LUNCEDO MTWENTWE: Entrepreneurs: take care of your mental health

Every October, the world pauses for Mental Health Awareness Day, but for South Africa’s entrepreneurs and small business owners, mental health issues are a daily reality and too often swept under the rug in the name of ambition.

This past week, private hospital group Netcare reported a sharp rise in demand for mental health care in South Africa, a trend echoed by medical aid and insurance claims.

Globally, it is reported that 72% of entrepreneurs experience mental health challenges, with burnout, depression and anxiety the most common conditions. Research by Prof Michael Freeman shows that entrepreneurs are twice as likely to suffer from depression, require psychiatric hospitalisation or experience suicidal thoughts.

South Africa, much like the rest of the world, has normalised a hustle culture that glorifies overwork. If you are not grinding 17 hours a day, sleeping on the office couch and sacrificing your wellbeing, you don’t deserve success. This narrative may sound inspiring in glossy start-up biographies, but for most SMEs it is toxic and unsustainable.

Running a small business is already a high-pressure environment. In South Africa, entrepreneurs struggle to access capital and battle with rising operating costs, red tape and economic uncertainty. Add something else to the mix, like the hustle culture, and you create a perfect storm for burnout, which is not a badge of honour but a damaging business risk. Exhaustion dulls decision-making, stifles creativity, and erodes resilience, the qualities entrepreneurs need most.

In most cases, the consequences extend beyond the founder. Leaders set the tone for the team and if the entrepreneur is running on fumes, employees quickly follow, which has a measurable cost.

According to the World Health Organisation, depression and anxiety disorders cost the global economy roughly $1-trillion (about R17-trillion) annually in lost productivity. Locally, the South African Depression and Anxiety Group has reported a sharp rise in work-related stress and anxiety, particularly after the pandemic.

Yet we continue to promote entrepreneurship, especially to the youth, without equipping them with the skills and mindset necessary to navigate the realities of business. What appears glamorous on the surface is often gruelling in practice. Business education and coaching are key to strengthening both the entrepreneurial journey and self-awareness. Mentorship and guidance, as well as learning from those who have weathered the ups and downs, are critical to helping founders avoid costly mistakes.

I ask myself, why does this matter for South Africa’s economic agenda?

Simply put, SMEs are the backbone of our economy. They contribute roughly 40% of GDP and provide 60% of employment. When SMEs falter, many jobs are lost and communities suffer. When entrepreneurs collapse from burnout, entire enterprises can come tumbling down.

Most small businesses don’t have the luxury of HR departments or corporate wellness programmes. That makes it even more urgent for SME leaders to consciously foster healthier cultures. Success should not be measured by hours worked but by sustainable outcomes. Normalising rest, setting boundaries and creating space for balance are not signs of weakness. They are investments in survival.

Supporting an entrepreneur’s mental health isn’t a roadblock to growth, it’s what makes that growth last. When entrepreneurs are resilient and well-balanced, they’re better equipped to lead with a clear vision, innovate, and stay focused on their goals.

There are practical steps SMEs can adopt, even on limited budgets. Founders can join peer support groups to share the load of leadership and learn from others’ experiences. Business incubators and funders can integrate mental health resources alongside financial support. Leaders can model healthy behaviour by respecting time off and encouraging employees to do the same. Mindfulness practices have helped countless entrepreneurs stay centred, with even Steve Jobs dedicating time to daily meditation.

Mental health is a pillar of resilience, innovation, and productivity. If South Africa is serious about building a strong SME sector, we must dismantle the myth that success comes only through relentless grind. We need to teach entrepreneurs that prioritising wellbeing is not optional but a strategic decision that protects the business, its employees and the communities it serves.

Let us challenge the narrative. Our entrepreneurs deserve more than survival. They deserve to thrive. As Steve Jobs said: "The people who are crazy enough to think they can change the world are the ones who do."

• Mtwentwe AGA (SA) is MD of Vantage Advisory and host of the SAICABIZ Impact Podcast