by Aphelele Mtwecu

About four years ago, while working in corporate, a colleague came into work, clearly devastated after losing her sibling to gun violence. Tip-toeing around this situation, we all kept our distance, exchanging awkward greetings and unsolicited words of comfort, as if any of it could cover her grief.

Barely ten minutes in, she collapsed into a heart-wrenching wail. Her cries filled the entire room, a sound that stopped everything. We all stood from our cubicles and instinctively surrounded her, offering what little we could. None of it was enough. She was gut wrenched. Eventually, her partner arrived to take her home. She was in no state to work, to sit at a desk and pretend the world hadn’t crumbled around her.

I recall sitting back and thinking,

‘Why did she even come to work?’ But the answer was also there for me: ‘Because she had to.’ Even in that moment of unbearable grief, we all knew the weight of financial needs rested on her shoulders.

As a strong advocate for mental health, I sit with the same discomforting question many years later: Can we afford to take care of our mental health? In theory, yes, but in practice? In a country where so many of us are just one paycheck away from poverty, the answer isn’t simple.

According to Statistics  South Africa, the upper-bound poverty line, 2024 is R1,634 per person per month. With only 5% of the national health budget allocated to mental health services​ prioritizing mental health feels like a luxury for most. This minimal allocation is reflected in the lack of accessible and affordable services. Private therapy sessions  cost between R600 and R1200 per hour, putting them well out of reach for the average person.

So, even when one’s mental health is deteriorating, walking away from a job isn’t always a viable option. The saturated job market offers little room for vulnerability, where the fear of job loss often outweighs the risk of burnout. The balance between survival and self-care becomes blurred. According to a 2023 survey by the South African Depression and Anxiety Group (SADAG) , 60% of employees reported staying in a toxic environment due to financial pressures. Despite being told that no job is worth sacrificing our mental health, many choose to pick the devil they know over the uncertainty of the unknown. In South Africa, with high competition in the job market and minimal job security, it’s common for people to remain in toxic situations rather than risk unemployment by seeking new opportunities.

Furthermore, according to the Mental health risk in South Africa study conducted by Wits University, most cases of anxiety and depression are found in lower, more rural provinces. Despite this, mental health challenges can challenge individuals of all socioeconomic backgrounds, including those working at high levels in the corporate world.

In a recent LinkedIn post , I came across the case of Anna, a 26-year-old woman from India with a well-paying job, who tragically passed away, reportedly due to work-related stress. The consensus and clarion call to all people in corporate was to put yourself first and prioritize your mental health above all else. I was immediately conflicted – If I found myself in a toxic work environment, would I leave? Or would I head back to the Eastern Cape, bask in the sun, go to ‘my friend’, eat an apple munch, and ask my parents for R5 airtime? I digress… But seriously would I endure the stress and stay or take the risk of leaving?

As valid as these sentiments are, do they truly reflect the contextual daily struggles of working-class South Africans?

The Disconnect of Realities

There is a growing movement in high-income countries to encourage employees to prioritize their mental health, making it non-negotiable, and even quitting if necessary. Finnish government sets a strong example by implementing legislation that protects mental health of workers whilst on the job. Under Finland’s Occupational Safety and Health Act, employers must assess and mitigate work-related stress and mental strain to improve their mental health. Globally, there is an increasing sentiment that no job is worth sacrificing your mental health for.

Most South Africans are often disconnected from these messages. With unemployment hovering currently at  32% and financial security for those with jobs being precarious, the choice isn’t between a healthy satisfying career and mental well-being – it’s between survival and burnout.

The Grey Area

Maybe this is the most difficult part of the conversation around mental health, it’s not just about self-care, therapy, or wellness programs. It’s about survival, one tied to an economy that doesn’t provide safety nets. Leaving a toxic workplace isn’t always straightforward, especially when there’s no assurance of better prospects. Many of us find ourselves in a delicate balancing act, striving to safeguard our mental health while existing in a society that constantly pushes us to our limits.

While my advocacy for mental health is unshakeable, and in no way is this a contestation of that fact, I am, however, sitting on the edge of my seat, thinking, is there a grey area here?

Imagine a single mother, her face marked by exhaustion, rushing from one underpaying job to another, all to make sure her children don’t go to bed hungry. Or think about a recent graduate, full of potential, now clouded by the toxic environment of a job they can’t afford to leave. For these individuals, the suggestion to ‘just quit’ can seem not only impractical but also deeply insensitive.

These aren’t just hypothetical scenarios they are the lived experiences of countless South Africans, each carrying their unique burden while trying to maintain their sanity. It’s a delicate, often painful balancing act that deserves communal grace and human centered policy development.

It’s about acknowledging that mental health in South Africa looks different from mental health elsewhere. This is the grey area where discussions about mental health need to go beyond idealized notions of “putting yourself first.” As Frantz Fanon once said, “The condition of man is a collective condition,” reminding us that true mental health cannot be achieved singularly by the societal structures that shape our lives. Mental wellness, especially in South Africa, must be rooted in a holistic, community-centered approach that addresses the individual and the collective plight for change.

And maybe, by acknowledging the grey areas, we can begin to imagine more holistic interventions that make sense for us, interventions that don’t require us to choose between survival and sanity but allow room for both.

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About the author:

Aphelele Mtwecu is a content writer, activist, and creative force passionate about youth development, transformation, and social impact. She is deeply committed to advocating for mental health and working to remove the stigma around mental health. She is also committed to creating more safe spaces for young people to engage. As a 2016 Activator and member of the ACTIVATE! Change Drivers writer’s hub, Aphelele, uses her writing to inspire and advocate for positive change.