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Addressing Africa’s growing mental health crisis

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In 2022, the World Health Organization reported that Africa is home to six of the top ten countries with the highest suicide rates.. South Africa reported a suicide crisis in 2022, joining Lesotho, Eswatini, Zimbabwe, Mozambique, and Central African Republic as the African countries with the highest suicide rates. A mental health crisis is silently plaguing the continent, as depression and suicide rates continue to rise in Kenya, Nigeria and Egypt.  

There is no simple answer as to why so many African countries are battling high suicide rates, and in many cases the reported figures don’t fully capture the extent of the continent’s mental health crisis. For people living in conditions of adversity – facing violence (including gender-based violence), poverty, unemployment, food insecurity and drug abuse – the risks of suicide are much higher. Studies have shown that rates of unemployment and underemployment are significant drivers of suicide. This correlation cannot go unnoticed, as African countries like South Africa have the highest unemployment rates in the world.  

A growing mental health crisis in Africa 

The Covid-19 pandemic has had an undeniable impact on people’s livelihoods and wellbeing, with the loss of loved ones, loss of jobs and sources of income and the rapidly increasing costs of living. The impact of these crises often goes ignored, as mental health and suicide prevention measures can only minimally address these structural determinants of mental health. African cultures, traditional values and gender norms often contribute to a culture of stigma, where individuals, particularly men, cannot voice these personal challenges and seek support. Suicide rates among African men are at least 3 times higher than in women.  

But there is one group we all know about but have not built adequate measures to protect it. Gifted children and adults need more mental health support if we are to unlock their greatest potential for the development of the continent. Much research has been conducted on how to support gifted children in education, however, there hasn’t been sufficient study into the mental health challenges of gifted adults. Giftedness is defined as a trait of individuals that demonstrate exceptional ability to reason and learn in one or more domains, such as mathematics, music, language and/or a set of sensorimotor skills like painting, dance, and sports.  

Research over the past decades has identified unique characteristics and experiences of gifted people that contribute to their mental health challenges, resulting in issues such as unhealthy perfectionism, anxiety, depression and even suicidality. Gifted children, who are often highly sensitive, intelligent, analytical, and curious, have a 1 in 10 chance of going into depression. More peculiarly, gifted individuals have a higher chance of suffering from ”Existential Depression”. Existential Depression is a psychological state of despair and hopelessness where one questions the meaning and purpose of life, their reason for existence, the nature of the world, and the significance of their actions and choices. People with existential depression may struggle to find satisfying answers to life’s major philosophical questions and may feel isolated and disconnected. 

Despite gifted individuals’ track record of early success in life, they may have a much more difficult time recovering from and dealing with setbacks and failures. The challenges of burnout, stress, and difficulties in managing interpersonal relationships are all factors that put a strain on gifted people’s mental health. When placed in the appropriate education system with individual early education support, gifted students can succeed and thrive. However, the reality is that most African countries lack the infrastructure to identify and nurture exceptionally gifted children, and provide special education to and counselling to support their mental wellbeing.   

Building the infrastructure and capacity to support mental health  

While the number of people affected by mental health in Africa is on the rise, and more gifted individuals go unidentified and unsupported to navigate their unique experiences as adults, mental health support infrastructure remains bleak. Africa has one psychiatrist for every 500,000 inhabitants, 100 times less than the WHO recommendation. Suicide prevention is rarely prioritised in national public health programmes, just as mental health is not often covered in health insurance policies.  

Across Africa, underinvestment from governments is one of the biggest barriers to adequate mental health service provision, with African Ministries of Health only allocating about 90 US cents per capita to mental health on average. These funds are often allocated to large urban psychiatric institutions, with only about 15 per cent getting to the primary and the community health levels. Special education and support for gifted individuals is also often only accessible to people from urban and wealthy backgrounds.  

More collaborative efforts are needed to fund the research to understand the extent and nuances of the mental health crisis in Africa, to provide appropriate mental health support and create awareness to reduce stigma. The African Mental Health Research Initiative (AMARI) is an example of a mental health initiative that is prioritizing mental health research, to produce African scientists that are finding trailblazing solutions to mental, neurological and substance (MNS) abuse disorders.  

Funded by the Science for Africa Foundation (SFA), with support from Wellcome and the UK Foreign, Commonwealth & Development Office (FCDO), AMARI researchers are working to reduce the mental health treatment gap in Africa by understanding MNS conditions and designing treatments to meet the unique needs of patients. Additionally, researchers across 6 African countries are studying the effect of mental health problems on management of non-communicable diseases such as diabetes, as well as the impact on caregivers. Others are studying the impact of maternal depression on mother-to-child HIV transmission.   

Despite mental health often being sidelined from public health national priorities in Africa, these African researchers are finding novel connections between mental health and non-communicable disease treatment outcomes. This kind of local research, along with the training of more mental healthcare professionals, is crucial to addressing the growing mental healthcare crisis the continent faces.  

On the other hand, gifted individuals in Africa stand as a reservoir of untapped potential, holding the key to innovative solutions for not just mental health support but also areas like engineering, architecture, medicine, sports, art, and music. Their unique abilities and perspectives have the power to reshape the mental health landscape on the continent, provided they are equipped with the right tools through capacity building. 

Mental healthcare should be a public health priority in Africa; so, let us rally investments and national commitments to ensure more Africans can access the life-saving care, support, and treatments they need. Let us prioritise and build programmes that take care of the mental health of gifted individuals. They have so much to offer this beautiful continent.    

Moses Alobo is Head of Programmes at Science for Africa Foundation, a physician and public health researcher specialising in building locally relevant innovations for Africa.  

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