The State of Mental Health in South Africa | EAPA-SA

Conservative research-based estimates show that as many as one quarter of South African employees will be diagnosed with depression during the course of their employment. However, only between 15% to 25% will seek and receive help. Mental disorders result in massive amounts of lost productivity each year and it is estimated that employee absenteeism on account of depression costs the South African economy approximately R19-billion annually. How do organisations start creating a workplace that puts a priority on emotional and mental wellbeing?

The state of South Africa’s mental health in a global context

According to the second Annual Mental State of the World Report 2021 from Sapien Labs, published in March 2022, South Africa ranks as one of the worst countries regarding mental health.

The 2021 Report is based on 223,000 responses from 34 countries, all with access to the Internet, in four languages. Quantifying a mental health quotient (MHQ), the report summarises the outcome of research that examines global trends across five different functional dimensions of mental wellbeing: Mood & Outlook, Social Self, Drive & Motivation, Mind-Body Connection, and Cognition.


Functional dimensions of mental wellbeing:

South Africa scored the lowest average score on the mental health wellbeing scale. The rate of distressed or struggling on the scale increased by 8%, from 28.5% in 2020 to 36%. The report summarised MHQ scores that included South Africa as follows: 

“Within the Core Anglosphere, the United States and Canada were the highest (both at 63) while the UK, at 46, was lowest, representing the widest regional range. We note that among other English-speaking countries outside of the Core Anglosphere, Singapore was highest at 74 while South Africa was lowest at 46, along with the UK.”

Click here to read the full report.


The state of mental health in South Africa in a local context 

A recent white paper by the Wits/Medical Research Council, Developmental Pathways for Health Research Unit (DPHRU) reveals that 25.7% of South Africans are most likely depressed, with more than a quarter of respondents reporting moderate to severe symptoms of depression. The prevalence of mental illness was different across all nine provinces, with higher rates in the Northern Cape, Eastern Cape, Western Cape, Gauteng and Mpumalanga.

Click here to read the full paper.

““The shame which many South Africans, particularly black communities, place on people who live with mental illnesses are preventing sufferers from seeking help.” 

Stigma and lack of public spending in South Africa aggravate the problem

In an article written by Associate Professor, William Gumede (School of Governance, University of the Witwatersrand), published in October 2021, he opines, “The shame which many South Africans, particularly black communities, place on people who live with mental illnesses are preventing sufferers from seeking help.”

The article goes on to say:

“Before the Covid-19 pandemic, only 15% of South Africans with mental health receive treatment. This is due largely to the fact that many do not seek help because of the public stigma attached to mental illnesses and because in many cases mental health support is just not available in public medical facilities.

South Africa only spends 5% of its total health budget on mental health – putting South Africa at the bottom of international benchmarks of country public spending on mental health. This translates into less than 1 person per 10 receiving mental health care. Poor South Africans are worse off when it comes to access to mental care – because of the lack of capacity, accessibility and resources in the public health sector for mental health care.

A 2019 survey by the Faculty of Health Sciences at the University of Cape Town showed that so severe are the shortages of mental health specialists, that only three provinces had child psychiatrists. The survey revealed that drugs for chronic mental illnesses such as depression, bipolar disorder and anxiety were routinely unavailable.”


What is the state of employees’ mental health at work in South Africa?

When employers consider how to approach the question of employee mental wellbeing, many of them tend to do so in the context of absenteeism or medical aid claims. The advent of COVID-19 may have seen a more holistic refocus on mental health in the workplace, however it is only one factor among many that contributes to mental health issues in the workplace. The ones linked explicitly to the workplace include rising job insecurity, an increase in automation along with rapid technological advances, and high job demands. The issue of declining levels of mental health is worsened by the fact that there is still a significant stigma attached. In the workplace, SADAG has revealed that just one in six employees are likely to disclose their mental health issues to their manager. As a result, workers do not approach their employers to ask about possibly taking time off to deal with and manage their depression or anxiety. And, some employers might not even consider depression a viable reason to take leave since it is not a routinely talked-about subject. To start with, organisations need to start giving emotional and mental health the same priority as physical health.

In terms of managing employees with mental health issues in the workplace, employers should adopt a proactive approach. Here are five ways organisations can help:

  1. Educate employees on depression and especially how cognitive symptoms can affect work performance.
  2. Raise awareness of any existing employee assistance programmes (EAPs) and emphasise that they can help with mental health problems, like depression, too.
  3. Promote a culture of acceptance around depression and other psychiatric disorders – they are no different to diabetes or asthma.
  4. If an employee shares their struggle with depression, refer them to a mental healthcare professional and reassure them the illness can be treated.
  5. Explore creative ways to support an employee’s recovery, like flexible/adjusted working hours or working from home for a while.


In conclusion, the challenge employees face when it comes to mental health issues in the workplace is that South African employers simply do not see it as a priority – or one that warrants proactive measures. Going forward, employers need to take the time to educate themselves about mental health in the workplace and how they will manage employees who live with depression and anxiety. They should also examine how their working environment may be contributing to the issue.