Mental health is no longer on the sidelines of healthcare. It is becoming one of the factors determining whether people with cancer, diabetes, cardiovascular disease, and other chronic conditions stay healthy.
The numbers behind Discovery Health’s HealthTrend26 report make a compelling case. Drawing on more than 30 million life years of data from Discovery Health Medical Scheme’s 2.7 million members between 2015 and 2025, the report analyses more than 570 million healthcare interactions, 7.5 million hospital admissions, and nearly 28 million hospital days.
The report suggests that mental health is increasingly shaping healthcare outcomes across the system. When mental health conditions are combined with chronic illnesses, healthcare costs rise sharply, hospital admissions increase, and treatment becomes more complex.
The findings were presented by Discovery Health chief executive Dr Ronald Whelan at the launch of the report. The presentation was followed by a panel discussion featuring Discovery Health chief clinical officer Dr Noluthando Nematswerani, cardiologist Dr Dave Jankelow, and medical oncologist Dr Keorapetse Tabane, who explored what the data may mean for healthcare outcomes in practice.
At the same time, Discovery’s findings challenge some common assumptions about mental health.
Although diagnosed mental-health conditions among young adults have increased by 80% over the past decade, hospital admissions have declined, suggesting that more people are seeking help and receiving treatment before reaching crisis point.
More people are coming forward
The most visible trend in the report is the growth in diagnosed mental health conditions among younger members.
Discovery found that mental health prevalence among members aged 20 to 30 increased by 80% over the past decade, representing almost 19 000 additional young members living with a diagnosed mental-health condition. Approximately one in seven members in that age group now has a diagnosed condition.
Depression remains the dominant diagnosis, accounting for 63% of mental-health claimants, often linked to anxiety.
The data also reveals notable differences between demographic groups.
Women have a 1.5-times higher prevalence of diagnosed mental-health conditions than men, with 17% of female members now living with a mental health condition.
Members on single policies also show higher rates of diagnosis than those on family policies. Discovery found that about 17% of members living alone have a diagnosed mental health condition.
Discovery executives cautioned against interpreting the increase in prevalence as evidence that South Africans are simply becoming less healthy.
Nematswerani said part of the increase reflects greater awareness, better recognition of symptoms, and a growing willingness to seek help.
The growth in psychologist utilisation appears to support that view. Between 2008 and 2025, the number of psychologists covered by Discovery Health Medical Scheme increased by 125%, giving members significantly greater access to mental health services.
Nematswerani said the challenge is no longer only identifying mental health conditions but ensuring that people receive support before those conditions become severe.
Why admissions are falling
One of the most surprising findings in the report is that hospital admissions for mental health conditions have moved in the opposite direction to prevalence.
While more people are being diagnosed, admission rates for mental health conditions have declined by about 11% over the past decade.
Discovery believes this reflects earlier intervention and better management.
Whelan said the data suggests that many of the additional diagnoses being made today are milder or moderate conditions that are being identified and treated before they escalate to the point of requiring hospitalisation.
Nematswerani said mental healthcare is increasingly shifting away from crisis intervention towards ongoing support and management.
Rather than waiting until members require hospital admission, healthcare providers are focusing on earlier diagnosis, counselling, psychological support, and preventive interventions.
Discovery has also invested in predictive models that identify members at risk of depression, allowing earlier intervention before serious deterioration occurs.
The result appears to be a healthcare system that is becoming better at identifying mental health challenges before they become psychiatric emergencies.
Mental health changes everything
One of the report’s most significant findings is the extent to which mental health influences outcomes across the rest of the healthcare system.
Discovery’s data suggests that mental health acts as a multiplier when combined with other chronic illnesses.
Members living with a chronic condition but no mental health diagnosis incur healthcare costs that are about 2.5 times higher than healthy members. When a mental-health condition is added, those costs rise to 3.8 times higher.
A similar pattern appears in hospital admissions.
Members with chronic illnesses have a hospitalisation risk that is 2.1 times higher than healthy members. Add a mental health condition and the risk increases to 3.5 times higher.
The findings suggest that mental health influences far more than emotional well-being. It increasingly affects whether patients manage chronic conditions effectively, adhere to treatment plans, and avoid serious complications. That helps to explain why mental health has become a growing focus for medical schemes and healthcare providers.
The hidden link with heart disease and cancer
Jankelow said cardiovascular specialists are increasingly aware of the impact mental health can have on recovery and long-term outcomes.
“We don’t want people with heart disease to be depressed; they have a worse outcome,” he said.
He explained that heart attacks, cardiac procedures, and major cardiovascular diagnoses often leave patients feeling vulnerable and fearful. Those emotional responses can influence recovery, treatment adherence, and willingness to participate in rehabilitation programmes.
The HealthTrend26 report found that members with cardiovascular disease and a co-existing mental-health condition incur approximately 50% higher healthcare costs than cardiovascular patients without mental-health conditions.
Tabane highlighted a similar challenge in cancer care.
She cautioned against viewing every emotional response to cancer as a psychiatric illness.
“The issues surrounding grief, loss of health, uncertainty are normal human emotions. They are not pathological emotions,” she said.
Even so, she argued that cancer care increasingly requires psychological support because patients often struggle with fear, uncertainty, and the emotional impact of living with a serious diagnosis.
Both specialists pointed to the same conclusion: outcomes are shaped not only by the disease itself, but also by how patients cope with it emotionally.
A different approach to healthcare
Discovery believes these findings point towards a more integrated healthcare model.
The report argues that healthcare increasingly needs to recognise the overlap between conditions rather than treating them in isolation.
The report found that 30% of members with mental health conditions have at least one additional chronic condition. Nearly half of members with cardiovascular disease have another chronic illness, while 92% of members with diabetes live with at least one additional chronic condition.
These overlaps are becoming more common as people live longer and survive diseases that were once fatal.
Discovery’s response includes programmes such as Personal Health Pathways, predictive risk models, and personalised interventions aimed at identifying health risks earlier and supporting members before conditions become severe.
For Nematswerani, one of the biggest concerns remains the impact on younger adults.
Referring to the sharp increase in diagnoses among members aged 20 to 30, she noted that these individuals represent the country’s future workforce, leaders, and decision-makers.
The HealthTrend26 findings suggest that mental health can no longer be viewed as a standalone healthcare issue. It increasingly shapes outcomes across the healthcare system, influencing everything from chronic-disease management to hospital admissions and treatment costs.
For doctors, medical schemes, and patients alike, the challenge is recognising that mental well-being and physical health are far more closely connected than previously understood.
