capped at 21 days annually, leaving many patients to pay out of pocket.
Advocating for change
Advocacy efforts by public figures and mental-health campaigns are breaking down stigma and encouraging people to seek help. In addition, each of us can contribute by fostering open, honest conversations and checking in on our loved ones. On a personal level, healthy habits such as maintaining a balanced diet, regular exercise and mindfulness can promote mental wellbeing.
For those struggling with mental health issues, support exists in public clinics, hospitals, private providers and online platforms, but early recognition, consistent treatment and adhering to prescribed care plans are all key to recovery.
Staying aware of your overall wellbeing and recognising early warning signs – both in yourself and those around you – is essential.
Help is at hand
If you or your loved one is struggling with mental health issues, please reach out to the Wellness Team, our wellness partner ICAS, or contact SADAG on 0800 456 789 and LifeLine SA on 0861 322 322.
