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Reframing Mental Health: EMpower’s Quest to Support Young People in South Africa and Beyond

Posted 14 May 2024 in EMpower News   |   Share

Since COVID-19, people seem more comfortable talking about their emotional state and are less likely to be judged. It has become okay to say, "I feel depressed," "I feel anxious," or "I feel isolated.” And yet, the term “mental health” still carries a considerable stigma. Often, when used, it’s interpreted as "mental disorder."

EMpower is one of the few organisations in the development space that early on understood mental health as a positive value rather than a negative one. We all have mental health in the same way that we have physical health. And just as there are behaviours that support physical health, such as eating well, getting enough sleep, and exercising, there are behaviours that support mental health, such as accessing safe spaces and making meaningful connections with people who provide you with a sense of security and support.  

As a senior programme officer based in South Africa with experience in the mental health field, I have seen this firsthand.

The South African Child Gauge, an annual publication by the Children’s Institute of Cape Town that reports on and monitors the situation of children in South Africa, provides a helpful way of framing mental health, placing it on a continuum of “Thrive, Survive, and Struggle.”  

  • At one end of the continuum, young people are “thriving,” experiencing contentment and happiness—with the ability to emotionally self-regulate, manage adversity, and engage in life’s daily activities with enthusiasm and to their full potential.  
  • Young people, who are “surviving”, still cope with their everyday routines but may be worried, anxious, and distressed about one or more areas of their life.  
  • Young people who are “struggling” experience regular feelings of anxiety or low mood, worry excessively, have difficulty coping with their schooling or work, and may have poorer quality of relationships. This does not constitute a mental disorder, but young people may find daily tasks more difficult and take up self-soothing behaviours such as substance use.  
  • Without support, a young person may move down the continuum to developing a common mental disorder such as anxiety or depression. They may not be coping with their daily tasks, avoiding social interaction, or engaging in more risky behaviours while experiencing significant emotional pain and suffering. They may even consider taking their own lives.  

At EMpower, we partner with many organisations supporting young people who are "surviving" and "struggling"; intervening early prevents them from moving further down the continuum. Additionally, we help young people to stay in school, get better grades, find jobs and work, and realise their potential. We advocate for layering mental health into other programmes to enable young people to thrive.

For 22 years, we have been working with local organisations in South Africa that are innovatively serving young people through diverse interventions, including sports and the arts. We took the learnings from our work with these grantee partners and published a report last year about advancing adolescent mental health, featuring several key recommendations. These include:  

The presence of safe and reliable adults in their lives—who not only share life experiences and a common language with the young people but are also trained and know when and how to refer them to other specialists when needed.  

  • Creative methodologies such as basic mindfulness techniques to help young people calm down and emotionally self-regulate.
  • Art and storytelling to help young people express themselves and develop self-awareness.
  • Movement approaches that help to physically de-stress young people.

I frequently hear organisations talk about the outcomes that many donors prioritise—how many young people stay in school and graduate, how many improve their grades, and how many can attain and retain employment. While these pursuits are undoubtedly valuable, it is crucial to recognise the challenges young people face, particularly those residing in communities characterised by pervasive violence and frequent experiences of loss. In such environments, young people’s access to mental health support is often severely limited—and their capacity to achieve progress on these other results is also more likely to be curbed.

We know for a fact that there is a shortage of psychologists, social workers, and therapists to meet the growing demand for mental health support worldwide. There is also a compelling body of evidence that suggests that given the inaccessibility of and stigma associated with formal mental health services—making it less likely that young people will get clinical care—community interventions are even more crucial.  

These are exactly the type of initiatives our grantee partners are leading. They are based in local communities—employing and training people within these communities to deliver programmes that support young people emotionally and physically, thereby changing the trajectory of their lives. While this work may not always be referred to as “mental health,” it is very much about building young people’s resilience and coping skills as they navigate their healing journeys.

Finally, I would be remiss if I didn’t emphasise the importance of achieving global peace and addressing structural inequities, especially in the context of its relationship with young people's mental health. These are vital steps towards creating an environment where young people across intersections can feel secure and access the resources they need to support their mental well-being.   

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