As Suicide Becomes a Leading Killer, SA’s Mental Health Crisis Demands More Than Just Talk

On World Mental Health Day on October 10^th, as global organisations issue rallying cries for awareness, a silent and escalating crisis is claiming more lives in South Africa than car crashes, crime, or accidents.

The uncomfortable truth, revealed by stark new data, is that talking about mental health, while crucial, is no longer enough, says Yael Geffen, CEO of Lew Geffen Sotheby’s International Realty, who is also a prominent, outspoken national mental health advocate.

Suicide has overtaken motor vehicle accidents as the leading cause of unnatural death among South Africans aged 41 to 60, accounting for a staggering 45% of claims in this age group, according to data from Discovery Life.

This mid-life cohort, often bearing the weight of financial pressure, familial responsibility, and career stress, is at the epicentre of a national emergency, according to Geffen.

The statistics paint a devastating picture. Discovery Life’s data, released earlier this year, shows suicide-related insurance claims surged by 62% in 2024 compared to the previous five-year average. Overall, suicide now accounts for 35% of all unnatural death claims – well ahead of motor vehicle accidents (23%) and crime (17%).

“We have spent years, rightly, trying to destigmatise mental health conditions. We’ve encouraged people to talk, to share, to say, ‘It’s okay not to be okay’,” says Geffen.

“But we are now facing a brutal reality: what good is talking if there is nowhere for people to go for professional, accessible help? We are sending people into a battle armed only with words, when they need clinicians, medication, and sustained therapy.”

The crisis is not confined to South Africa. New World Health Organization (WHO) data from September reveals that over a billion people worldwide are living with mental health conditions, making it the second leading cause of long-term disability. The global economy loses an estimated $1 trillion annually in lost productivity.

Yet, the systemic response remains critically underfunded. The WHO’s 2024 Mental Health Atlas report indicates that median government spending on mental health has stagnated at a modest 2% of total health budgets since 2017.

The disparity is shocking: high-income nations can allocate over R1,100 per person to mental health, while low-income nations spend less than R1.

“We must move from silence to openness, from stigma to empathy, and from neglect to support,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO. “Shifting the narrative on suicide also means driving systemic change, where governments prioritise and invest in quality mental health care and policies to ensure everyone gets the support they need.”

This systemic failure is acutely felt in South Africa, which the WHO ranks among the top 10 countries globally for suicide rates. The continent of Africa bears the heaviest burden, with the highest age-standardised suicide rate in the world.

Geffen says our national picture is one of profound gaps and inequities.

“The National Planning Commission’s Mental Health Situational Analysis released last year estimates that only a quarter of South Africans in need of mental healthcare receive it.

“With approximately 27% of the population experiencing mental health disorders, the treatment gap is a chasm.

”It’s also highly doubtful that we’re getting a complete picture of the size of the crisis, because of under-reporting and inadequate record-keeping – especially in the over-burdened state sector.

Geffen says the data tells a story of a broken system.

“We see that 63% of individuals who died by suicide had a prior diagnosis. They were ‘in’ the system. They sought help.

“But the system is so overburdened, under-resourced, and fragmented that it failed to catch them. In the public sector, waiting lists are a form of torture, referrals are slow, and the critical shortage of psychiatrists and psychologists means many who cry for help will never receive it.”

The crisis is exacerbated by a stark gender disparity. Men are four to five times more likely to die by suicide than women.

Geffen says the deep-seated stigma around mental health issues that persists in South Africa, particularly in rural areas, only deepens the crisis. In these underserved regions, where mental health services are minimal, the stigma can be fuelled by a lack of information or knowledge, fortifying shame and often preventing individuals from seeking care.

“Awareness without access is just noise,” Geffen argues. “We have successfully started the conversation, but now we must channel that collective will into demanding tangible action.

“We need a Marshall Plan for mental health in this country. This means training more professionals, integrating mental health into primary care at every clinic, and making sure that a person in crisis in a rural village has the same right to care as someone in a wealthy suburb.”

The economic argument is equally compelling. The Mental Health Situational Analysis noted that South Africa loses billions annually due to lost productivity from mental health issues.

Geffen says as the world marks World Mental Health Day on October 10th, the call is no longer just for awareness, but for accountability and urgent, systemic investment. The lives of those in their prime, those who should be the backbone of the nation, depend on it.

“The time for gentle reminders is over,” concludes Geffen. “We are in a state of emergency. We have the data. We know the human and economic cost. Now we need the political will and the budgetary commitment to match the scale of the crisis.

“Otherwise, the sad truth is that the talking we’ve done will just be echoes in our graveyards.”