South African men are facing a mental health crisis, but many are suffering quietly behind a mask of strength, according to psychiatrists, who warn that harmful ideas about masculinity continue to prevent men from seeking help.
While women are more likely to be diagnosed with depression and anxiety, mental health experts say men often delay seeking support until they are already in crisis, leading to devastating consequences for themselves, their families and society.
According to statistics, one in eight men will experience depression and one in five will struggle with anxiety at some point in their lives. Yet many cases go undiagnosed because men frequently display emotional distress differently.
Men less likely to seek help
Dr Gagu Matsebula, a member of the South African Society of Psychiatrists (SASOP), says men are significantly less likely to seek medical or psychological assistance, even when help is available.
“Men are less likely to attend preventative healthcare visits, less likely to seek help early and more likely to present when their condition has already progressed significantly,” he says.
“What we often see is that men only seek assistance in the very late stages of the condition. This contributes to poorer health outcomes, higher mortality rates and a greater burden of untreated mental health conditions.”
Suppressed vulnerability
Matsebula believes much of the problem stems from societal expectations that men should be strong, fearless, emotionally controlled and self-reliant.
From an early age, many boys are taught to suppress vulnerability and avoid showing emotional pain. As adults, this can make it difficult for men to recognise and communicate what they are experiencing.
“Society tends to allow men to express emotions such as anger or frustration, but feelings like sadness, fear, hopelessness or anxiety are often discouraged,” he explains.
Mental health professionals describe this as restrictive emotionality, the tendency to suppress emotions because vulnerability is viewed as incompatible with masculinity.
The result is that depression and anxiety often present differently in men than in women.
Instead of appearing sad or tearful, men may become irritable, aggressive, emotionally withdrawn or engage in excessive work, substance abuse and reckless behaviour.
Untreated mental health conditions
According to Matsebula, untreated mental health conditions can affect every aspect of a man’s life, from relationships and parenting to work performance and physical health.
“When anxiety and depression remain untreated, men often turn to unhealthy coping mechanisms that temporarily dull distress but ultimately worsen it,” he says.
These coping mechanisms can include alcohol abuse, gambling, drug use, social isolation and risk-taking behaviour.
Globally, men account for the overwhelming majority of deaths linked to homicide, road accidents and suicide. Mental health experts say untreated trauma, chronic stress, substance abuse and emotional isolation often contribute to these outcomes.
Poor productivity in the workplace
A 2023 analysis estimated that South Africa loses approximately R161-billion every year due to untreated mental health conditions through lost productivity, absenteeism and reduced participation in the workforce.
“Mental health is not only a healthcare issue. It is also a workplace issue, a family issue and an economic issue,” says Matsebula.
Mental health struggles rarely appear overnight. Experts urge men and their loved ones to pay attention to persistent changes in behaviour, mood and daily functioning.
Warning signs may include:
- Persistent irritability or anger
- Emotional withdrawal or isolation
- Changes in sleep patterns or appetite
- Loss of interest in hobbies and activities
- Increased alcohol or substance use
- Feelings of hopelessness or emotional numbness
- Constant anxiety, worry or panic
- Difficulty concentrating
- Fatigue and low motivation
- Reckless or risk-taking behaviour
Matsebula says men should seek professional support when these symptoms begin affecting their work, relationships, sleep or overall quality of life.
Treatment options can include counselling, psychotherapy, cognitive behavioural therapy, support groups, lifestyle changes and, where necessary, medication.
Normalising conversations on emotional wellbeing
Mental health experts believe one of the most powerful ways to help men is by normalising conversations about emotional wellbeing before problems reach crisis point.
Rather than confronting someone aggressively about their behaviour, Matsebula encourages friends and family members to approach the conversation with empathy.
“If a man has become quieter or more withdrawn, instead of asking, ‘What’s wrong with you?’, rather say, ‘I’ve noticed you seem quieter lately. Do you want to talk about it?’”
Call for greater investment in mental healthcare
He says meaningful support is often found in simple actions such as listening without judgement, offering reassurance, spending time together or helping with everyday tasks. Matsebula argues that society needs to rethink the way it views mental health.
“If a man develops chest pain, severe headaches or an injury, nobody tells him to simply toughen up and ignore it. Mental health should be treated no differently,” he says.
“Experiencing anxiety, depression, emotional distress or burnout does not make a man less resilient, less capable or less masculine. It simply means he is human.”
SASOP is calling for greater investment in mental healthcare, stronger public awareness campaigns and expanded community-based support services. The organization believes that reducing stigma around men’s mental health could save lives.
“The message men need to hear is simple,” says Matsebula. “Speaking up is not weakness. Reaching out is not failure. Mental health conditions are treatable, and seeking support early can change and save lives.”
- South African men face a mental health crisis but often hide their struggles due to societal pressures to appear strong and self-reliant, delaying help-seeking until crises occur.
- Men experience depression and anxiety differently, often showing irritability, aggression, or risky behaviors rather than typical sadness, leading to underdiagnosis.
- Untreated mental health issues contribute to unhealthy coping mechanisms like substance abuse, social isolation, and increased risks of suicide, accidents, and violence.
- Mental health problems among men significantly impact workplace productivity in South Africa, costing an estimated R161-billion annually through absenteeism and reduced work participation.
- Experts urge normalizing emotional wellbeing conversations, early professional support, and greater investment in mental healthcare to reduce stigma and save lives.
While women are more likely to be diagnosed with depression and anxiety, mental health experts say men often delay seeking support until they are already in crisis, leading to devastating consequences for themselves, their families and society.
Dr Gagu Matsebula, a member of the
“Men are less likely to attend preventative healthcare visits, less likely to seek help early and more likely to present when their condition has already progressed significantly,” he says.
“What we often see is that men only seek assistance in the very late stages of the condition.
Matsebula believes much of the problem stems from societal expectations that men should be strong, fearless, emotionally controlled and self-reliant.
From an early age, many boys are taught to suppress vulnerability and avoid showing emotional pain. As adults, this can make it difficult for men to recognise and communicate what they are experiencing.
“Society tends to allow men to express emotions such as anger or frustration, but feelings like sadness, fear, hopelessness or anxiety are often discouraged,” he explains.
Mental health professionals describe this as restrictive emotionality, the tendency to suppress emotions because vulnerability is viewed as incompatible with masculinity.
Instead of appearing sad or tearful, men may become irritable, aggressive, emotionally withdrawn or engage in excessive work, substance abuse and reckless behaviour.
“When anxiety and depression remain untreated, men often turn to unhealthy coping mechanisms that temporarily dull distress but ultimately worsen it,” he says.
Globally, men account for the overwhelming majority of deaths linked to homicide, road accidents and suicide. Mental health experts say untreated trauma, chronic stress, substance abuse and emotional isolation often contribute to these outcomes.
A 2023 analysis estimated that
“Mental health is not only a healthcare issue. It is also a workplace issue, a family issue and an economic issue,” says Matsebula.
Mental health struggles rarely appear overnight. Experts urge men and their loved ones to pay attention to persistent changes in behaviour, mood and daily functioning.
- Persistent irritability or anger
- Emotional withdrawal or isolation
-
Changes in sleep patterns or appetite - Loss of interest in hobbies and activities
- Increased alcohol or substance use
-
Feelings of hopelessness or emotional numbness - Constant anxiety, worry or panic
- Difficulty concentrating
- Fatigue and low motivation
- Reckless or risk-taking behaviour
Matsebula says men should seek professional support when these symptoms begin affecting their work, relationships, sleep or overall quality of life.
Treatment options can include counselling, psychotherapy, cognitive behavioural therapy, support groups, lifestyle changes and, where necessary, medication.
Mental health experts believe one of the most powerful ways to help men is by normalising conversations about emotional wellbeing before problems reach crisis point.
“If a man has become quieter or more withdrawn, instead of asking, ‘What’s wrong with you?’, rather say, ‘I’ve noticed you seem quieter lately. Do you want to talk about it?’”
He says meaningful support is often found in simple actions such as ing without judgement, offering reassurance, spending time together or helping with everyday tasks. Matsebula argues that society needs to rethink the way it views mental health.
“If a man develops chest pain, severe headaches or an injury, nobody tells him to simply toughen up and ignore it. Mental health should be treated no differently,” he says.
“
SASOP is calling for greater investment in mental healthcare, stronger public awareness campaigns and expanded community-based support services.
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