Editor's Note: The real cost of mental health: Why SA workplaces can’t afford to look away

By any measure, the cost of unaddressed mental health in South Africa is staggering. Depending on how it's calculated, mental health challenges are costing the South African economy between R161 billion  lost in reduced productivity, absenteeism, presenteeism, and staff turnover. These numbers, drawn from credible studies by institutions such as Investec should give business leaders pause.

Because this is not just an economic issue—it’s a workplace crisis in plain sight. And something that is worth highlighting as October marks Mental Health Awareness Month. 

Presenteeism, where employees show up physically but are too mentally unwell to function properly, accounts for the lion’s share of the loss. Unlike absenteeism, which is easier to track and quantify, presenteeism is insidious. An employee may be logged on or at their desk, yet disengaged, overwhelmed, unable to concentrate or make sound decisions. According to the same research, this alone costs businesses nearly R96 500 per affected employee per year.

Absenteeism also takes a toll, with mental health-related absences costing the South African economy between R12 billion and R16 billion per year, according to Occupational Care South Africa. It equates to thousands of lost hours and millions in wages spent on workers too unwell to function.

These statistics are a hard economic truth: poor mental health isn’t just a personal burden—it’s a business liability.

Yet despite the scale of the problem, workplace mental health remains under-resourced, under-recognised, and, often, mishandled. In many companies, especially in resource-constrained environments, mental health is seen as a ‘soft issue’—something best left to employee assistance programmes, annual awareness campaigns in October, or the occasional wellness webinar. These interventions, while not without merit, don’t scratch the surface of the deeper problem: that work itself is a source of mental distress.

South African workers, like their counterparts globally, are expected to operate in an environment of relentless uncertainty: stagnant economic growth, high unemployment, increasing cost of living, and rolling societal stressors—from crime to load shedding—create a background hum of anxiety. At the same time, workplace cultures often reward endurance rather than balance. The employee who burns out is quietly replaced; the one who takes time off is seen as weak; the one who copes silently is celebrated.

But this model is no longer sustainable. South Africa’s economic competitiveness is directly tied to the cognitive and emotional capacity of its workforce. When that capacity is depleted, it doesn’t just affect individual workers—it affects companies' ability to innovate, manage risk, adapt to change, and retain talent.

A 2023 study published by Investec puts the issue in even starker terms: the collective economic burden of untreated mental health issues includes not only lost productivity but also premature mortality and increased healthcare costs. And this is just the financial impact—there are cultural and reputational costs, too.

Firms that ignore mental health concerns are more likely to see increased staff turnover, disengagement, and reputational damage. In the age of social media and employer review platforms, a toxic or indifferent workplace culture spreads quickly—and young talent, especially, is becoming more discerning. For a generation entering the workforce with clear expectations around balance, purpose, and mental wellness, a company's commitment to mental health is no longer optional—it’s a differentiator.

The good news is that supporting mental health at work doesn’t need to be revolutionary to be effective. It begins with a shift in mindset—from seeing employees as units of output to recognising them as human beings with fluctuating capacity. It continues with leadership that models vulnerability and openness. And it culminates in structural changes that reduce overwork, normalise flexibility, and embed support into the culture—not as a one-off campaign, but as a long-term investment.

Companies that have made this shift—whether by allowing flexible hours, reducing email overload, rethinking performance expectations, or simply encouraging time off without guilt—report stronger employee engagement and better retention. When people feel psychologically safe at work, they are more creative, more loyal, and more able to withstand external pressures.

This matters even more in South Africa, where access to public mental health services remains limited, and where societal stressors often spill into the workplace. In effect, employers are being asked to carry a larger share of the burden. After all, the workplace is one of the few places where mental health interventions can be normalised, scaled, and made consistent.

So let’s stop treating mental health as an HR sideline. Let’s stop assuming the costs are invisible. —it’s a crisis worthy of the boardroom.

And the opportunity is real. Businesses that act now to support their employees will not only reduce their exposure to risk—they will build trust, loyalty, and resilience. They will position themselves as employers of choice in an increasingly conscious labour market. Most importantly, they will treat their workers not as expendable assets, but as the core of their long-term viability.

Because in the end, companies don’t compete with strategy alone. They compete with people. And people can’t give their best when they’re barely holding it together.

Philippa Larkin is the executive editor of Business Report

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