Dr Ali Hamdulay, CEO, Metropolitan Health
As mental health needs rise and become increasingly intertwined with physical health, World Mental Health Day on 10 October is a timely reminder that South Africa needs to make it easier for people to seek support early.
According to 2026 data, there is a rising burden of disease across a range of conditions, with this trend particularly evident in mental healthcare.
The World Health Organisation estimates that mental disorders affect 11% of people in the African Region. In South Africa, the South African Depression and Anxiety Group (SADAG) estimates that 23 people die by suicide each day, while a further 460 attempt suicide daily. Behind each number is a person, family, workplace and community that may have needed support sooner.
Between 2019 and 2025, the prevalence of depression increased by 22%. Over the same period, Government Employees Medical Scheme (GEMS) saw admissions for depression rise from 206 to 274 per 1,000 beneficiaries treated for depression – a 33% increase. This points to a growing need for mental healthcare and, importantly, increased reliance on in-hospital treatment, which can be more costly.
The financial impact is equally significant. As an example, in 2025 GEMS, the largest closed medical scheme in South Africa, paid R2.75 billion towards the treatment of depression, compared with R923.9 million in 2019 – representing a 198% increase in spend.
While Mental Health Awareness Month provides an important opportunity to raise awareness, encourage conversations and challenge stigma, awareness alone is not enough if people still struggle to find, afford or confidently access support before their mental health reaches crisis point.
Mental health is closely interconnected with many other aspects of wellbeing and health. Mental health conditions frequently co-exist alongside physical illnesses, financial stress, social challenges and life-style related risk factors, with these co-morbidities and correlations often influencing both development and progression of mental illness. Understanding these connections is essential to identifying risk earlier and supporting more holistic, integrated care.
This connection is becoming increasingly visible across South Africa’s healthcare and workforce landscape. Metropolitan Health is seeing this increase in mental health conditions among members, as a reflection of a broader need for support, available earlier, easier to access and better integrated into everyday healthcare.
For public-sector employees – including teachers, nurses, police officers and other frontline workers – the pressure can be particularly intense. These professions are often expected to perform in demanding environments while navigating personal, financial and family responsibilities of their own. Yet, South Africa’s public health system faces a significant shortage of primary and specialised mental health professionals.
Mental healthcare should be a connected and accessible part of everyday healthcare, with primary care serving as an important entry point for support. A more integrated approach, spanning prevention, early identification, treatment, recovery and ongoing wellbeing, can help people access care earlier and achieve better health outcomes.
From crisis response to earlier support
The first step is to normalise proactive mental healthcare. A person should feel as able to seek help for persistent stress, poor sleep, anxiety or emotional exhaustion as they would for high blood pressure or recurring pain.
That requires care pathways that are simple to understand and easy to navigate. Employees and members need to know where to start, what support is available, and how to move from a first conversation to appropriate care without unnecessary complexity or delay.
It also requires a more integrated model. Mental-health concerns may present alongside chronic conditions, pain, substance use, fatigue or changes in physical health. Healthcare providers, employers and medical schemes all have a role to play in recognising these connections and ensuring that support does not sit in a separate, difficult-to-reach corner of the healthcare system.
South Africa’s National Mental Health Policy Framework and Strategic Plan 2023–2030 points in this direction, with its focus on integrating mental healthcare into primary healthcare and strengthening community-based support. Building capability among general practitioners, nurses and counsellors to identify early signs of distress can help more people receive appropriate support before their challenges escalate.
Workplaces must make support practical
Employers also have an important role to play in turning mental health awareness into meaningful action. While many workplaces offer support programmes, barriers such as stigma, concerns about confidentiality and fear of being judged can prevent people from using them.
Creating psychologically safe environments, where employees feel comfortable seeking help, raising concerns and having honest conversation, is therefore as important as making support available.
Practical steps such as clear communication, empathetic leadership, and flexible support mechanisms can help translate good intentions into meaningful outcomes for employees and organisations alike.
This World Mental Health Month, there is an opportunity to move beyond awareness alone. By making mental healthcare accessible, preventative and integrated, South Africa can help more people seek support early – when it can make the greatest difference.
ENDS
