Poor mental health costs the world economy approximately US $2.5 trillion, yet across the globe, less than 2% of health budgets are spent on mental health. This is according to a new report titled Return on the Individual (ROI) launched by the Speak Your Mind campaign on 17th April 2020. The Speak Your Mind campaign (a nationally driven, global mental health campaign) advocates for ending the silence around mental health to put pressure on governments to invest in, educate and empower people in order to provide them with support and the resources for their mental health. The report estimates that around 20 percent of the world’s working population suffers from some form of mental health illness at any given time, with depression and anxiety being the common mental disorders, prevalent across demographics. It further estimates that we lose 12 billion productive days on a yearly basis as a result of depression and anxiety alone. In South Africa, like in most low and middle-income countries, mental health remains under-funded, with stigma against those who suffer from mental illness being a stumbling block. The World Health Organisation’s Mental Health Atlas for 2017 shows that the country has a severe shortage of mental health professionals as well as community-based mental health outpatient facilities.
Estimates from 2017 show 284 million people are living with anxiety and 265 million with depression. An estimated 50 million people are living with dementia, and this number is projected to triple by 2050 – with 10 million new cases each year. In more severe cases, conditions such as these can lead to suicide, which claims the lives of close to 800,000 people every year and is attempted by many more.
South Africa’s National Mental Health Policy Framework and Strategic Plan 2013-2020 correctly points out that mental health problems have serious economic and social costs as a result of a myriad of issues including reduced productivity and loss of income. The impact of untreated mental illness was found to be more costly on the country’s economy than to treat it. Data from South Africa’s first nationally representative survey of mental disorders in 2002 found that “lost earnings among adults with severe mental illness during the previous 12 months amounted to R28.8 billion” . Yet expenditure on mental health is one of the areas in the country that is ripe for reform, with proper alignment needed to ensure that mental health features in national health and social development priorities.
The ROI report states that between 76 and 85 percent of people with mental illness receive no treatment in low and middle-income countries. The latest available data shows that only 5% of the national health budget goes towards mental health services, while there is no data on the spend of the Department of Social Development on mental health services aside from the disability grant. There are still serious challenges with unequal allocations of resources at a provincial level, making early interventions almost impossible for many people. The ROI report, which was conceived at a global meeting of mental health campaigners in 2019, says the COVID-19 pandemic has made the need to invest in mental health even more urgent. With most countries under lockdown with severe restrictions on normal habits, there are now more people working at least part-time from home as a result of short-term responses by governments and businesses to the COVID-19 pandemic.
The ROI report states the current international emergency “has led to an increase in conversations about employee mental health among employers across all sectors as they work to maintain and strengthen employee morale and productivity in times of uncertainty. Moreover, reports predicting a huge impact on the global economy from COVID-19 is causing further concern - for governments, companies and individuals. Mental ill-health typically rises during an economic recession.” Statistics from the ROI and data from the National Mental Health Policy Framework and Strategic Plan 2013-2020, are proof that mental health and economic performance interlink. The COVID-19’s threat to long-term mental well-being, coupled with the fact that as many as 20 percent of the world’s working population has some form of mental health condition at any given time, means governments should act swiftly in making mental healthcare a priority.
The South African Federation for Mental Health (SAFMH) commends the South African government on developing and adopting the National Mental Health Policy Framework and Strategic Plan 2013-2020, which promised improved mental health for all in South Africa by 2020 and planned adoption of the National Health Insurance (NHI). However, there is no compelling evidence showing that the government has succeeded in scaling up primary mental health services which include community-based care, Primary Health Care, and district hospital-level care. Including mental health in the NHI implementation provides ample opportunity for mental health service scale-up to be embedded in the country’s future health service delivery strategy .
In light of the progress made to date and more importantly the government efforts in the fight against COVID-19 pandemic, SAFMH would like to urge the government now more than ever to further prioritise and invest in mental health and ensure that mental health is integrated into wider COVID-19 response efforts. In the first report of its kind, ROI reveals the wider social and business case for investing in mental health. Instead of looking at traditional return on investment in mental health, measured in financial terms, the report puts the human being at the centre and highlights the wider Return on the Individual that can’t be easily quantified. This return is not only beneficial for businesses and the overall economy, but also for physical health outcomes, maternal and child health, communities, workplaces, family wellbeing, and society as a whole. The full report can be found here.
Masutane Modjadji (Project Leader – Info & Awareness, SAFMH)
011 781 1852
Please note that, until further notice, SAFMH will only be available for phone interviews and email enquiries