October was just Mental Health Awareness Month, a time to remind ourselves that mental health is a vital aspect of overall health, and that struggling is not a sign of weakness but a natural part of being human (Government Communication and Information System [GCIS], 2024).
In a country as diverse and complex as ours, conversations about mental health are often silenced by stigma, fear, or misunderstanding. But what if being “not okay” wasn’t something to hide? What if, even here, it could be something we’ve discussed together?
The Weight of Silence
Despite growing awareness, mental health challenges remain widespread and undertreated in South Africa. Research shows that nearly one in three South Africans will experience a mental disorder in their lifetime, yet up to 75% of people who need mental health care never receive it (Herman et al., 2009; Petersen et al., 2021).
This gap is due to limited resources, but it’s also due to stigma. Both public stigma (negative societal attitudes) and self-stigma (internalised shame) prevent individuals from seeking help or speaking openly (Radebe et al., 2022).
Stigma manifests in everyday ways:
- Being told to “be strong” instead of “get help.”
- Fearing that therapy is only for “rich” or “crazy” people.
- Using religious or cultural explanations that, while meaningful, may discourage professional support.
- Viewing individuals who receive therapy as being “weak”.
As one South African study explains, stigma is reinforced by cultural beliefs, misinformation, and systemic inequality (Lund et al., 2022).
Why Stigma Persists in South Africa
- Cultural Interpretations
In many South African communities, mental illness is still understood through spiritual or ancestral frameworks, which can be both protective and limiting (Nyaumwe et al., 2024). These beliefs can strengthen identity and belonging, but they may also lead to delayed help-seeking when distress is attributed only to spiritual causes.
- Gendered Silence
Men, in particular, face cultural pressure to suppress emotions. A study conducted among Black South African men in a rural district found that depression was often dismissed as “not manly,” leading to untreated symptoms and social isolation (Mashego et al., 2022).
- Systemic Barriers
Even within the healthcare system, mental health literacy remains low, and stigma persists among professionals, leading to avoidance or dismissal of psychological distress (Botha & Koen, 2021).
These factors intertwine to form what researchers call a “stigma ecosystem” one that can only be dismantled through education, inclusion, and compassion (Petersen et al., 2021).
What We Can Do
Breaking the stigma requires everyone. You don’t need to be a psychologist to make a difference.
- Talk openly: Start conversations about emotions and mental health in your circles.
- Listen deeply: Offer empathy without judgment.
- Challenge myths: Correct misinformation when you hear it.
- Encourage help-seeking: Remind others (and yourself) that therapy, support groups, or medication are valid forms of care.
- Use creativity: Art, journaling, or storytelling can help externalise and process emotions safely.
- Support initiatives: Engage with organisations like TTP that offer psychoeducation and safe spaces for expression.
Moving Forward, Together
This Mental Health Awareness Month, let’s redefine what strength means. Strength is not silent endurance; it’s the courage to speak, to feel, to ask for help.
We may not dismantle stigma overnight, but every time someone says, “I’m not okay” and is met with understanding instead of judgment, we take a step toward a more compassionate South Africa.
In this space, and in our hearts, it’s okay to not be okay. Even here, in South Africa.
References
Botha, U. A., & Koen, L. (2021). Mental health stigma among healthcare providers in South Africa: A review of the literature. South African Journal of Psychiatry, 27(1), a1592. https://doi.org/10.4102/sajpsychiatry.v27i0.1592
Fraser, A., Tan, M., & O’Connor, J. (2021). Arts-based mental health interventions: A scoping review of community and participatory approaches. Frontiers in Psychology, 12, 642136. https://doi.org/10.3389/fpsyg.2021.642136
Government Communication and Information System (GCIS). (2024). Mental Health Awareness Month 2024. https://www.gov.za
Herman, A. A., Stein, D. J., Seedat, S., Heeringa, S. G., Moomal, H., & Williams, D. R. (2009). The South African Stress and Health (SASH) study: Twelve-month and lifetime prevalence of common mental disorders. South African Medical Journal, 99(5), 339–344.
Lund, C., Brooke-Sumner, C., Petersen, I., & Bhana, A. (2022). Stigma and mental health in South Africa: Towards a framework for understanding and intervention. Global Mental Health, 9, e24. https://doi.org/10.1017/gmh.2022.24
Mashego, T. A., Sumbane, E. F., & Maputle, M. S. (2022). Perceptions of depression among men in a rural district of South Africa. Frontiers in Public Health, 10, 935052. https://doi.org/10.3389/fpubh.2022.935052
Nyaumwe, L., Moyo, M., & Maduna, P. (2024). Mental health literacy among Black South Africans: Cultural interpretations and barriers to care. Journal of Psychology in Africa, 34(2), 157–167. https://doi.org/10.1080/14330237.2024.2363690
Petersen, I., Baillie, K., & Lund, C. (2021). Mental health service provision and access in South Africa: A review of challenges and policy responses. International Journal of Mental Health Systems, 15(1), 77. https://doi.org/10.1186/s13033-021-00517-3Radebe, N., Sokhulu, L., & Mokoena, S. (2022). Public and self-stigma towards mental illness in South African communities: Implications for mental health care. African Journal of Primary Health Care & Family Medicine, 14(1), a3493. https://doi.org/10.4102/phcfm.v14i1.3493