Mental Health in South Africa: A Journey of Self-Healing

Mental health has been at the forefront of social issues of late and has been described as a ‘pandemic’ and an ‘escalating crisis’ by various publications. Living with a mental illness can be both paralyzing and overwhelming; so much that it can lead to one ending their own life. According to the World Health Organization, nearly 800,000 people die by suicide annually around the globe. For every person who succeeds, there are more than 20 people who attempt suicide. Suicide has become the second leading cause of death in 15-29-year-olds, and yet, less than two percent of the global health budget is allocated to mental health.

In South Africa, in addition to a lack of resources, there is a stigma attached to mental illness. People living with mental illnesses are perceived as crazy, under a spiritual curse, weak, or simply misunderstood. The fact that these illnesses are often devoid of physical symptoms combined with the lack of appropriate terminology in African languages to describe psychological symptoms, all contributes to the complexity of mental illness in the South African context, making it that much harder to grasp.

As such, there is an ongoing debate on the relevance of Western psychology, based on Euro-centric standards, being applied to the South African context. There is in large part an agreement among field experts that a “uniquely South African solution” is required. Although precise approaches and perspectives vary, the general consensus is that therapy must be decolonized, in line with a more culturally appropriate ‘Africanized’ psychology.¹

Regardless of one’s school of thought, the reality is that one-third of the South African population continues to suffer from mental illnesses. Among those facing a mental illness, only 16 percent receive treatment. On average, there are 0.28 psychiatrists and 18 beds available in mental health facilities per 100,000 people.² Furthermore, the South African Government has reserved only three percent of its total health budget for mental health and only one percent of this figure is dedicated to children and adolescents.

Research has shown that people who consider themselves as the ’other’ or feel isolated from “mainstream” society are most likely to die by suicide. Therefore, implementing the fading but long-standing concept of ubuntu, seems like a viable option. Ubuntu is an African moral concept/theory coined from the phrase “umntu ngumntu ngabantu,” which translates to “a person is a person through other persons.” The beauty of this type of humanity is that it does not neglect the person, but rather celebrates personhood in relation to others (i.e.,  “the relationship of the self in community and of the self and the community is a co-dependent one”).³  According to Mkhize, a South African psychologist, ubuntu thrives ‘’if people mutually recognize the obligation to be responsive to one another’s needs.”⁴ 

Despite the fact that ubuntu might be difficult to teach, it isn’t too far gone within South Africans to reach. Take a community gathering for creative art therapy for example. Creative art therapy—music, dance, and drama therapy—has been proven effective in supporting those with mental illnesses as it encourages self-expression and appreciation of the other. It is a low-cost solution that helps address the problem of insufficient healthcare workers and isolation. Creative art therapy can also assist those that aren’t aware of their condition and foster a sense of community—the strongest mode of suicide prevention. Creative art is also universal and cannot be claimed by any one person. Therefore, Africans can rest in knowing that they are, at that moment, self-healing. 

Instead of always seeking far and wide, a closer look at what already exists within the communities might save lives.

Notes:

1. Malose Makhubela, “‘From psychology in Africa to African psychology’: Going nowhere slowly,” Psychology in Society (2016) :1-18, http://www.scielo.org.za/pdf/pins/n52/01.pdf.
2. Crick Lund, Sharon Kleintjes, Ritsuko Kakuma, Alan J. Flisher, “Public sector mental health systems in South Africa: Inter-provincial comparisons and policy implications,” Social Psychiatry (July 2009), https://www.researchgate.net/publication/26276489_Public_sector_mental_health_systems_in_South_Africa_Inter-provincial_comparisons_and_policy_implications.
3. Sinethemba Makanya, “The missing links: A South Africa perspective on the theories of health in drama therapy,” The Arts in Psychotherapy (July 2014), https://www.researchgate.net/publication/277490900_The_missing_links_A_South_African_perspective_on_the_theories_of_health_in_drama_therapy.
4. Ibid.