Stop the silent stalker of suicide

Mental health in the workplace needs to be taken seriously.
Mental health in the workplace needs to be taken seriously.

There's a silent stalker in our midst that is claiming precious young lives. We need to take urgent action, writes Lizette Rabe.

It so happened that just hours apart two talented, gifted young graduate students, continents apart died of suicide. One at Stanford University, one at Stellenbosch University – as globally, at many other institutions of higher learning, where a silent stalker is claiming precious young lives. 

Statistics show that suicide is the second leading cause of death amongst university students. But let's include all young people, as we have seen just this week with another tragedy: the death of Khwezi Mthembu, daughter of ANC chief whip Jackson Mthembu. 

Khwezi's tragic death was widely reported on, as was that of the Stanford student. She was Olympic cycling medallist Kelly Catlin,  graduate student in computational and mathematical engineering, one of a set of triplets. The PhD student at Stellenbosch University who died of suicide was a much more private tragedy, as she was not a public figure, as was the case with Kelly and Khwezi.

But they are all tragedies of the most severe kind. And in all three cases – and all those that happen every moment – we as a caring community need to say: depression is a treatable disease and suicide a preventable tragedy. 

According to statistics, South Africa has the eighth highest rate of suicide in the world. Young adults aged 19 to 24 are considered to be the most at-risk group for depression and suicide. And the lives of these victims' families have changed for ever. As Kelly's father said: "There isn't a minute that goes by that we don't think of her and think of the wonderful life she could have lived. There isn't a second in which we wouldn't freely give our lives in exchange for hers. The hurt is unbelievable."

It is clear that especially on our campuses urgent intervention is needed. Just days after the deaths of the two students – and, as said, they are only two of far too many every single day – a global survey of graduate students simply and succinctly stated: "There is a mental health crisis in graduate education, and research institutions need to take action to address it." 

Another recent study in the UK – a poll consisting of almost 38 000 students and described as the largest mental health survey ever conducted among university students – found that "rates of psychological distress and illness are on the rise in universities" with "alarmingly high" levels of anxiety, loneliness, substance misuse and thoughts of self-harm. Again, with the same conclusion: An "urgent call to action" is needed.

These studies now empirically show that students are suffering from unprecedented mental ill-health. In too many cases it develops to a fatal stage. If these young people were the victim of a real-life murderer on our campuses, there would have been a public outcry. Why not also for this so devious silent stalker? We need to break the deadly grip of this killer on our campuses, and we can do so by breaking the silence and the stigma. To do that, we need to normalise and humanise mental health – to destigmatise mental health. 

Similarly, we also need to humanise the deaths of those who fell victim to a fatal depression, where our most important organ, our brain, fatally and terminally malfunctioned and just could not sustain life anymore. Call it a psychological stroke. The absence of life-sustaining neuro-transmitters meant that the person's brain could not support its life functions anymore and self-destructed.

Therefore, to help break the stigma, we need to think and talk differently about mental health. As Beth Brodsky, associate professor of medical psychology at Columbia University in a study on mental health among the medical profession, stressed: "Suicide is an illness and not a crime." 

That means even a verb is important: People do not commit suicide, she emphasised. They die by suicide. 

But back to our student community. The survey among graduate students concluded that the new results will hopefully add to a conversation that might result in a "cultural change". 

That is exactly what is needed. Our culture regarding our attitudes towards mental health needs to change. Too many cultural prejudices, whether the result of religion or tradition, still prohibit a clearer understanding based on scientific knowledge of mental health. 

The survey of graduate students covered 234 institutions across 26 countries. It showed "strikingly high rates of anxiety and depression". Of the respondents, 41% showed moderate to severe anxiety. Almost as many, 39%, showed moderate to severe depression. In both cases that is more than six times the prevalence found in studies of the general population. 

One new element in the lives of young people is social media. A recent UK report indicated that "social media addiction should be considered a disease amidst growing concern over the impact social networks are having on users' mental health". The report suggested "there was good reason to believe" that sites such as Facebook, Instagram and Twitter – "which are constantly competing for users to spend more time on their platforms" – could be having "a corrosive effect" on the youth. 

The World Health Organization (WHO) has already proposed that gaming disorder should be included in the next revision of its International Classification of Diseases manual. The WHO categorises it as a mental illness "in which increasing priority is given to gaming", to the extent that gaming "takes precedence over other interests and daily activities".

The graduate students' survey stressed that institutions need to create programmes to help find solutions by realising that mental health is "an essential component of the skillset that is necessary for successful career development". Awareness of mental health issues need to be increased, together with access to dedicated support. It also stated that supervisors should be trained to identify struggling students and refer them to available help.  

In another paper, Professor Frederik Anseel of King's College London also concluded that there is "a serious problem with mental health in academia". The matter is so severe that since Anseel and his co-authors published their paper, "they have been receiving three or four invitations per week from institutions to present their findings and help set up monitoring and prevention practices".

One initiative is to set up a peer support network. For instance, one such network was started by graduate students at the University of California, Berkeley, after a close friend in their programme died of a fatal depression. Similarly, at Stellenbosch University, SRC member Melt Hugo started #SUpport, a student initiative with the slogan "Maties for Mental Health" to support fellow-students. 

A clear work-life balance, with exercise as an important aspect, is also needed. In South Africa the Varsity Sports Series has this objective, with seven sports codes that will be played across all participating campuses in the name of mental health for the second year running under the Speak Up slogan, an initiative of the Ithemba Foundation.  

All of these projects are laudable. But institutions of higher education themselves, together with governmental health departments to ensure the necessary funding, need to formalise interventions – urgently. We need to stop that silent stalker. 

- Lizette Rabe is a professor at Stellenbosch University and founding director of the Ithemba Foundation, a non-profit organisation with two public health goals: to raise awareness of depression and related diseases as clinical, biological diseases, and to support research. 

For help, contact:

Lifeline: 0861 322 322

SADAG helpline: 0800 567 567 or sms 31393

Mental Health Information Centre (MHIC): 021 938 9229 or email

For information:

WHO's website on mental health

SA Federation for Mental Health



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