Men's mental health in focus: An expert tells us what's needed for the situation to improve in SA

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  • South African men have a higher suicide rate than women.
  • An expert says that using cultural spaces can help destigmatise mental health for men.
  • Traditional healers and mental health practitioners in SA need to work together to extend mental healthcare services.

Research by the  World Health Organization (WHO) has shown that South Africa has the third-highest suicide rate of all African countries. A previous Health24 report shows that the prevalence of depression in South Africa is close to 10%. Women are more affected by depression, but men are almost four times more likely to commit suicide.

To investigate men's mental health and examine solutions towards depression and suicide, Health24 spoke to Clinical psychologist and researcher Anele Siswana. 

Toxic masculinity

Siswana says that part of understanding men's mental health is understanding toxic masculinity and its negative impact.

"Toxic masculinity is the other spectrum of masculinity that has unhealthy traits that we can see in men who act in particular ways. A toxic man is a man who would abuse his power over others, who would abuse a woman, for example. But the whole essence of toxic masculinity is a social construct that draws from different aspects or lenses," Siswana explains.

He, however, cautions that men's mental health cannot be limited to toxic masculinity, but that expectations of men in society also play a role.

"Not all men who have depression or attempt or die by suicide are toxic," he says. 

"Society places certain expectations on men, and when they don't fit into the role of a provider, a life-changing person, an influential person or a "fixer", these hopes and expectations placed on them, potentially, can lead to suicide."

How depression manifests

Siswana says that how depression manifests has nothing to do with gender.

"Mental health disorders or any form of psychological pain has no gender or sexual orientation. What this means is that men have feelings. Men are vulnerable. Men are soft. Men are typical of what every human being would feel," he says.

He explains that men typically won't show emotions in front of their loved ones, but that clinical depressive symptoms like stress, lack of sleep, frequent headaches are exhibited. Most mental health disorders are, however, invisible, he says.

"It only becomes visible when we see the anxiety affecting a man's ability to do normal things: He is always worried. He's always frustrated and has constant headaches," Siswana says.

Siswana warns that men should not downplay the physical symptoms of depression they may be experiencing.

He also highlights that many men do not have the words to describe their mental health symptoms and that their mother tongues might not have names for mental disorders. 

Access and collaboration

Part of the solution towards improving mental health care for men is improving their access to services, says Siswana.

He says that the cost of private mental health care services in South Africa is a barrier and that specialists and medication are also out of the reach of most South Africans.  

To make mental health services more accessible, Siswana says that there should be, for example, a collaboration between the government and boys' traditional spaces, such as initiation schools, to destigmatise male mental health issues.

"We can have something like a curriculum or programme run by the Department of Health or Social Development to target the places where boys go during June and December. This can help young men to understand that there is space for talking about these things. This can be a space to express vulnerability while we're being initiated to be men," he explains.

Including traditional medicine

According to a report published in The Conversation, 80% of South Africans consult traditional healers, and there are more than 200 000 traditional healers in the country. Most people in rural areas use traditional healers as their primary healthcare providers. Siswana says that traditional healers should be given basic training and understanding of mental health disorders.

He adds that mental health practitioners also need to understand that there can be cases where people may need both western medicine and traditional attention.

"Clinical voices [western medicine] will be destructive and will cause distress in the patient. However, the voices of amathongo [the ancestors] will clearly indicate something prophetic or something that's going to happen or something that is happening now, and that will cause no significant distress," he explains.

"The key thing is education and empowerment for mental health experts to understand and be privy to how the spiritual world works, so that when the case is no longer clinical, but spiritual, the patient can be sent to someone with a better understanding of the situation," he says.

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READ | Mental health in SA ranked among the worst in the world

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