Mental health is fundamental to our ability to think, emote, interact with each other, earn a living and live life to the fullest. That’s why the promotion of mental health should be a vital concern of individuals, communities and societies everywhere.
October is Mental Health Awareness Month. With an estimated 450 million people worldwide suffering from mental or neurological disorders or psychosocial problems, this is an important time to raise public awareness about mental health, and to reduce the stigma and discrimination that people with mental illness are often subjected to.1
A recent report by the Lancet Commission found that mental health disorders are on the rise in every country in the world and could cost the global economy up to $16 trillion between 2010 and 2030 if the increasing incidence of mental health disorders is not addressed collectively. The report noted that the growing crisis could cause lasting harm to people, communities and economies worldwide.2
“Mental health includes our emotional, psychological, and social well-being,” says Megan Hosking, psychiatric intake clinician at Akeso Clinics. “Mental health is not only the absence of mental illness, but is rather explained as ‘a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community’, according to the World Health Organization (WHO).3 It affects how we think, feel and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through to adulthood.”
Many mental illnesses are a result of a combination of factors. These include physical/biological factors such as a predisposition to a particular illness or chemical imbalances, psychological factors such as experiences of stress or trauma, and social factors such as exposure to poverty or violence.
Adolescence and mental health
According to the WHO, half of all mental illness begins by the age of 14, but most cases go undetected and untreated.
“Adolescence is a time of development filled with many physical and emotional changes and challenges and along with hormonal changes may bring mood swings, changes in behaviour, and more,” says Hosking. “However, these are often just termed as adolescents ‘being difficult’, and that’s why symptoms of mental illness may be missed or not recognised, and therefore go untreated. Some symptoms of mental illness also display differently in adolescents.”
From an early age, children should be encouraged to view themselves positively and be aware of their strengths. They should be learning as much as they can about themselves. When problems or crises arise, children should be taught how to work through and deal with them so that when other issues arise later in life, they don't feel disempowered to manage the issues. Developing positive relationships and connections with those around them can also be very helpful.4
Awareness is key
Hosking says that ongoing public education is helping to make people more aware of the options available for help, as well as the choices they have when it comes to their mental healthcare. Care is also becoming more person-centred, with attempts to include the individual as well as their family in the treatment decision-making process.
“We can never have too much awareness about mental health issues,” she explains. “With ever-changing trends, new research and experiences shared by those with, or affected by, mental health issues, our scope of awareness can constantly be challenged. We need to constantly work to inform people about all the services available, how people can seek help for themselves and loved ones, and improve access to care on all levels.
Although there are many campaigns targeting stigma, this remains a big challenge. In workplaces, universities, and schools, mental health issues are still not being prioritised. Until this becomes a priority, the stigma around mental health issues will continue to have an impact on individuals who are affected and are seeking care.”
One of the challenges in South Africa is the lack of recent studies on the incidence of, and trends in, mental health issues and care. The South African Stress and Health (SASH) study, conducted between 2003 and 2004, is the only nationally representative study of common mental disorders.4, 5
“Much has changed in the last 14 years, and these figures may not be accurate today. The study suggests that up to one third of South Africans suffer from a mental disorder,” says Hosking. “Given that certain diagnoses, as well as children and adolescents, were excluded, it is thought that the number of people who will experience mental illness at some point in their lifetime is actually higher than 30% of the population. Some of the more common disorders seen include depressive and mood disorders, anxiety disorders, as well as substance use disorders.”
The dangers of ignoring mental health issues
Undiagnosed, untreated or unmanaged mental health issues have multiple effects on the life of the person and their families. Relationships may be negatively impacted. Productivity at work may decrease, and there may be increased absenteeism. Performance at school or university may be negatively impacted. When there are issues in education and productivity at work, this could lead to bigger issues in society such as a more unhealthy workforce, and fewer people able to work and function at their best.
How to be proactive
Being more proactive about mental healthcare happens on a personal level, and in interactions with others. It's important to reflect on yourself, your mood, and how you are feeling and coping with things you experience. Identify your emotions, how you react to situations, and recognise when these change unexpectedly.
“If you experience changes that you're unsure of, or have difficulty coping or managing any symptoms, it's best to seek professional assistance,” says Hosking. “Contact a helpline, see a doctor or seek therapy. With others, we can be more proactive by asking how they are doing and actually listening to what they say. Showing care and compassion for the people around us, encouraging them to seek help when they are struggling, and supporting them when they do, are all steps that can help to make a difference.”
What to do if you or a loved one are experiencing mental health issues
- Seek assistance. Reach out to the people around you, organisations, or psychiatric services. Speak to someone about what you're going through and get some guidance about what steps you can take.
- If it's a loved one, speak to them about why you're concerned, and support them through treatment and recovery. It is never too late to seek help.
- If you are on a treatment plan, stick to it. Don't default on any medication.
- Have open and honest conversations with your doctor, psychologist, counsellor or social worker about what you are going through. It can feel overwhelming, but with treatment and support, improvement in functioning and other areas of your life can often be seen and felt.
- Ask questions about things you're unsure of, and use the opportunity to educate yourself and those around you on mental health.
Global facts and figures6
- Around 20% of the world's children and adolescents have mental disorders or problems.
- Mental and substance use disorders are the leading cause of disability worldwide.
- About 800 000 people commit suicide every year.
- Mental disorders are important risk factors for other diseases, as well as unintentional and intentional injury.
- Stigma and discrimination against patients and families can prevent people from seeking mental health care.
- Human rights violations of people persons with mental and psychosocial disability are routinely reported in most countries.
- Globally, there is huge inequity in the distribution of skilled human resources for mental health.
1. World Health Organisation. [Internet]. Mental disorders affect one in four people. Available from: http://www.who.int/whr/2001/media_centre/press_release/en/
2. The Lancet. [Internet]. The Lancet Commission on global mental health and sustainable development. Available from: https://www.thelancet.com/commissions/global-mental-health
3. World Health Organisation, Mental Health: A State of Wellbeing. 2014. Available from: http://www.who.int/features/factfiles/mental_health/en/
4. American Psychological Association. 10 Tips to Build Resilience. Available: https://psychcentral.com/lib/10-tips-to-build-resilience/
5. Stein, D. et al. 2008. Lifetime prevalence of psychiatric disorders in South Africa. British Journal of Psychiatry, 192(2): 112-117.
6. World Health Organisation. [Internet]. 10 facts on mental health. Available from:
About the Akeso Group:
Akeso Clinics is a group of private in-patient psychiatric hospitals, and is part of the Netcare Group. Akeso provides individual, integrated and family-oriented treatment in specialised in-patient treatment facilities, for a range of psychiatric, psychological and addictive conditions.
Please visit www.akeso.co.za, email [email protected], or contact us on 011 301 0369 for further information. In the event of a psychological crisis, please call 0861 435 787 for assistance.