Every November, the unmistakable symbol of the moustache becomes more than a style statement; it becomes a conversation starter. Movember is a global movement that challenges one of the most damaging stigmas of our time: men's silence around mental health.
While men account for the majority of suicides worldwide, they are often the least likely to reach out for support. Movember shines a light on the need to normalise mental health conversations and make seeking help a sign of strength, not weakness.
As a company that processes healthcare claims from medical practices across South Africa, Healthbridge has identified a troubling pattern.
This isn't just about statistics. It's about a male patient who dutifully manages his blood sugar but silently struggles with overwhelming anxiety, never mentioning it because "real men don't complain".
It's about a hypertension patient whose medication adherence drops not because he doesn't care, but because undiagnosed depression has robbed him of the motivation to care for himself, and he's too ashamed to admit he's struggling.
What our data reveals
Our analysis of South African medical aid claims from January 2022 to December 2024, using the diabetes, hypertension, anxiety and depression ICD-10 codes that doctors use for diagnosis and billing, covers 188 098 unique patients across 2 616 medical practices, offering a comprehensive view of healthcare trends nationwide.
Our data revealed the following:
- Diabetes is the dominant chronic condition in this analysis, representing the most prevalent lifestyle-related disease and the condition most frequently followed by a mental health diagnosis.
- Patients diagnosed with chronic conditions like hypertension or diabetes face a dramatically elevated risk of developing depression or anxiety disorders.
- Among patients with both a chronic condition and a mental health diagnosis, 68% received their mental health diagnosis after their lifestyle disease diagnosis, establishing a clear temporal relationship.
- This risk is highest in the critical 12 months immediately following their initial diagnosis. In fact, 40% of patients with a chronic condition received a mental health diagnosis within just one year, a speed of connection that represents the most alarming finding.
- The risk compounds significantly when patients have multiple chronic conditions. Compared to patients with diabetes alone, those with both diabetes and hypertension show an 11 percentage point greater risk of mental health diagnosis within the first year for females, and a 24 percentage point greater risk for males.
Put differently, when you diagnose a patient with diabetes or hypertension today, there's a significant probability that within the next 12 months, that same patient will be grappling with depression or anxiety.
We're calling this the "Year of Risk", a critical period when patients are most vulnerable to developing mental health conditions.
The data furthermore suggests that men with multiple chronic conditions face disproportionately higher vulnerability, more than double the mental health risk compared to those with diabetes alone. Yet despite this elevated risk, men remain significantly less likely to be diagnosed with a mental health condition.
This gap suggests that targeted mental health interventions and proactive screening protocols at the point of chronic disease diagnosis could help identify and support at-risk male patients who might otherwise go undetected.
Understanding the data's scope
It’s important to understand what this dataset reveals and what it may conceal. Our analysis is based solely on medical aid claims, meaning it reflects patients with healthcare coverage who are accessing formal medical services.
The incidence among the broader South African population, particularly those paying out of pocket or not accessing care at all, is likely to be far more severe.
We're also analysing data from various medical specialties, not just general practitioners.
This means the pattern we're seeing isn't confined to primary care settings; it's systemic across the healthcare spectrum.
Finally, our dataset likely includes patients who may have had chronic or mental health issues diagnosed before January 2022. Despite this, the 68% post-diagnosis pattern, the 24% greater risk for males and the 40% within-one-year finding remain stark indicators of a crisis unfolding in real-time across South African medical practices.
The local context
South Africa's context is particularly urgent. We face some of the highest chronic disease burdens on the continent, with approximately 8.22 million (30.8%) South African adults with no private health insurance living with hypertension, and around 4.2 million people have diabetes, translating to one in nine adults.
In 2024, research at semi-rural South African clinics found that among patients with hypertension and/or diabetes, 32% experienced depression, 40% had panic disorder and 33% showed signs of PTSD.
Despite these alarming statistics, depression and anxiety disorders among patients with hypertension and diabetes remain poorly detected, especially at the primary healthcare level.
The consequences extend far beyond individual suffering. When depression and anxiety coexist with chronic conditions, treatment adherence plummets, quality of life deteriorates and mortality risk increases.
The relationship between chronic physical illness and mental health operates through multiple pathways: the psychological shock of diagnosis, the daily burden of self-care and medication adherence, medication side effects that impact mood and the biological mechanisms of chronic disease that directly affect brain chemistry.
For patients, these pathways converge into a single reality: managing a chronic condition is mentally and emotionally exhausting. And our data shows that for 40% of patients, this toll manifests as a diagnosable mental health condition within the first year.
The critical 12-month window
Our data shows that the first 12 months after a diabetes or hypertension diagnosis are a critical window for intervention – one that should fundamentally change how we approach chronic disease management.
Our findings suggest that a chronic lifestyle disease diagnosis acts as a significant trigger or accelerant for mental health issues. This isn't a vague correlation; it's a predictable pattern occurring across nearly a quarter of a million patients.
What if every hypertension or diabetes diagnosis automatically triggered a mental health screening protocol? What if practice management systems flagged these patients for routine psychological check-ins at three, six, nine and 12 months post-diagnosis, just as they flag them for HbA1c tests or blood pressure monitoring?
From silos to integration
Movember reminds us that men’s mental health deserves attention, and with the right support, patients living with chronic illnesses can lead healthier, more balanced lives.
However, while integrated care models could dramatically improve outcomes, the gap between recognising this need and actually implementing it often comes down to practicality. Manual screening processes add significant administrative burden to already overstretched healthcare teams.
This is where our cloud-based EMR solution makes integrated care achievable. The system has integrated validated mental health screening tools directly into the clinical workflow, including the GAD-7 (Generalised Anxiety Disorder-7) and PHQ-9 (Patient Health Questionnaire-9), two of the most widely used and clinically validated screening instruments globally.
The system automatically calculates scores and displays them with immediate clinical interpretation. For example, a GAD-7 score of 21 instantly flags as "moderate to severe anxiety", while a PHQ-9 score of 26 indicates "severe depression", with no manual calculation required.
The system uses AI to review a patient’s full medical history and automatically insert relevant screening scores into clinical notes, referral letters or specialist care requests. Doctors no longer need to remember scores or open separate documents during consultations.
This isn’t about replacing clinical judgment; it’s about removing administrative barriers that can prevent consistent, high-quality care.
When screening becomes this seamless, it becomes sustainable. When it's sustainable, it becomes routine. And when it's routine, we start closing that detection gap that's leaving our chronic disease patients struggling silently with mental health conditions.
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