Table of Contents
- The Do Team
Introduction
Mental health in South Africa has long been a critical issue, with significant treatment gaps and unequal access to care. The National Mental Health Policy Framework, adopted for the first time in 2013, aims to address these challenges by providing a comprehensive roadmap for improving mental health services across the country. While the new framework for 2023 – 2030 is a necessary step forward, its implementation faces several challenges—especially when it comes to stigma, resource distribution, and disparities in healthcare access. In this article, we explore how the new framework could impact South Africa’s mental health landscape and what it means for organisations and society at large.
Deputy President of the African National Congress, Paul Mashatile. Photo: SA News. South Africa’s long-awaited new National Mental Health Policy Framework and Strategic Plan 2023 – 2030 was published and presented at the SA mental health conference in April 2023.
Overview of the National Mental Health Policy Framework
The National Mental Health Policy Framework was first implemented in 2013, reaching the end of this policy in 2020 (2013-2020). It was developed to respond to South Africa’s growing mental health crisis. It sets forth a plan to enhance access to mental healthcare, reduce the stigma around mental health, and promote the integration of mental health services into the broader healthcare system. This is especially vital in South Africa, where mental health issues affect a significant portion of the population, yet access to care remains limited.
According to a study, 16.5% of South Africans experience common mental disorders (anxiety, mood, and substance use disorders) within a 12-month period. Additionally, 30.3% of the population has experienced a common mental disorder in their lifetime (NCBI).
The framework acknowledges the socio-economic factors that exacerbate mental health issues and sets ambitious goals to address them. It highlights the need to prioritize mental health in policy decisions and provides a blueprint for action at both national and local levels.
The policy also sets out to strengthen mental health promotion, prevention and advocacy. Photo: Spotlight
Translating these goals into reality remains a significant challenge. In low-income countries, fewer than 1 out of 10 individuals with mental illness receive the care they need. Evidence suggests that between 75% and 95% of people with mental disorders in low- and middle-income countries, like South Africa, cannot access mental health services. Those who do, often receive insufficient or inappropriate care. (Mental Health South Africa)
In South Africa, 84% of the population relies on the government-funded public health sector, while 16% access private healthcare using private funding mechanisms (NCBI). Currently, only 20% of psychiatrists in South Africa work in the public sector, which serves 84% of the population – in rural areas psychiatrists are employed at a rate of 0.03 per 100,000 people (Oxford Academic).
The framework’s success will largely depend on its ability to bridge these gaps in public health services.
Mental Health and the National Health Budget
Budget allocation for mental health in South Africa has long been inadequate. According to a 2020 NCBI journal report, despite the adoption of the National Mental Health Policy Framework in 2013, which calls for parity between mental and physical health services, mental health spending remains low, at around 2.6% of the national health budget. The National Department of Health notes that obtaining accurate data on resource allocation is challenging, as each province independently manages its health budget. Out of South Africa’s nine provinces, only two have fully costed mental health plans (NCBI).
Most of the mental health resources—approximately 2.2% of the national health budget—are reserved for psychiatric institutions, leaving primary and community-based care critically underfunded. Furthermore, the Life Esidimeni tragedy in 2016, occurred during the period of the previous Mental Health Policy Framework (2013-2020). 140 people tragically lost their lives during a mismanaged deinstitutionalization process, exposing systemic neglect in the country’s mental health services and further highlighting the need for greater consideration in budget allocation and implementation plans.
Sifiso Mkhasibe was diagnosed with bipolar disorder in 2007. He says his experience with the illness prompted him to start volunteering and creating awareness of mental health conditions Photo: Spotlight.
Mental health activists like Siphiwe Sifiso Mkhasibe have raised concerns about the gap between policy and practice. Mkhasibe argues that “Without the proper infrastructure and trained professionals in place, the new policy may end up being just another document.” (Spotlight). This further highlights the need for practical solutions that address stigma, resource allocation, and active management of the policy’s implementation.
Addressing Stigma Through Awareness and Education
One of the most significant obstacles to the success of South Africa’s National Mental Health Policy Framework is the enduring stigma attached to mental illness. In a country where mental health is still a taboo subject for many, stigma prevents individuals from seeking help. The World Health Organization (WHO) has emphasized that globally, stigma, discrimination, and human rights violations impede access to mental health care, particularly in low- and middle-income countries (World Health Organization).
As Siphiwe Sifiso Mkhasibe, a South African mental health and disability activist, shared in his public reflections, “There were times when I couldn’t speak about my mental health because of the fear of judgment. The shame attached to mental illness in South Africa is heavy, but we must talk about it openly if we want real change.” By normalizing conversations about mental health, society can help dismantle these harmful stereotypes (Spotlight).
During Mental Health Awareness Month (October) in 2023 Health Minister, Dr Joe Phaahla, raised concerns that only 30% of people who battle with mental health issues receive treatment in South Africa. Phaahla further spoke of social stigma and discrimination, stating he believes it is rife and serves as a barrier to asking for help, making the recovery journey harder. The Minister emphasised that the government is now intensifying mental health awareness campaigns to empower citizens to reduce the stigma associated with mental illness and promote help-seeking behaviours and emotional well-being practices. (SA News)
October 2023, Health Minister, Dr Joe Phaahla, and attendees joined the global community in observing World Mental Health Day. Photo: SA News
Education and awareness programs within schools and workplaces can serve as powerful tools for change. Integrating mental health education into daily life is key to addressing stigma at its roots. Here, institutions like do life play an active role by offering resources and solutions to promote mental health awareness in businesses and educational environments. By supporting organizations to foster inclusive and supportive environments, we can create spaces where mental health is openly discussed, and stigma is systematically broken down.
The Role of Businesses in Mental Health Support
Businesses and educational institutions have a unique opportunity to champion mental health and implement the National Mental Health Policy Framework’s objectives. In a nation where 84% of the population depends on public healthcare, institutions that actively integrate mental health support into their culture can lead the way in normalizing care and reducing the treatment gap.
According to the framework mental health conditions such as depression and anxiety are estimated to cost South Africa more than R61.2 billion annually in lost productivity and earnings. The framework emphasizes that the societal costs of untreated mental illness far surpass the public sector expenditure on mental health services. In essence, the economic burden of not addressing mental health issues outweighs the cost of providing adequate care.
For businesses, creating supportive environments that prioritize mental wellbeing can lead to healthier, more productive teams. Educational institutions, meanwhile, can prepare the next generation by offering mental health resources, fostering emotional intelligence, and building resilience. These organizations can take inspiration from global examples where mental health programs have been successfully implemented, such as in Canada and New Zealand, where national campaigns have increased mental health awareness by over 20% (World Health Organization).
Do life can provide tailored solutions for businesses and schools to address mental health proactively. By offering wellbeing memberships, resources, and training programs, do life helps organizations promote mental health in a way that aligns with the goals of the National Mental Health Policy Framework. Whether it’s through workshops, online resources, or daily practices, institutions can support their teams in navigating mental health challenges while contributing to long-term societal change.
How Do Life Supports Mental Health in South Africa
The role of do life in supporting the National Mental Health Policy Framework cannot be understated. With wellbeing memberships and programs designed for individuals, businesses, and educational institutions, do life empowers growth by providing the practical tools needed to foster mental health and emotional intelligence.
Through tailored solutions, do life aligns its offerings with the framework’s goals of reducing the treatment gap, addressing stigma, and promoting mental wellbeing across South Africa. For businesses, these tools can help create workspaces that prioritize employee mental health. For schools, they can provide students with the emotional skills needed to thrive in an increasingly complex world.
In addition, do life encourages a holistic approach to mental health by blending emotional growth with real-world readiness. This creates an environment where individuals, teams, and institutions are equipped to handle mental health challenges and promote resilience, contributing to long-term societal wellbeing.
In Closing
The National Mental Health Policy Framework is an important step forward in addressing South Africa’s mental health crisis, but it will require significant effort to overcome challenges like resource shortages, stigma, and implementation gaps. By actively engaging businesses, schools, and society at large, and with the help of initiatives like do life, South Africa can take meaningful strides toward reducing its mental health treatment gap and fostering a more inclusive, supportive environment for all.