OPINION | The hidden pandemic: men’s mental health

South Africa faces a mental health crisis that remains largely hidden beneath layers of stigma, inadequate resources, and insufficient infrastructure. Despite the country's progressive constitution and policies, mental health remains an often overlooked aspect of public health, especially in rural and underserved areas. The intersection of mental health with gender-based violence (GBV), trauma and societal inequalities adds to the challenges, making it urgent and important to confront these issues head-on. 

Mental health as a crisis issue in SA 

Mental health challenges in South Africa are significant, with one in four people expected to experience some form of mental illness in their lifetime (WHO, 2001). Common issues include depression, anxiety, substance abuse and post-traumatic stress disorder (PTSD), yet access to mental health services remains limited. This lack of resources becomes particularly evident in rural areas, where mental health services are scarce (BMC Health Research, 2022), and public facilities are often overwhelmed. 

While the government has made strides in addressing mental health through policy frameworks, implementation remains inconsistent. Mental health resources allocated to mental health are disproportionately low compared to other areas of health care (SA Society of Psychiatrists), creating an environment where mental illness often goes untreated, leading to a ripple effect on individuals, families and communities.

The stigma surrounding mental health 

One of the greatest barriers to mental health care in South Africa is the stigma associated with mental illness. Many individuals, particularly men, are reluctant to seek help due to societal pressures and cultural norms that view mental illness as a sign of weakness. This stigma is further amplified in communities where mental health issues are misunderstood or associated with spiritual beliefs and superstitions. 

Speaking to Mordecai Ndlovu, a member of the ACTIVATE! Change Drivers network and Generation G Champion, Activator! and founder of the Men in Black Doeks initiative, he shared insights into how mental health is intertwined with gender-based violence and harmful gender norms. Ndlovu explained: “Growing up in a patriarchal society, I witnessed first-hand how toxic masculinity perpetuates GBV. Men in Black Doeks was born out of a desire to challenge these norms and promote gender equality.’’ He shared how the initiative engages men and boys in conversations about gender justice, encouraging them to become allies and advocates for change. 

By addressing these harmful norms, initiatives like Ndlovu’s are working to break down the stigma that prevents many men from addressing their mental health needs and becoming part of the solution to both GBV and mental health crises. 

Mental health services and gaps 

South Africa does have mental health services available through both public and private healthcare systems. However, these are often inaccessible to most of the population due to financial constraints or geographic location. Public mental health services are overstretched, with long waiting times, and often lack the specialised care needed for complex cases such as trauma or GBV recovery. 

Programmes like the Sizo GBV App provide innovative solutions to some of these gaps. Ndlovu explained the reception of the app, noting, ‘’The Sizo GBV App has been well-received, with users praising its accessibility and anonymity. The app provides vital resources, support, and guidance for survivors, offering mental health tools like counselling services and coping mechanisms.” 

While digital interventions such as these offer some relief, the broader structural issues within South Africa’s mental healthcare system remain, and these solutions are often limited in reach.

Confronting mental health through gender-transformative approaches 

Efforts like the Generation G programme have been instrumental in integrating mental health discussions into broader social justice movements. Ndlovu shared how mental health is central to his work in the programme: “As a Generation G leader, I emphasise mental health discussions, particularly when engaging men and boys. We explore the intersection of masculinity, GBV, and mental health, encouraging open dialogue and empathy.” 

Speaking to Nomthandazo Shabangu, a Gen G Champion and Activator about how the Generation G programme has been active in its efforts to fight gender-based violence, she shared with us that in 2024, the programme launched #PhumzaMfazi, a campaign of the Gen G programme, and a brainchild of the late Nkokheli Mankayi, that seeks to encourage victims of gender-based violence to leave abusive relationships and link them to relevant stakeholders that can support their recovery. The campaign was about promoting awareness around GBV and policies that are in line to ensure victims are well taken care of, encouraging the community to take a stand against GBV, and collaborating with relevant stakeholders to ensure that help and support for survivors is available whenever needed. This initiative reflects the growing recognition of the critical role mental health plays in the recovery and empowerment of survivors. 

Prospects for a better tomorrow loom  

By addressing the stigma around mental health, improving infrastructure and integrating mental health into broader social and gender justice efforts, the country can take steps towards healing. Initiatives like those led by Ndlovu and the Generation G programme provide hope and a framework for future interventions, demonstrating that mental health must be at the forefront of our national agenda to ensure a healthier, more equitable society.