Domestic workers’ mental health is on the decline in SA — we need an empathy audit

According to Dr Kagisho Maaroganye, the public sector national convenor of the South African Society of Psychiatrists, a quick look at South Africa’s health budget and its allocation shows that “mental healthcare continues to be allocated only 5% of the national public health budget, and since the health budget itself is declining in real terms, the mental health portion is actually declining in monetary terms”.

In addition, the South African Depression and Anxiety Group reports that only one in 10 uninsured South Africans has access to the mental healthcare services they need. This is a grave statistic considering that only 15% of our population have medical insurance or medical aid, and that mental health is on a downward spiral in the country.

Mental health matters, but after reading my colleague Takudzwa Pongweni’s recent article about a report by Sweepsouth on the declining state of the mental health of domestic workers, I realised that we often don’t think about this as it relates to people who work in informal employment and earn low incomes, especially those who work in our homes.

This issue is usually explored and acted on from a middle- to high-income perspective, which points not only to class and access biases, but also, by extrapolation, to who is humanised and centred in our society, and who goes overlooked and unnoticed.

I remember once reading that those on the margins of society often have to wear a mask and put on a performance of always being happy and smiling despite their grim circumstances. By this I mean that the expectation is that your domestic worker must always have a sunny disposition despite the difficult circumstances they face daily.

They wake up at the ungodly hour of 3am or 4am and walk bravely through the dark – facing dangers where they live (which is usually in a township or informal settlement) – to catch more than one mode of transport to arrive on time for work.

Sometimes when they arrive at work it’s too early (but rather that than being late) and their employers, who don’t want to be disturbed before their stipulated time, will not open for them until they’re ready. 

When one thinks about the load that domestic workers often carry apart from the work they do, which is long hours of physical labour with low pay and minimal time to rest, one needs to bear in mind that they are often also the heads of households with multiple dependants, who look to them for both financial and emotional support.

Read more: Cost of not treating mental health is much more than a human rights issue

However, where does one realistically even find the time to identify that one’s low mood and general feeling of unhappiness and being overwhelmed have triggered a mental health problem?

Even after identifying that something is not right, what access to mental healthcare is realistically available when it is even difficult for the middle class to access it consistently and in a way that is affordable?

We all have equally important lives and deserve to have our dignity acknowledged. The Sweepsouth report should give us all pause for thought, but most of all compel an empathy audit of how we acknowledge to one another that life is hard and that we are all doing the best we can. DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R35.