The shocking state of mental health in South Africa in 2019

Published: August 21, 2019 / 37 Comments

Mental Health in South Africa

With studies revealing the poor standing of mental health in South Africa, on whom does the onus fall to remedy lack of counselling resources?

As many as one in six South Africans suffer from anxiety, depression or substance-use problems (and this does not include more serious conditions such as bipolar disorder or schizophrenia), according to statistics released by the South African Depression and Anxiety Group (SADAG).

Furthermore, research reveals that over 40% of people living with HIV in South Africa have a diagnosable mental disorder. A study done by UCT’s Department of Psychiatry and Mental Health indicates that, in low-income and informal settlements surrounding Cape Town, one in three women suffers from postnatal depression, while research from rural KwaZulu-Natal shows that 41% of pregnant women are depressed – more than three times higher than the prevalence in developed countries.

Dr Eugene Allers, a leading South African psychiatrist and former President of the South African Society of Psychiatrists (SASOP), believes that when crime and motor-vehicle accidents are taken into consideration, up to 6 million South Africans could suffer from post-traumatic stress disorder.

What’s more, says Cassey Chambers, Operations Director at SADAG, because “people don’t know where to go to get help, or are too scared to seek it, the stats we have are still not a true reflection of what is actually happening on the ground.”

However limited, looking at what evidence we do have, one can safely conclude that the state of country’s mental wellbeing is in severe crisis. Yet, despite the acute need for it, South Africa’s mental healthcare resources are wholly unequipped to handle the burden placed on them. SADAG claims that less than 16% of sufferers receive treatment for mental illnesses. And, although over 85% of these patients are dependent on public health-sector services, there are only 18 beds for every 100 000 people available in such hospitals (and only 1% of these are reserved for children and adolescents!).

The root of the crisis

The primary burden of mental healthcare falls on community-based providers, says Chambers: “Clinics, support groups, even lay counsellors and community leaders are having to step in where institutionalised help is not available. Only 27% of South Africans reporting severe mental illness ever receive treatment. This means that nearly three-quarters of these sufferers are not accessing any form of mental health care at all.”

In addition to a lack of resources, stigmas surrounding mental health pose a major stumbling block when it comes to treating the disease in South Africa, explains Chambers. “In Zulu, there is not even a word for ‘depression’ – it’s basically not deemed a real illness in the African culture. As a result, sufferers are afraid of being discriminated against, disowned by their families or even fired from work, should they admit to having a problem. There is still the perception that someone with a mental illness is crazy, dangerous or weak. Because there is often an absence of physical symptoms with mental illness, it is considered ‘not real’, a figment of the imagination.”

Experts unanimously agree that the nature of the mental health situation in the South African context requires a uniquely South African solution. According to Chambers, there is most definitely scope for an approach to dealing with our country’s mental health issues that incorporates both western medicine and traditional healing. “Addressing the cultural belief systems at play is crucial for finding ways to best help patients and their families, and traditional healers can play a significant role in this regard,” she says.

The first line of defence

Because of the huge responsibility that falls to community healthcare providers when it comes to dealing with mental illness, Chambers stresses that it is these traditional healers, along with local nurses, counsellors and coaches who are at the forefront of fighting the mental-illness pandemic in South Africa.

Lance Katz, Managing Director at the South African College of Applied Psychology (SACAP), agrees that “the intervention of skilled professional counsellors and coaches” is key to the solution. SACAP’s teaching programme places an emphasis on both practical application and cultural diversity when it comes to psychological training. Fieldwork experience is an integral part of SACAP’s curriculum, and the organisation offers over 100 placement sites in the Gauteng and broader Western Cape regions, SADAG among them. “The fieldwork component gives students the opportunity to not only sharpen their counselling skills in a real-world context, but also to make a positive difference to people’s lives at the same time,” says Katz.

In addition, a “Diversity in the South African Context” module is also incorporated into the teaching syllabus, the aim of which, explains Katz, is to create awareness of the impact of context and contextualised dynamics that ultimately shape the development of individuals and counselling practice within South Africa: “By encouraging those entering the field of mental healthcare to conceptualise possible action for effective change within the South African context, we can make a start to addressing the problem,” he says.

Chambers agrees, “The first step to helping patients and loved ones is to get them to talk about it. There are still so many sufferers who feel alone, scared and misunderstood. Increased awareness and a policy of educating the public about mental health issues will encourage more people to share their diagnoses and seek help.”

You can join the fight. Studying a counselling course at SACAP will set you on the path to becoming a registered counsellor, so you can play a role in alleviating the heavy burden being placed on mental health services in South Africa. For more information, enquire now.

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Your Comments on “The shocking state of mental health in South Africa in 2019”

  1. Caroline latta

    My 34 year old son is living rough on the streets of Cape Town – Rondebosch area. He is in a state of tik induced paranoia / psychosis. I fo not know how to get him the help he needs as I am not there. Please advise.

  2. Carin Olwagen

    To: SASOP/ Dr Allers

    NHI Bill vs RC’s future

    I am a registered counsellor in practice and am concerned about the future of us as RC’s in the light of the new NHI Bill.

    As we all know we are already struggling with recognition and mostly with referrals and job opprtunities in our category, not to mention the limits being placed on our scope as service providers.

    Please can I get feedback with regard to this critical issue.

    Also in response to the article placed on the website of SACAP with regards to the mental health crisis in S.A. and the training of registered counsellors –

    – what opportunities are there for us as RC’s who are struggling to make the health centres; clinics; doctors; the community etc. aware of the benefit of our services despite all the training and placements being done as we who have already registered struggle to get jobs?

    Looking forward to your reply.

    Kind regards
    Carin Olwagen
    Registered Counsellor

    • Marketing Team

      Hi Carin, it would be best to send this email directly to the addressed parties. We sincerely hope you get a response.

  3. Noma

    Im a 33 year old lady residing in Cape Town. I always find myself surrounded by family and friends who are thanking me for taking off their burden. Then friends started recommending each other so i would find myself talking to strangers that I sometimes never get to meet.

    I then realized that i have an ability, after couple of years working for Department of Health in Eastern Cape, i resigned and relocated to Cape Town. My wish is to work and change children’s lives. Every problem is 2 sided, a lesson & a solution side. We have to remain positive in any situation we find ourselves in, life is not guaranteed to be smooth, the bigger the problem, the bigger the solution.
    Low income earners / informal settlement is my ideal people. I wish to volunteer and give free classes at their places of residence. They need help and they dont afford to leave children and sit in session that requires them to take taxis, even if they were free.

    there is a great way to deal with them, starting with giving the sessions funky name and open them for anything to avoid the stigma. I can make the difference, from 10 year old to 80 year olds, the heart is what i would deal with.

  4. Francois Holliday

    Hi . I just want to find out if you give afordable evaluation and counseling to people who cant realy afoard counseling

    • Marketing Team

      Hi Francois, please visit the Counselling Hub in Woodstock which is a low-cost counselling service that supports individuals in facing their life challenges. They offer up to 6 sessions for only R50:

  5. Maxwell

    How do I get hold of SASOP and SADAG?
    From you SACAP which desk/person can I be in contact with?

  6. Anonymous

    What can we do to help organizations, I suffer with depression myself and I hate it, I want to help people who suffers with the disorder.

  7. Phelo Pita

    Good day, may I get information about such organisations.i want to be involved I lost someone close to depression and I dont want other people to go through the same.Pleease give me e-mail address or contact number of people to contact with any information.


    Harish Jagtani Foundation is South Africa’s local non-profit organization near me is where you can help for Women and child welfare

  9. Nontando bekizulu Siwa

    Hi i need to know what can I do instead of get him old brother he was smoking drugs a lot now he say he stopped bt he is so dangerous to people now.he like to fight for 19 and I’m married because I was running away at home because of him.but now I’m not happy at all because his abusing my mother now



    My son suffered from bipolar over the years it became so bad that every morning when i lay my eyes on him tears will roll down my cheek. I tried so many medications to make him okay but all to no avail until a friend gave my Dr Barasa of email address and told me he has heard so many things about the wonders of the DR when she visited her husband’s people in Africa i hurriedly wrote to Dr Barasa and we spoke he told me that he was going to send me herbs that my son will be okay after using the herbs. so we both agreed though the charges was quiet expensive i didn’t really care as i needed the cure for my son so desperately,I then went to western union to transfer the money there the agent warned me not to send money to Nigeria that they were all scammers i laughed uncontrollably cause to me he sounded so foolish and image dainty due to the fact that my friend from whom i got Dr Barasa email address was more than a sister to me so i told him to keep his advice and kindly transfer the money. So after three days of sending the agreed payment to him i received the herbs here in Germany and my son took it as directed by Dr Barasa of and he got well.There is no joy bigger than to see your children all healthy i thank Dr Barasa a lot for all that he did for my son and promised to share my testimony with the world now i know that there is power in herbs are you also suffering from bipolar or your ward kindly get in touch with Dr through his email or call his mobile +2347060595685 he is indeed a good man and a savior of life

  11. Thato

    This was very helpful. Thank you so much. I am an honours students in psychology and have gained a lot of knowledge about the standing of mental health and mental health services in South Africa.

  12. Sipho Nkomo

    What would you do if one day you just woke up
    and your whole life has changed, all of a sudden
    you are afraid to meet people on the streets.
    You are afraid of riding on taxis or trains, you
    feel so much anxiety to a point where you don’t
    feel good enough. You are self conscious all the
    time. You feel you have bad breath and don’t
    want to talk anymore because you think your
    breath will smell bad for other people. You don’t
    play soccer or exercise anymore because when
    people stare you start to shake. This goes on
    and on and you tell your family and they say you
    making all of this up there’s nothing going on
    with you, you turn to smoking and being drunk a
    lot and they say it’s what you have always
    wanted. When I’m drunk I’m not myself and don’t
    have so much anxiety that is why I can pick up
    women but when I’m a lil sober in the morning it
    becomes difficult to communicate to the girl. At
    that time your family is separated everyone lives
    their own lives now no one has got time for you.
    They are all trying to protect their ‘homes’ I feel
    like a burden from all of this. All they want is for
    me to get a new job whereas I’m going to fail
    again because I’m sick but if a job got me when
    I was better I would obviously give it my best
    shot because I have always wanted to be
    successful and live a good life like everbody
    else. These feelings of anxiety and depression
    have taken a lot of my life, a good 6 yrs of my
    life, I’m losing strength

  13. Adele Bezuidenhout

    It would be best to talk to your GP so that they can refer you to another psychiatrist for a 2nd opinion.

  14. Petrus Smit

    I have talked to SADAG in 2014

  15. Petrus Smit

    One of my brothers, the second oldest did destroyed the inside of our house on the 7 October 2013 because he receive wrong treatment and diagnoses at a public hospital.The hospital has diagnose him with Psychosis but in reality he has Schizophrenia.He was also very violent towards us.It is because of wrong treatment?We’re very traumatrised.We suffer also financial now

    • Adele Bezuidenhout

      Hi Petrus,

      We’re sorry to hear about your current situation. It would be best to talk to SADAG as they will be able to assist and support you in this regard.

  16. Wade


    my mother is always depressed and angry my step dad recently passed and I just had a life threatening accident she has health problems and is pushing everyone away…. I do not not what to do as she threatening get to kick me out the house

    • Adele Bezuidenhout

      Hi Wade,

      We would recommend that you contact the SADAG Mental Health Line on 011 234 4837. We wish you all the best during this trying time.

  17. Theresa

    Hi there,

    My husband and I are helping a young couple in need with place to stay in our house, I’m very worried cause the lady has mood changes every few minutes she gets very aggresive and suicidal at times, I have a 20 month old toddler and I’m afraid for her safety, The lady says she was on medication for her temper, but she stopped using them in 2013 both her sons have been taken away from her, but she says its because she couldn’t care for them, but my argument is, she’s not allowed to be alone with either of them… Could this be a warning sign that my child and myself are in danger?

    • SACAP


      It would be advisable to contact a health professional for advice on what would be the best way forward for you, your family and the young couple staying with you.

  18. Jane Maxhana

    Is there any work done into translating psychiatry language to indiginus languages ? What is being done to educate people in their laguages ?

  19. Mat

    Hi am 34 I have been taking wellbutrin for about 2years now however I have been feeling depressed long before then. I have been having this feeling that I have seen all that life had to offer and that there was nothing more out there that I could possibly be interested in. I went through 3 relationships but I ended up smothering the person as I was dependent on them to give me the will to continue living. In the beginning of each relationship I would be very happy even shave buy new clothes etc like the clouds would go away but then that would later change to dependense and controlling I.e she must answer her calls whenever I needed her 24/7. If that did not happen I would loose my temper and threaten to leave the relationship but then come back begging to be taken back. I have also been taking sleeping pills as I struggle sleeping and if I do manage to sleep I would be lucky to be asleep past 4am. I have been hopping jobs hoping that I would find something worth staying for in a company but to no avail. I have never gone for any formal counselling as I have been putting it off due to shame but I believe I do need to. Please assist me in finding the right place of assessment.

    • SACAP


      Please approach your nearest clinic or hospital and ask to speak to a nurse or doctor. They will be able to refer you to a counsellor.

  20. vilen

    Im going to be 21 this year…. i have a personality disorder (schizoid) i really want to get help but i cant afford it… please help

    • SACAP


      Have you gone to your local government clinic or hospital for assistance? They will be able to refer you to someone who can help you.

    • Jane Maxhana

      Hi u can go to your local clinic u will get help free of charge u will b seen by mental health nurse who will book u 4 psychiatrist !

  21. heather

    hi I have a father that has been diagnosed with bi-polar and the psychiatrist that he goes to says he has dementia too he is becoming impossible to live with soon as my mom gives my children attention he does something to spite them or me if im out for too long he lets my tyres down a bit if i leave my car keys laying around he steals my money out my purse thats locked in my car he was in rehab for prescription painkillers but i get the feeling he is buying something like pain killers unless its the sugar but he has to be on “hi” all the time or he gets depreast he eats everything he can possibly eat he eats every 2 hours i think he is scared he forgets to eat he complains about being constipated, heart, pain depending what advert is on tv he steals my medication out my meds box even my childerns cough mixture he has left them on the bottem of the lable so we cant say he finished it, if you ask him why he is doing something he denies it its not him and gets very upset that you say he did something, we have 2 boerbull x pits they show signs of abuse they some time bark at him when he is agro his cat is battling to walk on her back legs i think he has done something to her too the vet says it looks spinal damage he manipulates everybody he comes into contact with he breaks stuff and says it was not him i got the feeling he gets agro when he is left at home on his own but we cant take him with he fights with my kids and if we do take him with we have this atmosphere because my children are tired of him he does not understand he has done so much damage in the last 7 years, what can we do to help him and get him the help he needs?

    • SACAP


      It would be best to consult your nearest clinic or doctor, and they will refer you to a specialist who may be able to assist.

      • DementiaSA

        In response to Heather’s question :
        Hi Heather I would also like to suggest that you contact our organisation, DementiaSA (email: or contact one of our counsellors on our national helpline on 0860 636 679 / 0860 MEMORY or see our website and I hope we can help you with finding where your father can be assessed depending on where you live.
        I hope we can help – with my very best wishes, Karen Borochowitz, National Exec Director, DementiaSA

  22. Thembisile Jerusia Jumba

    i have a problem and i need help so where can i get help i live in Vosloorus Boksburg and im not working so i can’t afford private clinic. i always feel sad and i have even tired to committee suicide but i didn’t die even now writing this i feel sad, hurting i need help i don’t want my daughter to grow up without her mother. if i tell my family they will think that im crazy, my husband and i are always fighting and im the one course all the fight his good to me and love my daughter as his. please i need help i have this anger on everything im life and myself i hate myself.

    • SACAP


      It would be best to approach a government clinic and they will refer you to professionals who will be able to assist you accordingly.

  23. Gloria Maxam

    The reason for me being in this website is that. I am currently writing my exams for a degree in social work with UNISA. My main interest is gain more knowledge and hands on training in working with mentally challenged people.

    Whiles also counselling the families, educating the society about mental illness,help and treatment which available. Also advocate for group works, recreational facilities, where mentally disabled people can go, meet and mix with other people.

    My interest and concern, stems from the fact that I have a son, who has a honours in, suffers from schizophrenia is currently taking medication, but is isolating himself and has no interest in socialising, has never attended any group work, because non has ever been offered to him. Also no place to go to where can keep himself busy, learn some skills.

    He used to work as a business analyst. Sadly he cannot go back to a job which is too stressful for him.

    I have seen many parents who are stressed with the fact that their loved ones are mentally ill. I have also experienced cases where these people are not looked after by their families, because they regard them as a shame to the family or a burden.

    • Sheena Jacobs

      Looking for mental health statistics Northern Cape Province, more specifically schizophrenia for research purposes. What a disater!. Any ideas?