Depression in the work place

One in four South African employees are diagnosed with depression annually. There are ways you can seek help while your identity is protected by law.

You find your life spiralling out of control. There is an overwhelming feeling of helplessness and the things that used to interest you do not anymore. If this is what you are going through, you are not alone.

In South Africa, 4.5 million people suffer from depression, costing the country $16.6 billion of its Gross Domestic Product due to lost productivity, either due to absence from work or not attending work citing sickness.

These are figures by the IDEA study of the London School of Economics and Political Science in 2016.

According to the South African Depression and Anxiety Group (SADAG), depression is among the prevalent mental disorders in South Africa, resulting in one-in-four South African employees diagnosed with depression annually.

Meet Mfuneko Mthi, a prison warden from Kokstad, a little town nestled between South Africa’s KwaZulu-Natal and Eastern Cape provinces. Today, he sounds upbeat and has a positive outlook on life but this was not the case two years ago.

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He suffered from depression. It all started when he and his childhood friend were shot at by a gang leader in their community.

Mthi escaped death but the trauma manifested as depression.

The two years took a toll on his personal and professional life.  

As a prison warden, he had to work closely with prisoners and at times, their correctional services uniforms would bring back painful flashbacks of his offender.

From then, it progressed to the perpetual submission of medical certificates, one after the other, as he desperately tried all means to run away from his inner demons. 

“I started reporting sick from work on a regular basis, even though I was not sick. I could not face the correctional services uniform after I had seen my offender, during the victim-offender dialogue (VOD),” Mthi says. 

“The VOD is a voluntary process, where the offender and victim are able to talk about the effects of the crime. Through the VOD program, victims of crimes… engage with offenders and communities so that relationships can be restored and forgiveness sought,” states a report by the Department of Correctional Services.

During the times that Mthi was present at work, leaving early also became a regular practice and isolation was his best-kept secret to maintain sanity, he says.

I would leave early to go to my place and consume alcohol. I used up all my leave and sick days at work just to avoid being around people.

Mthi needed to go back to the root of the problem in order to get the help he needed.

He details how he and his friend were attacked by the same perpetrator on two separate occasions.

“When I was in my teens, a gang leader who was feared in our community, used to recruit the youth to commit crimes. When my friend and I refused, he assaulted us. It is then that our parents opened a case of common assault with the police,” Mthi says.

The unexpected happened.

“On the day we got back from his bail hearing, he shot my friend and I, saying that nobody presses criminal charges against him.” 

Mthi suffered multiple gun-shot wounds but his friend did not survive the onslaught.

 As the wounds healed, the internal scars continued to bleed; life’s problems rubbed salt into Mthi’s wounds.

“A friend of mine committed suicide in 2017 and till this day, we do not know what led to him doing that.

“But he did make us aware that he was experiencing a series of problems, and his job as a prison warden was taking a toll on him due to the number of traumatizing things that happen in prison,” Mthi says.

 He would drown his sorrows in alcohol when the waves of depression were unrelenting.

“I would drink a lot to help me sleep most of the time. Even though I would go out sometimes, I got to a point where I was overdoing it and that led to me being broke and that created a cycle which would lead to more depression.” 

Mthi realized he had a problem and he took the first step towards healing.

He called SADAG, an organization in South Africa at the forefront of patient advocacy and educating society on mental illness.

 “They told me that I had depression symptoms and advised that I go see a nearby clinical psychiatrist,” Mthi says.

According to Charity Mkone, a clinical psychologist, the societal stigma associated with depression makes it difficult for it to be warranted an illness. 

“It is something that is not seen as a real illness…people think that it is something that you can control and that you choose whether to be depressed or not. They also think that because of certain circumstances – such as being a prominent figure – you do not have a right to be depressed,” she says. 

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However, that is not true. Most people, according to Mkone, have had some form of depression in their life, where they present SIGMECAPS symptoms (as defined in the box-out).

 “To some degree, we have all expressed these feelings at a point in our lives. But it is usually a phase. But for someone struggling with depression; that becomes a dominant way of feeling, as opposed to someone who is feeling like that because of the circumstances, and once the problem has disappeared, they are fine. A depressed person would still feel depressed,” she says.

 According to SADAG, rural-based studies have found a prevalent rate of 18% depressive symptomatology and 27% rate of depression, as opposed to the urban settings where as much as 25.2% of the population is depressed and in peri-urban settlements where 34.7% of the people have postpartum depression.

 There are 23 known suicides in South Africa per day, making it approximately 8,000 suicides each year. Based on research from SADAG, for every person who commits suicide, 10 have attempted it.

In South Africa, even though women are two times more likely to suffer from depression, men are more prone to committing suicide. This is often because men in South Africa battle to come forward with mental health problems due to the stigma attached to mental health.

“It has a lot more to do with the stigma and that men don’t actually come out to say that they are depressed. It makes them feel that they are weak people because one of the symptoms of depression is deep overwhelming sadness,” Mkone says.

Men are five times more likely to be successful at suicide then women

Charity Mkone

Suicidal thoughts normally manifest when depression goes untreated for a long time.

Mkone says that when men commit suicide, they are found to do it in a more lethal manner.

  One of the first steps that could be used within communities in order to assist people suffering from depression is to be more aware of the symptoms.

The more measures are taken to educate people in the workplace and in communities concerning depression, Mkone believes this would alleviate the number of suicidal deaths because persons suffering from depression would get the help they need at an early stage.

 It is, however, important to note that depression may be caused by a number of problems such as external factors, genetic inheritance, an imbalance of brain chemicals, certain medical conditions, substance abuse as well as other various medical conditions.

This is why mental illness is a treatable condition and, as a result, 80% to 90% of people have had a good response to medical care.

Depression in the work place

Depression in the work place is becoming more visible.

“According to the medical ethical code of conduct that all clinical psychologists sign and are bound to, the sessions that you have with the client are strictly confidential unless the client gives you written consent to divulge information about their sessions,” says Mkone.

“In terms of a patient requiring a written letter for work, we can provide a medical certificate,” she says.

One in six employees are willing to disclose their mental illness, according to a 2017 survey by SADAG.

Nadine Mather, who is a senior associate at law firm, Bowmans, says: “An employee is not obliged to disclose to their employer that they suffer from depression or any other mental condition. An employee may, however, voluntarily choose to do so.”

  She added that should there be a case where the employer is aware that the employee suffers from depression and it affects their performance at work, then they may address the matter following the correct procedures, and it would be illegal if they dismiss the employee without that.

Depression is regarded as a sub-category of “incapacity” and is recognized as a fair reason to terminate an employee’s employment under the South African law should they no longer be fit to perform their duties.

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“In this regard, our law places an obligation on employers to investigate the cause, degree and effect of the employee’s depression or mental condition thoroughly, in order to ascertain the impact that it might have on the employee’s work,” says Mather.

If the employer can prove without reasonable doubt that the business or company cannot function without the duties of the employee within a certain time period, then that could result in the termination of their duties.

“Only when an employer has followed a fair process and can show that there is no prospect of an employee recovering sufficiently to justify their continued employment, or improving within a time period during which an employer could cope without suffering significant loss as a result of an employee’s absence, would termination of the employee’s employment for depression or a mental condition become justifiable,” Mather says.

“On the other hand, where the employee is too ill to work and the employer fails to follow a fair process, the employee may, in certain circumstances, be awarded compensation up to a maximum of 12 month’s remuneration,” she says.

When an employer realizes that their employee is suffering from depression, they are obligated to support them.

In Mthi’s case, the employers were supportive.

They tried to accommodate him by removing him from traumatizing environments that made him feel uncomfortable.

Mthi is no longer on medication for his depression, but along the way, he has found the positive aspects of life. 

“I go to the gym during my spare time and I also sell t-shirts. With the money I make from selling them, I assist the less fortunate in my community, by buying them school uniforms,” Mthi says.

He is also working with some of his colleagues to build houses in his community.

Proving that Mthi is no longer the bleak and lost man he was two years ago, he initiated a Facebook page last year called Depression is Real.

The page provides a platform to those who would like to talk about depression.

As depression is on the rise in the country, so are those that have won the war over the illness, like Mthi.

The trick is to seek help – before it’s too late.