If you are employed by a large organisation, there's a good chance that you’re working with someone who has a mental illness. What does this mean for you?
About 16.5% of the adult population in South Africa suffers from mental illness, so if you are employed by a large organisation, the chance that you’re working with someone who has any one of the range of mental illnesses is high.
Many factors contribute to this statistic, in South Africa: work-related stress, disease, poverty, abuse, sexual violence, as well as the decay of the traditional value system, says a study conducted by the Mental Health and Poverty research Program. Mental illness has a large genetic component to it, and while these factors may act as triggers, mental illness is very often chronic, and even though managed by medication and therapy, still a life long condition for the majority of people.
Unfortunately, mental illnesses carry a heavy burden of stigma, mostly due to a lack of understanding and poor education. So it’s no surprise then that many sufferers keep their mental illness secret, and some are indeed easier to hide than others.
It is interesting to note that in the course of data gathering, interviews and research conducted by Careers24 in the formation of this article, only one employee was willing to be quoted or mentioned by name in this article. This only goes to show how powerful the fear of discrimination against those with a mental illness is in South Africa.
What is a mental illness?
In South Africa, the definition of mental illness varies depending where you read it, but in the workplace it is classified as a disability, and therefore the one that is used comes from the Employment Equity Act, which describes people with disabilities as those who have “a long-term or recurring physical, including sensory, or mental impairment which substantially limits their prospect of entry into or advancement in employment.”
While many people have mental health concerns from time to time, it only becomes a diagnosable mental illness when the signs and symptoms are ongoing, and cause regular stress and negatively impacts the individual’s ability to function.
All of the below conditions are classified as mental illnesses:
Post Traumatic Stress Disorder
Grief and Loss
Obsessive Compulsive Disorder
Social Anxiety Disorder
Borderline Personality Disorder
Attention Deficit Disorder
Attention Deficit Hyperactive Disorder
Carmen Williams, a writer at Women24, suffers from a general anxiety disorder, along with depression and PTSD. You can read her story here, but for the purposes of this article she shares her workplace experience with us. Carmen has an incredibly close and supportive team that respects her illness and responds appropriately when she has an anxiety attack.
She tells us that many people lack empathy for their mentally ill co-workers, and that manifests in a lack of respect for the individuals needs. “It’s also important to be aware of how you talk about mental illness, and to understand the needs of your colleagues. I’m not saying that you should censor your words or curb your freedom of speech, but understanding how what you say can impact your workmate's day is key to them remaining a valuable member of the workplace.”
The South African situation
A study by the Mental Health and Poverty Project (MHaPP), based at the department of psychiatry and mental health at UCT in Cape Town, found that public attitudes toward mental health and treatment are generally negative, and that despite a supportive and progressive policy framework for mental health, this area is not given the priority it needs in South Africa.
“In Zulu, there is not even a word for ‘depression’, says Cassey Chambers, Operations Director at SADAG, “it’s basically not deemed a real illness in the African culture.” Most mental illnesses lack obvious physical symptoms, so are considered “not ‘real’, a figment of the imagination” she said in an interview with the South African College of Applied Psychology (SACAP).
Many South Africans still hold to the traditional belief that mental illness results from a demonic possession. Katherine Eyal, who faciliates a support group for students at UCT who have mental illnesses, says "This is tricky, because while mental illness isn't a well known concept in many African communities, that doesn't mean those cultures are ignorant. In many cultures around the world, mental illness is not a thing - it's shameful, or as a result of witchcraft - so this is a common thing in many cultures."
Writer and independent researcher at Wits University, Thabiso Bhengu, wrote that revealing that you are depressed is “challenging, because many people still do not believe that this mental illness is real. This is startling, considering that many people in this country are oppressed minorities and there has been research about the links of systemic oppression and mental illness.”
45% of the black patients who attended a community mental health clinic have consulted a Traditional Healer, while 26% also simultaneously seek treatment from both traditional healers and psychiatrists.
In a recent article for City Press, Depression is not rudeness, Bhengu shared how he drinks imphepho tea, a remedy for anxiety. “In a conversation about anxiety with sangoma Nokulinda Mkhize, she mentioned imphepho tea… it was used, and continues to be used, by many Africans. It is not a cure for my depression, but assists as one of the ways in which I cope with this illness.”
Katherine Eyal clarifies this by explaining "To say someone is hearing voices and should take anti psychotics to get rid of them, might be trumping a very strong traditional belief about being called by one's ancestors, for example. So that means actually a synthesis is important - Western and traditional medicine working together. At UCT we're trying to advocate a holistic approach - very often students who are suffering from depression might need both therapy, meds, and someone to talk about the cultural issues for new students at UCT, and how new cultural attitudes at UCT might clash with attitudes at home. It is very difficult discussing issues in therapy with someone not from your culture, and not in your mother tongue."
The costs of mental illness
Studies have found that it costs South Africa more to not treat mental illness than to address the issues. The expense includes costs related to the workplace, such as reduced productivity, absenteeism, staff turnover and loss of talented employees. Effectively, it costs more to replace a mentally ill employee than it does to assist them, yet employers underestimate the financial impact of mental illness on their business’ earning potential.
Then too, there is a strong correlation between mental health disorders and substance abuse. The South African Association of Social Workers in Private Practice estimates that 50% of workplace accidents are related to substance abuse, and an undetected substance abuser can cost the employer 25% of that person’s wages: a significant cost risk.
Investing in an Employee Wellness Program, de-stigmatising mental illness and encouraging employees to disclose their diagnosis therefore has a direct impact on the bottom line.
Employee Assistance Programmes
Some larger companies already have established Employee Assistance Programmes (EAPs) to support their employees whose mental health may impact their work performance.
The workplace EAP is also a valuable preventative tool in that it can address issues fueling stress and impacting on mental health, before more serious mental illness conditions develop.It’s no secret that healthy workers are more motivated, more productive and more engaged with their work. Companies with effective EAPs also save costs, by helping and retaining current employees.
There are many South African organisations which can assist companies in making improvements in their management of mental health in the workplace. Here are a few resources we suggest:
The SA Federation for Mental Health offers presentations and workshops on mental health in the workplace and assists companies in developing strategies to improve the mental health of employees and the reasonable accommodation of persons with mental illness in the workplace.
The South African Depression and Anxiety Group supplies leaflets for distribution on the workplace, which aim to promote understanding and minimise stigma.
Internationally, the UK has comprehensive national policies around mental health and provide excellent resourses for companies, which can serve as guides to local firms. See How to support staff who are experiencing a mental health problem and Support for managers for help.
Finally, the Constitution (Act 108 of 1996) prohibits against the unfair discrimination of people with mental disorders, and as such doing so is illegal and those who struggle with mental illness have legal protection and recourse for unfair dismissal or workplace discrimination in South Africa.
Written by Elizabeth Mamacos: Elizabeth currently serves as Editor at Careers24. She oversees a team of writers who specialise in career advice, and has a long history of both digital and print journalism. Elizabeth spends her free time studying and running after her toddler. If you would like to get in touch, email her at firstname.lastname@example.org.