Here we are, living in 2024—a year when mental health conversations are more common than ever. Around the world, people are finally recognising the importance of mental well-being. But in South Africa, our story is different. We’re not only dealing with mental health but also with the layered realities of our unique history and ongoing challenges. This year, South Africa marks 30 years of democracy — a milestone that celebrates our resilience and progress but also reminds us of the inequality, poverty, and mental health issues we still face. To truly understand where we are with mental health, we need to look at the “good,” the “bad,” and the “unspoken,” especially now, as we’re healing from the mental scars left by the pandemic.
The Good: More People Are Talking About It
One positive shift in 2024 is that more South Africans are open about mental health. Compared to a few years ago, people are finally talking about their struggles, breaking down stigmas that have long kept conversations about mental health behind closed doors. COVID-19 played an unexpected role in this — it highlighted just how fragile our mental health can be. We all felt vulnerable in one way or another, and this shared experience made it easier to discuss what we’ve been through.
From corporate wellness programmes to community workshops, initiatives are emerging that encourage people to get the help they need. Mental health apps, virtual therapy, and online support networks are making resources more accessible. Social media, too, plays a big role — it can be a lifeline, connecting people to resources and communities, but it also has its downsides. Used mindfully, though, these tools give people more options than ever to seek help and build support networks, even in a country where professional mental health services are limited.
The Bad: Growing Mental Health Challenges with Limited Support
Despite these positive changes, the reality is that the pandemic left many of us dealing with new and intensified mental health challenges. The stresses of unemployment, economic instability, and the lingering trauma from COVID-19 continue to weigh on us. South Africa’s mental healthcare system, already stretched thin, now has an even bigger job — to support a population with an increased need for mental healthcare.
Many people simply don’t have access to the help they need. Financial limitations, long distances to facilities, and a shortage of professionals make getting help a challenge. In rural areas especially, mental health services are sparse, and misunderstandings about mental health can create barriers to care. When someone can’t find or afford help, a manageable mental health issue can quickly spiral into a crisis, leaving people feeling like they have nowhere to turn.
According to the 2022 World Mental Health Report by the World Health Organization (WHO), pre-pandemic (2019) an estimated 970 million people in the world were living with a mental disorder, 82% of whom were in LMICs. Between 2000 and 2019, an estimated 25% more people were living with mental disorders, but since the world’s population has grown at approximately the same rate the (point) prevalence of mental disorders has remained steady, at around 13%.
Source: IHME, 2019
The Unspoken: October and the Shadow of Suicide
One of the most heartbreaking aspects of mental health in South Africa is that October sees the highest suicide rates. Why? The reasons are complex, but October is a time when many people feel intense pressure — from financial worries to exam stress, all against the backdrop of a long year. For those already struggling, October can be especially overwhelming, made worse by the “October blues,” a real phenomenon that mixes end-of-year fatigue with heightened stress.
Prof Jason Bantjes, Deputy Director at MAST-RU said: “Suicide is an important public health concern in South Africa. While it is difficult to determine suicide rates accurately, data collected by the SAMRC’s Burden of Disease Research Unit suggests that in the year 2020/21, approximately 11.5 people out of every 100,000 in the country died by suicide. The highest rate of suicide was among people aged 15 to 44, with 16.8 suicides per 100,000 people in this age group. Men in South Africa are much more likely to die by suicide than women—about 4 times more likely.”
Mental health is still a deeply private struggle for many South Africans. While we’re more open about it than in the past, there are still communities where mental health issues are avoided out of shame or fear of judgement. For some, this means suffering alone until it’s too much to bear. Cultural beliefs and misconceptions add to this silence; conditions like depression or anxiety are often spiritualised or misinterpreted instead of being recognised as legitimate mental health issues.
Looking Ahead: Building a Future Where Mental Health Matters
As we look to the future, it’s clear that South Africa needs more than just awareness. We need real, structural change. Mental health services must be integrated into primary healthcare. We need more trained professionals and programmes that reach underserved communities.
Educating communities to understand mental health can break down stigma and help people support each other. Schools, workplaces, and community centres have to be active in these conversations, making sure that people know where to turn before things reach a crisis.
In 2024, our mental health landscape reflects the complexity of a nation shaped by both struggle and hope. As we celebrate 30 years of democracy, let’s commit to building a South Africa where mental health is prioritised, where resources are accessible, and where no one has to suffer in silence. After all, mental health is a journey we’re all on, and our collective well-being depends on recognising the good, confronting the bad, and speaking about the unspoken.
“In the depths of winter, I finally learned that within me there lay an invincible summer. And that makes me happy. For it says that no matter how hard the world pushes against me, within me, there’s something stronger — something better, pushing right back.” — Albert Camus
Article written by: Zipelele Twaku
