While cases of mental illness are on the increase, it is still relatively difficult to understand how or why it affects us – from negative societal perceptions to discrimination within the health sector itself.

The Eswatini Economic Policy Analysis and Research Centre (ESEPARC) has seen it fit to interrogate the economic costs of mental illness in Eswatini through a study that is being conducted by Graduate Research Intern, Zenanile Dlamini.

Explaining mental illness during an in-house seminar held at the ESEPARC Boardroom on Friday (February 08), Zenanile noted that mental health and mental illness do not mean the same thing. “Mental illness develops as a result of the inability of individuals to cope with the normal stresses of life, to work productively and fruitfully, and contribute to their communities,” she said.

Mental illnesses include depression, anxiety, post-traumatic stress disorder, suicide, substance abuse, bipolar, schizophrenia, and many others. The World Health Organisation defines mental health “as the state of well-being enabling individuals to realise their abilities, cope with the normal stresses of life, work productively and fruitfully, and contribute to their communities” – a definition that has received some criticism.

“This definition is criticised for regarding well-being as a key aspect of mental health.” According to Zenanile, “it is difficult to reconcile this definition with the many challenging life situations in which well-being may even be unhealthy. The identification of positive feelings and positive functions as key factors to mental health can be deceiving because the reality is people in good mental health are often sad, unwell, angry or unhappy and this forms part of a fully lived life for a human being.”

She further explained that mental illnesses have been classified as a leading development issue as they put a strain on families, communities, and economies. Some of the factors that have been identified as contributors to mental illness include poverty, unemployment, low income or inequality, debt, food insecurity, low educational levels, poor housing, crime, violence, physical abuse, and malnutrition.

However, Zenanile pointed out that this does not mean that mental illness is only prevalent in such environments but individuals living under these conditions have a greater vulnerability towards mental illness. “Against this background, even without any data, we can get an idea of the condition in Eswatini when it comes to mental illness. Mental illness manifests in different ways, with suicide and depression being some of them.”

According to the Eswatini National Psychiatric Centre, in 2017, 125 cases of suicide were reported and most of these were a result of depression, with victims being between the ages of 13 and 32. However, suicide in Eswatini is most prevalent amongst 25 to 45 year-olds, which according to Zenanile implies that mental illness affects the most productive group in society as the youth comprises 79% of the country’s total population.

“With high rates of unemployment, poverty, and its associated factors, we need to understand the causal relationship between the social determinants of mental illness in order to address its key drivers and not just mental illness itself,” she added.

In light of this, Zenanile’s study seeks to understand the leading socio-economic contributors to mental illness in Eswatini and to quantify the loss for Eswatini’s economy to mental illness.