Mental health issues such as depression and anxiety are a growing problem worldwide, especially in countries such as South Africa. This country faces significant economic and social inequalities, a lasting impact of its apartheid history. These inequalities affect many areas, including healthcare, education, and economic opportunities. Mental health, in particular, has long been overlooked, with resources often falling short of what is needed. As a result, many mental health issues go undiagnosed and untreated.

A recent study funded by the NRF examined the prevalence of depression and anxiety among South African adults. It also explored how these mental health issues are linked to adverse childhood experiences (ACEs) and socio-demographic factors, such as age, education level, and employment status. The study involved a nationwide survey conducted between September and October 2021, where 3 402 adults from different provinces were interviewed. They were asked questions about their mental health and their experiences during childhood.

The results revealed important insights into the state of mental health across the country:

• Around 25.7% of adults in South Africa show signs of depression, with the Northern Cape reporting the highest rate at 38.8%. Anxiety affects 17.8% of adults, with the highest levels in the Northern Cape (29.3%).
• Mental health issues vary significantly by region. The Northern Cape, a rural area with economic challenges, has the highest rates of depression and anxiety, while urban provinces such as Gauteng have lower rates.
• High ACE scores are strongly linked to a greater likelihood of depression and anxiety in adulthood. Provinces such as the Western and Eastern Cape report the highest ACE scores.
• Older adults, especially those over 65, and individuals who are widowed, divorced, or separated are more prone to mental health issues. Education plays a protective role, with lower education levels associated with higher risks of depression and anxiety. Unemployment is also a major factor contributing to anxiety.
• There is a significant overlap between depression and anxiety, with 58.1% of those with probable depression also experiencing anxiety.

The study concludes that a large portion of South Africa’s adult population is at risk of depression and anxiety, particularly those who have experienced childhood trauma and those from lower socio-economic backgrounds. The findings highlight the urgent need for more accessible mental health services, especially in regions with high levels of mental health issues. For the full research article, visit