Not all pain is physical-Not all wounds are visible-Mental Illness is real

Growing up in South Africa, Swartruggens in the North West Province, my understanding of mental health was vague, I knew it related to the medical sphere and that medication could be used to treat it but I didn’t fully grasp the complex nature of its causes, symptoms and impact on mental health patients, their families and communities. I think this relates to a common stigma in our societies around mental health, where mental health patients are viewed or labelled as ‘ditsenwa’ in my language, which loosely translated means crazy. I feel this stigma comes from a lack of understanding of mental health. Physical illness is better understood. It is seen, it can be bandaged, and the healing process is visible. Whereas, mental illness is felt primarily by the mental health patient, it takes medication and something intangible like therapy to start the healing process. Thus, what has been a problem in many different societies is that there is limited knowledge on mental health and its detrimental effects on one’s functioning, health, wellbeing and increased stigma in seeking help.

In society today we are constantly see a lack of understanding and empathy with regards to mental illness itself through the gruesome events and human rights violations of the mentally ill, noted at Life Health Care Esidimeni. Facilities that are available are either not well equipped, service providers lack the knowledge in health care related to the field or just deliberately ignoring people’s rights to health care. We really need to re-evaluate ourselves as a nation because such neglect clearly shows the lack of respect for human life and the effects of that neglect on the vulnerable in our society such as mental health patients and their families.

October is mental health month and the aim of this month is to raise awareness on mental health in the country and to reduce the stigma attached to it. According to the South African Depression and Anxiety Group mental illness is on the rise countrywide with adults ranging from 16.5 % and children in the Western Cape alone ranging from 17% (SADAG, 2018). One in five people will suffer or are suffering from mental illness and the problem in the country is access to facilities that can assist in the treatment of mental disorders such as depression, anxiety, substance abuse and socio-economic stressors (SADAG, 2018).

A while back, I was listening to a radio program and the topic was based on an individual who had committed suicide due to debt, high stress levels and inability to cope. While listening to the show, the views on the person’s suicide caught the ear of many locals and everyone had a similar opinion that people who end up committing suicide are just lazy, not thankful for the life they have and they lack a “back bone” to face life. The assumption is that one is weak if they commit suicide, stress is not seen as something as important as physical illness. And many people lack the knowledge on what mental illness is, similarly to the concept of depression.

Coming to university in 2015, mental health was a topic from the first day of orientation. In their description of mental health they summed it up as one’s general wellbeing. Being well and balanced in the body, the mind and the spirit and in achieving this one has to understand and practice self-care. Students are one of the populations that are faced with mental breakdowns and mental health issues and as a result this has led to many students either using harmful substances as a coping mechanism or committing suicide.

I have proposed a question to my fellow colleagues and lecturers on how does one practice self-care and maintain balance when there are no support systems to guide them in that process? In my personal experience I’ve had to talk myself out of dropping out of school countless times, feeling like I do not belong in this prestigious university. I have had suicidal thoughts. Every time I was going through those phases and feelings I would wish for support from my family, and some sort of understanding from the University. I spent days explaining to my mother and siblings the importance of them checking on me. The importance of just sending an encouraging message or a message of love and care because countless times I felt alone in University and contact from them was what I needed to just get through the day.

We are all members of some system or another and the most primary of all is the family and the school environment and both of these systems are important as support systems. However the family systems in some communities or societies have the assumption that support is financial, neglecting the emotional aspect of it which is vital to one’s mental wellbeing.

The school is another primary system of socialisation where mental illness such as depression is prevalent. In South African schools, specifically with reference to public schools, I have recognised that there are limited support systems such as counselling services which are important to assist learners with the different issues they are facing in their developmental years. Anger is one emotion that they are unable to control, bullying is on the rise and many of our learners resort to violence or to committing suicide as a solution. There needs to be interventions to assist, educate and support learners, a place where they can feel free to talk about their issues without judgement.

We are seeing devastating news in institutions of learning daily. Learners are killing each other and their teachers, there are high rates of teenage pregnancy and substance use and school drop outs. In the University of the Witwatersrand this year alone there are more than two cases of suicide with the most recent occurring on the 19th of September 2018. Many social issues need intervention from the government but there is neglect on children and the youth’s mental health and wellbeing because of the assumption that children are unable to feel stressed or overwhelmed or affected by any issues. Interventions have to be done from grass roots level from as early as primary school because depression is real, it is on the rise amongst our youth and taking from us on a daily basis.

At the same time we should not neglect that the workplace is another systems that people are a part of. There needs to be awareness and the need to understand that the workplace is one area or system that affects mental health as well. Companies have to provide wellbeing or wellness programs aimed at ensuring that people are functioning well because work can be stressful and at the same time employees do not exist in isolation, there are family related stressors that employees need to understand and be aware of, to empathise and provide services that will aid employees. A healthy and happy employee is a productive employee and therefore the company or business or any working environment will benefit also in ensuring good mental health for their employees.

It should be recognised that a month alone to raise awareness on such an important issue as mental health is not enough. Discussions and policies that will be implemented have to take place as a way forward and funding has to go into organisations that can assist not only in urban areas but in rural areas, villages, townships etc., that will focus on helping people country wide. We need to build a society that cares for the wellbeing of its people so that growth and development can occur.

Written by Julia Makganye (Social Work Intern at The Centre for the Study of Violence and Reconciliation)


South Afrcan Depression and Anxiety Group. (n.d.). Retrieved from A South African Depression and Anxiety Group web site:


Published by CSVR Trauma Clinic

This blog represents thoughts of therapist working within the CSVR Trauma Clinic. The focus is on understanding the drivers and impact of violence on individuals, families and communities to work towards violence prevention and the building of peaceful societies

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