Mental wellbeing: SA hits rock bottom on global list

Mental wellbeing: South Africans hit rock bottom on global list
The Mental State of the World report states that South Africa had the lowest MHQ score of 46%. (Photo: Freepik)

The latest Mental State of the World report has identified South Africa as the lowest-ranked country based on mental wellbeing. It also revealed how the mental health of younger generations has plummeted; growing up in an internet-dominated and inequitable world. 

Published annually by the Mental Health Million Project, the report reached a total of 223 087 respondents from 34 countries. They form part of the Core Anglosphere, Spanish-speaking Latin America, the Arab world, Spanish & French speaking continental Europe and Africa

Data for the study uses an online assessment tool called the Mental Health Quotient (MHQ), which comprises 47 elements including both problems and assets.

With over 11 887 respondents, South Africa had the lowest MHQ score of 46%.  

“Surprisingly, Venezuela topped the list with an average MHQ of 91, while the UK and South Africa had the lowest scores at 46. At least eight out of the top 10 countries were from were countries where there is large English-speaking population like South Africa, India,” stated the report.

Higher education and employment

The report found that across all countries, higher education and being employed were associated with higher mental wellbeing levels.

In the third quarter of 2021,  SA’s unemployment rate hit 34.9% — the highest level since 2008.

Earlier this year, President Cyril Ramaphosa mentioned SA’s growth slump – which is characterised by the country’s deepening unemployment crisis.

“Unemployment has been caused by low growth, which has, in turn, resulted from a long-term decline in investment. The problems in the South African economy are deep and they are structural.” 

The World Health Organisation (WHO) states social, cultural, economic, political, and environmental factors such as national policies, social protection, standards of living, working conditions, and community support play a huge role in determining a country’s morale. 

SA also topped the list as the country with the highest percentage of people who are either ‘distressed’ or ‘struggling’. On the other side of the spectrum, populations are either enduring, managing, succeeding or thriving.

SA has the highest percentage of people who are distressed or struggling. (Photo:

The younger generation

According to the report, the alarming decline in the mental wellbeing of the younger generation was a global phenomenon.

“At least 44% of 18 to 24-year olds had mental wellbeing scores within this distressed or struggling range. This represents a growing gap between generations that, while present prior to the COVID-19 pandemic, has since been exacerbated. It also stands in stark contrast to the happiness and wellbeing patterns documented prior to 2020,” stated the study.

The study also confirmed that the decline across countries from 2019 to 2021 was significantly correlated to the stringency of government COVID-19 measures and  to the cases and deaths per million.

Authors of the report suggested reasons behind the rapid shift in mental wellbeing among young adults. They identified four potential factors:

  • Income inequality –
  • Political instability –
  • Factors related to the internet
  • Environmental toxins

Of the four, the internet has definitely had the greatest impact. An increase in social media usage and screen time occupies such a large fraction of waking time that it crowds out time previously spent on in-person social interactions. This is crucial when building and maintaining a strong ‘social self’, one of the five dimensions of mental wellbeing. The others are mood and outlook, drive and motivation, cognition, and the mind-body connection.

Gender gaps

In terms of gender, those identifying as non-binary or third gender had the lowest mental wellbeing of any gender group. Just over half of them, 51%, were either distressed or struggling on a clinical level. 

“In English-speaking, internet-enabled populations, there was near parity between males and females overall, although both genders were lower than their counterparts in other regions of the world,” read the report. 

The objective of the mental health project is to provide an evolving global map of mental wellbeing. It also enables deep insights into its drivers that can be used for more effective management through evidence-based social policy and interventions.

In 2020, South Africa had an MHQ score of 56% with at least a fifth of the respondents experiencing fear and anxiety. Of the eight participating countries, Singapore came in tops with 94%. – Health-e News


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