The conversation around mental health has shifted in recent years from a peripheral workplace wellness topic to a pressing macroeconomic challenge. According to the South African Depression and Anxiety Group (SADAG), an estimated one in three South Africans will be diagnosed with a mental health condition at some point.
This projection is closely mirrored by data emerging from the private healthcare funding sector. A comprehensive 13-year actuarial analysis of medical scheme data reveals a 46% increase in the prevalence of registered or claimed mental health conditions between 2012 and 2024. In 2024, one in seven Discovery Health Medical Scheme members — representing approximately 15% of the scheme’s overall population — was actively receiving treatment or claiming for a mental health condition, up from one in ten in 2012.
Mental health conditions have become one of the fastest-rising disease burdens nationally, with the number of individuals seeking psychiatric or psychological treatment having tripled between 2012 and 2024 for the first time. — Dr Noluthando Nematswerani, chief clinical officer at Discovery Health
To contextualise this burden, Dr Noluthando Nematswerani, chief clinical officer at Discovery Health, the administrator of Discovery Health Medical Scheme, reveals that the number of individuals actively living with a diagnosed mental health condition within the scheme is approximately 450,000.
“Mental health conditions have become one of the fastest-rising disease burdens nationally, with the number of individuals seeking psychiatric or psychological treatment having tripled between 2012 and 2024 for the first time,” she says.
The growing strain on mental wellbeing is particularly visible within the country’s workforce. Recent research conducted by SADAG indicates that more than half of employed South Africans (52%) currently suffer from a mental health condition, with burnout, clinical depression and anxiety emerging as the most prevalent diagnoses.
The baseline incidence rate for these conditions experienced a sharp acceleration during and after the Covid-19 pandemic. Actuarial records show a 70% increase in new mental health registrations between 2019 and 2023, compared to a significantly lower 48% increase recorded in the pre-pandemic window between 2015 and 2019.
“Data confirms that these conditions are chronic and long-term rather than temporary or situational,” says Nematswerani. “In 2024, only 14% of Discovery Health Medical Scheme members claiming for a mental health condition were newly diagnosed, while the remaining 86% had been living with and managing their condition for a year or longer.”
While mental health challenges cross all socio-economic boundaries, recent data highlights specific vulnerabilities among young adults and women.
“The sharpest rise in mental health conditions over the last decade has been observed among young adults aged 18 to 24, where the prevalence of these conditions more than doubled, marking a 128% increase,” says Nematswerani. “Interestingly, healthcare utilisation trends differ significantly by age. Younger consumers aged 20 to 29 tend to rely far more heavily on psychotherapy and digital support tools (accounting for 71% of their claims) rather than traditional prescribed psychiatric medication, which makes up just 26% of their care utilisation.”
Tragically, this youth trend is accompanied by an increase in claims linked directly to self-harm and suicide.
Between 2020 and 2024, says Nematswerani, individuals under the age of 24 showed the largest spike in self-harm-related claims, rising by 32% compared to an 18% increase among older demographics.
In alignment with global trends, women account for approximately 62% of all documented mental health cases. “Our data reveals that while women are statistically more likely than men to seek professional help and claim for psychiatric medication, this does not automatically imply that men experience these symptoms to a lesser extent; rather, it reflects different patterns in healthcare-seeking behaviour. In 2024, documented instances of suicide or self-harm remained 66% higher among women than men,” she says.
Adding that the intersection between physical health and mental wellbeing is substantial, she says those living with existing physical ailments face a much higher risk of mental health complications.
Discovery’s data reveals that 17% of individuals with an existing chronic medical condition claimed or registered for a mental health issue in 2024, compared to only 11% of those without any underlying chronic illness. Alarmingly, individuals managing three or more physical chronic conditions are 72% more likely to register a concurrent mental health claim.
Beyond clinical comorbidities, everyday social structures and environmental factors play a decisive role in shaping mental outcomes, says Nematswerani.
“Intergenerational patterns have strengthened significantly in recent years. Children raised in a family unit where an adult is diagnosed with clinical depression are five times more likely to experience depression themselves, showing a 15% prevalence rate compared to just 3% in families without an adult diagnosis,” she says.
The impact of a robust social support structure is evident in policy design. Individuals living on single-person policies experience a 1.38 times higher prevalence of mental health conditions than individuals residing within larger family units of four or more people.
As healthcare providers and funding frameworks look for innovative ways to curb this growing crisis, attention is shifting towards everyday lifestyle indicators that predict mental vulnerability. Emerging clinical research based on 47-million objective sleep records from over 105,000 members on the Discovery Health Medical Scheme confirms that sleep hygiene is one of the single most powerful predictors of long-term mental wellbeing, performing on par with traditional metrics like nutrition and physical exercise.
“The research reveals that individuals who routinely sleep less than six hours per night experience a 1.2 times higher likelihood of developing moderate-to-severe depressive symptoms compared to those averaging seven to eight hours. Furthermore, sleep irregularity — defined as sleeping outside a strict two-hour window of your normal schedule — is linked to a significantly higher risk of severe mood disturbances,” says Nematswerani.
“Conversely, maintaining sufficient Rapid Eye Movement (REM) sleep — the specific restorative sleep phase vital for emotional processing — is directly associated with reduced anxiety, lower depression, enhanced focus and greater emotional resilience. Actuarial tracking indicates that even minor, sustained improvements in sleep regularity and duration can positively alter objective mental health scores within a matter of months.”
As helpline volumes continue to surge — SADAG reports up to 3,000 incoming calls a day alongside hundreds of digital support requests — the integration of these preventative, lifestyle-based insights into formal healthcare funding frameworks will be critical to managing South Africa’s mental health landscape.