Supporting the Mental Health of South African NPO's


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Survey finds alarming rates of psychological distress and risk for mental illness within Non-Profit organisations


Since the outbreak of COVID-19 in March 2020, South African society has been put under severe strain. The exacerbation of already difficult psychological and socioeconomic conditions for many communities has seen non-profit organisations (NPOs) quickly mobilise to provide immediate support, essential emergency relief and life-saving resources for thousands of families across the country during these unprecedented conditions.

This has placed massive strain on services offered by NPONPOs, which has negatively impacted the mental health of those working in these organisations as they work tirelessly to assist the most vulnerable.

While NPO workers continue to provide crucial services for those deeply affected by COVID-19, they are still having to maintain their own needs – all within a context of limited resources, sustained exposure to social suffering, and novel pandemic conditions.

But at what cost? And what can be done to support these NPOs now and in the future?

In response to this, a first-of-its kind NPO Mental Health Support Programme and 24-hour toll-free Helpline was launched last October. NPOwer offers mental health care and support to all NPOs, NPO leaders, staff and volunteers, many of whom are experiencing unprecedented strain and burnout caused by COVID-19.

The South African Depression and Anxiety Group (SADAG) in partnership with
Tshikululu Social Investments, the two organisations behind the launch of NPOwer, recently conducted a Mental Health Support Programmes Survey to assess the impacts of the COVID-19 pandemic on NPOs and staff psychological well-being.


Conducted amongst nearly 200 NPOs between October 2020 and March 2021, this survey found that two-thirds of NPO professionals exhibited moderate to severe psychological morbidity, with two-thirds also facing an elevated risk of developing a psychiatric disorder. Over one-third of all NPO professionals were found to be exhibiting a high likelihood of having a severe psychiatric disorder by the time the survey was completed.

Significant risk factors for elevated psychological morbidity included social stress and fewer workplace mental health resources. The survey also found that men reported greater psychological distress compared to women. This is according to Biological Anthropologist, Dr Andrew Wooyoung Kim, from the Developmental Pathways for Health Research Unit at the Faculty of Health Sciences at the University of the Witwatersrand who, together with Tshikululu and SADAG, designed, implemented and analysed this survey.

“This is a particularly interesting finding because epidemiologically, women tend to be at a greater risk of developing psychiatric diseases or higher levels of psychiatric morbidity, but here we actually see the opposite, that men are exhibiting worse mental health in this sample,’ he says.

“NPO workers faced considerable stress at work and home and consequently, and exhibited a range of symptoms of psychological distress, including insomnia, helplessness, excessive worrying, a disconnect from their work and family, cynicism, and burnout,” he says. “The overall incidence of psychological distress was particularly alarming in this sample.”

Nearly half of NPOs did offer some form of psychosocial support to their staff, yet many NPO workers did not seek professional psychological assistance.

Reflecting on the findings of this survey, Clinical Psychologist Dr Garret Barnwell, says that he doesn’t think there is anyone who hasn’t been affected by some form of loss and grief during this global pandemic.

“What this research shows is that there is a tremendous need. We know that mental health care services are lifesaving, so for people who are struggling, getting access early is really important,” says Dr Barnwell, who worked in the NPO sector for over 10 years, including for Doctors without Borders.

“The finding about men is really concerning. We know men present late to services sometimes, we tend to bottle things up. We need to think a bit differently about masculinity and how to encourage one another to access care and be able to create reflexive and caring spaces for one another in the workplace,” he says.

Many who called the NPOwer helpline, which to date has handled over 4,800 calls since launching in October last year, expressed extreme gratitude for this programme, given the dire lack of psychological resources in the sector.

A social worker who called the helpline and who works for an NPO that assists the elderly, says that the situation has been very difficult since COVID began. She gets people calling her and asking her to help with accommodation and food, but she is stuck and helpless. No one is able to help because of COVID restrictions. She also cannot follow her normal self-care routine, such as visit friends, because of COVID, and she doesn’t know how to find a balance. She is struggling to have down time away from the stresses of work.

She says how frustrating it is to be surrounded by loss, not only in her professional life but in her personal life too. She also feels guilt when unable to help people due to circumstances beyond her control.

NPOwer provided an outlet for her to speak about her feelings, to be reassured that she is doing a great job and that she is doing everything she can to help people. This interaction boosted her confidence, enabled a discussion about how release her guilt and reassure her that she always has someone to talk to because the line is always here. That is what makes the NPOwer Mental Health Support Programme so vital.

Recommendations suggested as a result of this survey include the need to provide immediate mental health services to staff through the existing NPO resources, such as the NPOwer helpline, encouraging staff to make use of medical aid benefits or local clinics, or reaching out to available lay psychosocial resources such as church groups and support group networks.

Managing the expectations and clarifying roles and responsibilities of staff and implementing simple structured touchpoints with staff can identify challenges and help address issues as and when they arise.
Paying extra attention to schedules, time off, and workload can also help identify any staff that may be overloaded. Collaboration and communication with other NPOs, other civil society organisations, and other stakeholder groups can also help to maximize resource allocation, share solutions, and problem solve.

“Even with just taking that one step towards seeking help, calling the call centre, speaking to someone about your problems, talking to someone in your community, there are different forms of mental health resources, and this is the first step and a very important step to break that cycle, a small step that can really go a long way,” Dr Wooyoung Kim says.

Commenting on the outcomes of the survey, Petri Greef from SADAG reminds those working in NPOs that it is important to have boundaries for yourself, within your family and within your work, and to look after yourself. “We often say at SADAG that you cannot pour from an empty cup, so you have to look after yourself in order to look after others,” she says.

The tollfree NPOwer helpline is open 24 hours a day, 7 days a week, 365 days a year with counselling available in all 11 official languages. Call 0800 515 515 or send a dedicated SMS to 43010. You can also email This email address is being protected from spambots. You need JavaScript enabled to view it. or go to www.npowersa.orgfor more information. NPOwer will be hosting their next webinar on 22 July 2021 on secondary trauma and will also be launching support groups in the near future.


For more than 22 years they have partnered with investors to achieve sustainable social impact for today and for generations to come. Tshikululu views social investment as any financial commitment, be it grant making or impact investing, that seeks to drive, enable and measure social impact, which it does by partnering with clients, developmental agencies and other collaborative partners.

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The South African Depression and Anxiety Group (SADAG) is at the forefront of patient advocacy, education and destigmatisation of mental illness in the country. Its expertise lies in assisting patients and callers throughout South Africa with mental health queries.
SADAG is a Non-Profit Organisation, a Registered Section 21 Company, with an 18a tax exemption. It has on its board a powerful team of Patients, Psychiatrists, Psychologists, and General Practitioners. SADAG was established 26 years ago to serve as a support network for the thousands of South Africans who live with mental health problems. Currently, it is estimated that 1 in 5 people will, or do, suffer from a mental illness. SADAG manages a 22-line counselling-and-referral call centre, and is the voice of patient advocacy, working in urban, peri-urban, and the most rural communities across South Africa.

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