South Africa - Last year, Fort Hare University’s Psychiatric Nursing department found that not only was the country’s growing mental health crisis exacerbating the country’s substance and rising suicide levels, but it was a major contributor to increasing crime levels.

In the recently released National Crime Statistics for the three-month period ending December 2023, the effects of crime were found to be increasingly affecting children, and Fort Hare highlighted the mental health of both perpetrators and victims as a growing cause for concern.

Speaking openly about mental health in South Africa often requires navigating deeply entrenched traditional beliefs, pervasive stigma and misconception – a delicate balance between tradition and modernity.

Fear, lack of education and conservative religious beliefs have advanced theories that mental health issues equate to personal weakness or a lack of faith.

According to the World Health Organisation’s latest World Mental Health Report, “Several factors stop people from seeking help for mental health conditions, including poor quality of services, low levels of health literacy in mental health, and stigma and discrimination.”

In South Africa, the picture is far worse. A recent study, by the Wits/Medical Research Council Developmental Pathways for Health Research Unit (DPHRU), shows that “more than a quarter of South Africans suffer from probable depression with higher levels in certain provinces”.

Overcoming the stigma of mental health3 driven by traditional and religious beliefs is the first step to addressing an urgent need in South Africa. How? By dispelling myths and promoting empathy through education, communities can dismantle the walls of stigma and create a more supportive environment for people dealing with mental health.

THE IMPACT OF POVERTY ON MENTAL HEALTH

Adding to the complexity of dealing with mental health in South Africa is the impact of poverty, serving as a silent accomplice that intensifies the struggle of those affected. The stressors associated with economic hardship often act as catalysts for mental health struggles. Dr Ashleigh Craig, an emerging researcher at DPHRU, says people living in poverty and with poor mental health are at an increased risk of remaining poor2. “It’s a vicious cycle and has intergenerational effects.”

Recognising the undeniable link between poverty and mental well-being demands a holistic approach. This strategy should include not only mental health services, but also social and economic policies aimed at alleviating poverty, thereby fostering an environment conducive to better mental health.

In the public sector, mental health care remains underfunded, according to the WHO5, creating a significant barrier to accessibility. In the DPHRU study2 (Wits University, 2022), Dr Craig points out that few primary healthcare facilities in South Africa have mental health services. “This, in combination with mental health being low on the priority list, spells disaster. We need better implementation of mental healthcare plans, more skilled mental health professionals and more budget for prevention, treatment and support strategies,” she said.

The scarcity of resources underscores the urgent need for a re-evaluation of priorities in public health. Adequate funding would not only expand the reach of mental health services but also contribute to destigmatising mental health.

A MORE HOLISTIC APPROACH TO MENTAL HEALTH MANAGEMENT NEEDED 

Within this context, traditional and faith healers emerge as potential allies in the quest for mental well-being. According to a paper written by Tuviah Zabow, Emeritus Professor, Department of Psychiatry at the University of Cape Town, and published in the National Library of Medicine: “Indigenous healers are still widely used (in South Africa), especially for mental health problems. This is in part related to common beliefs that such problems are caused by bewitchment and that only indigenous healers can treat this, resulting in simultaneous consultations. Many patients still travel from distant areas to get psychiatric treatment in the city-based facilities.”

Acknowledging that traditional healers outnumber Western mental health practitioners, there is an opportunity for these healers to play a role in addressing mental health issues. By integrating traditional healing practices with modern mental health approaches, a more holistic and culturally sensitive support system can be established.

Zabow adds, “It is evident that culture-specific concepts of mental illness and related beliefs will affect the delivery of psychiatric services. An understanding of the systems of indigenous healing by healthcare providers is therefore essential in each region of the country, as these may differ regionally.”

ADDRESSING A GLOBAL HEALTH CHALLENGE

Paul Miller, CEO of Cipla South Africa, expressed the company’s commitment to addressing the needs of those affected by poor mental health: “Mental health has been identified as a global health challenge. In response to this, over the past few years, Cipla has had an intense focus on mental health. We want to reduce the stigma around mental health, and have also created a dedicated helpline which is managed by the South African Depression and Anxiety Group (SADAG) so that people know there is help and there is hope.”

Addressing mental health challenges in African traditional settings requires a multifaceted approach that combines education, poverty alleviation, and collaboration with traditional healers. By fostering understanding, breaking down stigma, and embracing cultural nuances, South Africa can pave the way for a more inclusive and supportive environment for mental well-being.

In a paper published in the National Library of Medicine, Omolayo Anjorin from the Institute of Psychiatry, Psychology & Neuroscience, Kings College London, United Kingdom and Yusuf Hassan Wada of the Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria argue, “Traditional healers will continue to have a substantial role in mental health-care delivery because they are not only available and accessible in the community, but they also constitute part of the community's cultural belief system, making them a vital part of the community. Thus, it is important to explore the role of traditional healers in the provision of mental health services and provide recommendations for better practice.”

Whether you are helping a friend, or need help yourself, you can always call the free Cipla SADAG 24-hour mental health helpline on 0800 456 789 or via WhatsApp on 076 882 2775 between 9am – 5pm.

Ends

About Cipla South Africa

Cipla Medpro South Africa (Pty) Limited (‘Cipla South Africa’) is a wholly owned subsidiary of Cipla Limited, India (‘Cipla’) and 3rd largest pharmaceutical company in South Africa (and 2nd largest in the Rx sector). Through Cipla’s ethos of ‘Caring for Life’, Cipla South Africa produces world-class medicines at affordable prices for the public and private sectors, advancing healthcare for all South Africans. 

For more information, visit www.cipla.co.za

About Cipla

Established in 1935, Cipla is a global pharmaceutical company focused on agile and sustainable growth, complex generics, and deepening portfolio in our home markets of India, South Africa, North America, and key regulated and emerging markets. Our strengths in the respiratory, anti-retroviral, urology, cardiology, anti-infective and CNS segments are well-known. Our 47 manufacturing sites around the world produce 50+ dosage forms and 1,500+ products using cutting-edge technology platforms to cater to our 86 markets. Cipla is the 3rd largest in pharma in India (IQVIA MAT July’23), 3rd largest pharmaceutical company in South Africa (and 2nd largest in the Rx sector) (IQVIA MAT July’23), and is among the most dispensed generic players in the U.S. For over eight decades, making a difference to patients has inspired every aspect of Cipla’s work. Our paradigm-changing offer of a triple anti-retroviral therapy in HIV/AIDS at less than a dollar a day in Africa in 2001 is widely acknowledged as having contributed to bringing inclusiveness, accessibility, and affordability to the centre of the HIV movement. A responsible corporate citizen, Cipla’s humanitarian approach to healthcare in pursuit of its purpose of ‘Caring for Life’ and deep-rooted community links wherever it is present make it a partner of choice to global health bodies, peers, and all stakeholders.

For more, please visit www.cipla.com, or click on Twitter, Facebook, LinkedIn.

THE LINK BETWEEN CRIME AND MENTAL HEALTH IN SOUTH AFRICA (2023) University of Fort Hare https://www.ufh.ac.za/news/News/linkbetweencrimeandmentalhealthSouthAfrica

FEELINGS OF FAILURE – Teen Suicide Week, South African Depression and Anxiety Group https://www.sadag.org/index.php?option=com_content&view=article&id=1924:teen-suicide-prevention-week&catid=111&Itemid=136

Minister Bheki Cele: Third Quarter Crime Statistics 2023/2024 (2024) South African Government News https://www.gov.za/news/speeches/minister-bheki-cele-third-quarter-crime-statistics-20232024-16-feb-2024

Lifting the veil on violence against children in South Africa (2024) Statistics South Africa https://www.statssa.gov.za/?p=17023

World Health Organisation (2022). Transforming mental health for all. [online] Available at: https://iris.who.int/bitstream/handle/10665/356119/9789240049338-eng.pdf?sequence=1.

Wits University (2022). 2022-11 - Mental health in SA is at shocking levels but people are not seeking help - Wits University. [online] www.wits.ac.za. Available at: https://www.wits.ac.za/news/latest-news/research-news/2022/2022-11/mental-health-in-sa-is-at-shocking-levels-but-people-are-not-seeking-help-.html

Zabow, T. (2007). Traditional healers and mental health in South Africa. International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists, [online] 4(4), pp.81–83. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734787/#:~:text=Even in metropolitan urban areas.

Anjorin, O. and Hassan Wada, Y. (2022). Impact of traditional healers in the provision of mental health services in Nigeria. Annals of Medicine and Surgery, 82, p.104755. doi:https://doi.org/10.1016/j.amsu.2022.104755.