In the evolving landscape of South African workplaces, a groundbreaking study from the University of Johannesburg has shed light on the persistent challenges to mental health equity. Titled "Advancing Workplace Mental Health Equity in Post-Apartheid South Africa: An Intersectional Mixed-Methods Study," this research by Anurag Shekhar and Musawenkosi D. Saurombe explores how intersecting social factors like race, gender, income, and generation influence employee well-being. Published in Frontiers in Public Health on May 11, 2026, the study highlights that while higher income generally correlates with better mental health outcomes, cultural and historical burdens such as "Black tax" and gendered caregiving responsibilities often undermine these benefits.
The research was conducted in a Johannesburg-based healthcare organization, reflecting broader trends in South Africa's diverse professional environments. With mental health issues costing the economy an estimated R232 billion annually in lost productivity, this work underscores the urgency for targeted interventions in workplaces, including universities where academic staff face similar pressures.
Post-Apartheid Legacy: Roots of Workplace Mental Health Disparities
South Africa's transition from apartheid in 1994 marked a pivotal shift toward democracy, yet the legacy of systemic inequality endures. Apartheid policies segregated access to education, employment, and healthcare, creating generational wealth gaps that persist today. Race remains a key driver of inequality, explaining 41% of disparities, with historically disadvantaged groups experiencing higher rates of mental ill-health.
In workplaces, this manifests as unequal distribution of psychological resources. For instance, "Black tax"—the cultural expectation for Black professionals to financially support extended family networks—stems directly from apartheid-era exclusion, where families pooled limited resources for survival. Today, even salaried employees grapple with hand-to-mouth living due to these obligations, eroding the protective effects of income on mental well-being. Statistics reveal that about 13% of South African employees have diagnosed mental health conditions, with over a third reporting excessive daily stress, exacerbated by these structural factors.
Universities, as microcosms of society, mirror these challenges. Academic staff at institutions like the University of Johannesburg navigate high workloads amid transformation pressures, where mental health support often lags behind equity goals outlined in the Employment Equity Act.
The UJ Research Methodology: A Mixed-Methods Approach
Shekhar and Saurombe employed an explanatory sequential mixed-methods design, combining quantitative surveys with qualitative insights for a nuanced view. The quantitative phase involved 87 employees assessing mental well-being via the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), perceived stress (Perceived Stress Scale-4, PSS-4), work engagement (Utrecht Work Engagement Scale-3, UWES-3), life satisfaction (Satisfaction with Life Scale, SWLS), and flourishing.
Demographics included gender, race (Black, White, Mixed ancestry, Indian/Asian), generation, income, and education. Non-parametric tests like Mann-Whitney U and Kruskal-Wallis revealed significant predictors. Qualitatively, a focus group of 9 participants and 10 semi-structured interviews, analyzed via reflexive thematic analysis, explained these patterns. Integration used the novel Intersectional Social Determinants Model of Workplace Well-Being, spanning macro (historical norms), meso (intersectional positions), and micro (job demands/resources) levels.
Quantitative Insights: Gender and Income as Key Predictors
Analysis showed gender significantly predicted mental well-being, with women scoring lower (p=0.015, effect size r=0.261). Income emerged as the strongest factor, positively linked to well-being (p=0.033), life satisfaction (p=0.011), and inversely to stress (p<0.001, ε²=0.163). Higher earners reported better outcomes across measures.
Surprisingly, race and generation had no main effects (all p>0.175), suggesting disparities operate through intersections rather than isolated categories. These findings challenge assumptions of uniform resource benefits, aligning with South Africa's high depression rates (25-27%) and workplace distress (35.8% of population).
Intersectional Mechanisms: Unpacking Qualitative Themes
Four themes illuminated quantitative patterns:
- Gendered unpaid labour: Women bear a "second shift" of caregiving, reducing recovery time and well-being, especially Black and Mixed ancestry women balancing professional roles with traditional expectations.
- Black tax: Financial support for kin overrides income gains, creating chronic strain. One participant noted, "We have the Black tax to pay... This can be so draining and hand-to-mouth."
- Masculine norms: Men suppress emotions to appear "tough," masking distress: "It is very difficult to talk about our mental health... Otherwise, we are labelled as weak."
- Racial intersections: Race amplifies other burdens, like kin obligations for Black employees.
The study integrates these into a model showing how apartheid legacies mediate well-being.
Photo by Artem Beliaikin on Unsplash
Black Tax: A Cultural Barrier to Mental Health Equity
"Black tax" exemplifies how post-apartheid inequities persist. Rooted in ubuntu—community interdependence—it requires professionals to subsidize unemployed relatives, perpetuating poverty cycles. Despite Employment Equity Act progress, this redistributes income, nullifying its protective role. The study finds higher-income Black employees still face elevated stress, urging financial wellness programs like emergency funds and counseling.Read the full UJ study.
In universities, where diverse staff manage research grants amid personal obligations, such interventions could enhance retention and productivity.
Gendered Caregiving and Women's Well-Being Challenges
Women, comprising half the workforce, report lower mental well-being due to unpaid domestic loads. Intersectionally, Black women face compounded strain from racialized poverty. The study recommends flexible hours, subsidized childcare, and caregiver leave—policies aligning with South Africa's family responsibilities push.
Higher education institutions could lead by auditing workloads and promoting gender-equitable support, fostering inclusive academic environments.
Masculine Norms: The Hidden Toll on Men
Men underreport distress due to norms demanding stoicism, particularly in racialized contexts. This delays help-seeking, risking burnout. Interventions like anonymous Employee Assistance Programs (EAPs) and male peer networks are vital. Universities, with their counseling resources, can model vulnerability through leadership training.
Implications for South African Universities and Workplaces
As knowledge hubs, SA universities like UJ are pivotal in addressing mental health equity. The study reveals academic workplaces vulnerable to similar intersections—faculty balancing publishing pressures with family duties. Broader implications include policy alignment with the National Mental Health Policy Framework, emphasizing disaggregated equity audits.
With 37% of men and rising rates showing mental health risks, proactive strategies prevent productivity losses.
Actionable Solutions: Culturally Responsive Interventions
- Workload redistribution and autonomy grants.
- Cultural competency training on Black tax and norms.
- Equity-focused EAPs with financial/ caregiving support.
- Leadership modeling for emotional openness.
Piloting these in universities could yield scalable models, enhancing staff flourishing amid SA's 30% mental disorder prevalence.
Photo by EqualStock on Unsplash
Future Outlook: Scaling Equity in Post-Apartheid Workplaces
This UJ study sets a foundation for larger trials, urging longitudinal research on intervention efficacy. As SA grapples with youth unemployment (55%) and economic pressures, integrating intersectionality into Occupational Health and Safety Act compliance is essential. Collaborative efforts between unis, government, and corporates promise transformative change.
For higher education, prioritizing mental health equity bolsters research output and talent retention, positioning SA as a leader in African well-being innovation.South African Depression and Anxiety Group resources.