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Keeping quiet about mental health matters doesn’t help

Stigma continues to be a significant barrier to quality care

Unfair societal expectations force men to shoulder more burdens than they can manage and end up being depressed as they tend to bottle things up and not share.
Unfair societal expectations force men to shoulder more burdens than they can manage and end up being depressed as they tend to bottle things up and not share.
Image: Theepatheep Kawinpathawee

Stigma and discriminating against mental health creates barriers that lead to people suffering in silence and not seeking help.

Jacob*, 42, never spoke to anyone about his mental health issues and says he feared that he would be labelled weak.

“There was a time when I felt like my life was falling apart. I lost my job in 2012 and for the longest time, I sought employment but could not find it. Years went by and I felt alone. I rented a room and needed to pay rent every month. People I called friends and family turned their backs on me during the most difficult period in my life,” says Jacob.

“Almost five years later, I found a job that wasn’t paying well and I worked because at least I was able to put food on the table for my mother, sister and her children. I could pay rent but just when I thought things were looking up, my mother was retrenched, making everything fall on my shoulders.

“I was depressed. I was working but my bank account was on a minus a few days after payday. I was depressed and at some point I thought of ending my life.”

He says his turning point was when a colleague spoke to him openly about their mental health issues.

“I never knew I had mental issues until I had a conversation with a colleague. We just sat, talked and talked for hours. It was only then that we both realised what was going on and keeping quiet was not going to help.

“I then went to our human resources department to find out if they could help and they referred us for counselling. Speaking to a professional helped me deal better with my mental health. Now it is a priority. I talk openly about stuff,” says Jacob.

He says some of the changes he made were to exercise more to reduce stress and he moved back home so he doesn’t have to pay rent for two places.

“People will always judge you for making certain decisions. Society thinks that as men, we’re supposed to hold things together even if it breaks us.

“It made sense to go back home and I intend staying there until I find a better paying job.”

The SA Depression and Anxiety Group (Sadag) says good mental health is crucial to everyone’s overall health and well-being.

Tuesday is World Mental Health Day and the department of health is calling on communities and people to “create an enabling environment for people to openly discuss mental health challenges and share experiences to help break down barriers and encourage health-seeking behaviour for early diagnosis and effective management”.

This year’s theme is “Mental Health is a Universal Human Right.

“…There is no health without mental health. Mental healthcare is a human right and advocating for access and equity is a social justice issue,” says Sadag board member and psychiatrist Dr Mashadi Motlana.

“Nowhere in the world do mental healthcare services enjoy parity with physical health in terms of funding. Stigma continues to be a significant barrier to quality care, social integration, and employment opportunities.”

The department of health says stigma and discrimination can make mental health problems worse.

According to Sadag, only one in 10 people with a mental illness have access to treatment.

“Mental health knows no boundaries or borders. It is a basic aspect of our overall health and should be considered a fundamental human right. SA’s current statistic is that one in three South Africans will or do have a mental illness at some point in their lifetime facing mental health challenges. The current landscape reveals significant gaps in mental health resources," says the organisation’s operations director Cassey Chambers.

“Mental illness can impact physical health, well-being, how people connect with others, and their livelihoods. Mental health conditions are also affecting an increasing number of adolescents and young people. A call for more services dedicated to children and adolescents is a reflection of commitment to nurturing the well-being and future of the younger generation.

“By investing in NGOs [nongovernmental organisations] and youth-focused programmes, we not only provide essential support for those in need but also contribute to the creation of a more resilient society. It is time to take a stand and make mental health matter.”

Chambers says while SA had taken steps towards strengthening mental healthcare in the past 20 years, including reforming the Mental Health Care Act 2002 and developing a national mental health policy framework and strategic plan 2023-2030, more needs to be done.

Chairperson of SA Mental Health Alliance Dr Mvuyiso Talatala says, “Less than 4% of the national health budget is spent on mental healthcare and the majority of that budget is allocated to inpatient hospital care.

“There isn’t nearly enough budget and resources allocated for outpatient programmes to help patients once they leave hospitals, and there isn’t enough money invested in community mental health systems.”

Health minister Joe Phaahla will host a commemorative event in Newcastle, KwaZulu-Natal, raise awareness and drive actions that promote and protect everyone’s mental health as a universal human right, among other things.

Sadag is encouraging you to #GoGreenForMentalHealth, “by rallying and encouraging peers, colleagues, friends and loved ones to wear green, be decorated in green and come up with creative ways to #GoGreen”.

“Let’s raise our voices together to help advocate for better mental healthcare and to recognise that mental healthcare is an integral part of the healthcare system. Now, more than ever, South Africans from all areas and walks of life need – and deserve – better mental healthcare and to know that their mental health rights are important,” says Chambers.

*Jacob is not his real name


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