South Africans are resilient. It’s a refrain we have heard repeated so often in the 29 years since the first democratic election that one wonders how true it is. Apartheid? South Africans are resilient. State Capture? South Africans are resilient. Load shedding and the energy crisis? South Africans are resilient. Cost-of-living crisis? South Africans are resilient. Global pandemic? South Africans are resilient.

On the face of it, yes, South Africans are resilient, and even in the darkest of times (thanks, Eskom), there is guaranteed to be a spate of memes poking fun at the situation within an hour of news breaking. Yes, South Africans are resilient, and our capacity for humour in difficult times never falters.

However, recent statistics from life insurers tell a different story. 

There is a price to be paid, and the increase in mental health claims tells … well … a depressing story. Life assurer, Liberty, says suicide claims accounted for half of mental health claims in 2022, while depression and anxiety accounted for 16%. Even more worrying, these statistics represent a reduction in the proportion of total claims compared with 2021.

Liberty says although the proportion of suicide claims has decreased, it has seen an increase in the proportion of claims related to mental illness in the income protection category. These relate to claims made by individuals who were unable to work for a short period due to mental illness and needed to claim from their income cover. 

“While we are seeing a considerable reduction in Covid cases, the long-term effects of the pandemic will remain with us for a while and this inevitably includes mental health issues,” says Dr Dominique Stott, Liberty’s chief medical officer.

Old Mutual’s top three claims under psychiatric disorders were major depression (46%), post-traumatic stress disorder (33%) and bipolar depression (7%). The age bands most affected were those between 40 and 60. Bipolar depression, which used to be called manic depression, involves episodes of depression and episodes of mania/euphoria. The switches between these two states may be fairly sudden and dramatic but are more commonly gradual in onset.

According to Mediclinic, judgement is often impaired during episodes of mania and this can result in socially embarrassing behaviour, sexual indiscretions, excessive spending and unwise business decisions. Bipolar disorder tends to be a chronic, recurring condition and is generally considered to have a poorer long-term outcome than major depressive disorder.

George Kolbe, head of Momentum’s life insurance marketing division, says there was a 7% decrease in suicide-related claims in 2022, although he did not elaborate on the numbers. 

In 2019, at the height of the pandemic, Momentum noted an alarming increase of 65% in the number of suicide claims, with males accounting for 88% of suicides. 

The South African Depression and Anxiety Group (Sadag) says calls have increased by 400% since the pandemic. The organisation fields around 2,500 to 3,000 calls a day and one in four calls is suicide related. 

Cassey Chambers, director of Sadag, says four of the country’s top life insurers paid out more than R52-billion on claims due to suicide in 2021.

“Key challenges include access to professionals. For example, a number of psychiatrists have already closed bookings for this year, as they have no more capacity,” she says. 

According to the Global Health Estimates report, South Africa has the third-highest suicide rate out of all African countries, at 23.5 per population of 100,000. DM