Around one in five adults suffers from a diagnosable mental disorder in a given year, according to the National Institutes of Health, and many suffer from more than one at a time – depressive illnesses, especially, tend to occur along with substance use and anxiety disorders. Untreated, this can lead to suicide, and in 2022 the South African Society of Psychiatrists reported that South Africa ranked 10th among countries with the most suicides: of the 13 774 reported, 10 861 were men, while 2 913 were women.
“Men in this country are five times more likely to commit suicide than women, but most calls to the South African Depression and Anxiety Group (SADAG) are from women – men don’t talk about depression, and they don’t seek help,” says Marion Scher, a volunteer for SADAG, in a new book, Men and Mental Health: Shattering the Silence (Bookstorm, May 2025).
Statistics in South Africa are very unreliable, says Johannesburg-based psychologist Zamo Mbele, vice-chairman of SADAG. “However, things are starting to improve. Men are beginning to recognise that they need to be accessing health services, especially when it comes to mental health.”
A challenge, he says, is the limited number of psychologists and psychiatrists practising. In addition, men, particularly those from marginalised communities, may face barriers such as financial hardship, poor access to mental health services, or mistrust in healthcare systems, says Randburg-based psychologist, Stephen Laverack. However, much of the problem remains rooted in stigma linked to gendered social roles, which traditionally saw expressing emotion as a sign of weakness in men, making them far less likely than women to seek help from friends or medical professionals for mental health problems.
“For some, suppressing emotions simply bottles them up, so pressure grows,” Mbele says. “It can drive them to escape in alcohol or substance abuse, and to aggression, acting out violently in domestic abuse, road rage, or corporate bullying. Many don’t know this can be a symptom of depression, because it aligns with our ideas of masculinity on the sports field and in the boardroom.”
5 ways men can take action: improving mental health
1: Recognise the signs
Feelings of restlessness, difficulty concentrating, low mood or mood swings, irritability, anger, aggressiveness, changes in sleep patterns and quality of sleep, new unexplained aches and pains, digestive issues and changes in appetite can all signal a potential mental health issue, Laverack says. “Men often express mental illness differently than women, leading to misdiagnosis or underdiagnosis. Depression may manifest as irritability, anger, or risk-taking rather than sadness. Anxiety may appear as control-seeking behaviour or substance use.”
2: Reach out
“Allow yourself to be vulnerable with yourself and others,” urges Mbele. “This is especially important if you have been a victim of childhood abuse and bullying, which is underreported among boys. Many feel unable to speak out, and resort to self-harm and suicide, or become bullies themselves in the cycle of abuse. It’s imperative to deal with childhood trauma.”
Speak to a trusted friend, family member or healthcare provider, or contact SADAG, which provides free helplines run by trained counsellors 24/7: phone 0800 567 567, SMS 32312, or visit www.sadag.org.
Support is also available through the South African Federation for Mental Health. Today therapy ranges from ‘talk therapy’ (psychotherapy or counselling) to cognitive behavioural therapy. “Essentially, it provides a safe, comfortable, and confidential space with a non-judgmental and trained mental health professional to understand issues contributing to your mental health problems, and to explore thoughts, behaviours, and relationships, leading to personal growth and improved wellbeing,” says Laverack.
3: Make time for friends
Men tend to prioritise work, then lose themselves in television, video games or social media, which can feed stress and tension. “Rather engage with, and unburden with, friends – something women are good at – but we often struggle with,” says Mbele. Start a conversation by saying something like “I’ve been going through a lot,” and take it from there. “Support groups, peer-led initiatives, and safe spaces where men can talk freely are crucial,” adds Laverack.
4: Consider how you deal with painful feelings
Think about ways you get through life and activities which may, temporarily at least, numb painful feelings. Substance use, sex, gambling, even gymming, when done too often, could be ways of avoiding tough emotions, says Laverack. There are positive things you can do. Go for a walk or play with the children. Engage in an absorbing hobby such as playing that neglected guitar. Try breathwork: sit quietly and focus on breathing slowly and deeply, to reach a more relaxed, stress-free state.
However, if these do not provide relief from painful emotions, consider getting help. You can consult with a GP, registered counsellor, psychologist, or psychiatrist.
5: Take care of your physical as well as mental health
Chronic stress can suppress the immune system, leaving you vulnerable to a range of ills. When you’re struggling with mental health issues, it’s easy to neglect healthy eating, exercise and check-ups. Have nutritious food, stay hydrated and cut back on stimulants like sugar and caffeine, to help maintain emotional balance. “Self-love is a crucial aspect of mental health for men, helping you develop a strong and positive relationship with yourself,” says Mbele.
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