Exploring the perceptions of mental health among young black isiXhosa-speaking people living in Nelson Mandela Bay

Abstract

Background: The presence of mental disorders during earlier years of life is a strong predictor for mental health problems in adulthood. Despite the multiple risk factors that can precipitate the onset of a mental disorder in young people, only 37.2% of young people who report depressive symptoms seek treatment. Black youth are at severe risk of mental illness because of their compounded risk factors. Health-seeking behaviour is influenced by awareness of mental health services and perceptions and beliefs regarding mental health. Aim: This study explored the perceptions, beliefs and attitudes of young Black isiXhosa-speaking people living in Nelson Mandela Bay toward mental health and illness, and examined how these perceptions, along with awareness of existing mental health services, influence help-seeking behaviour. Methodology: A descriptive qualitative design was employed. Data were collected through twenty (20) semi-structured individual interviews, two (2) focus group discussions, and one key informant interview, using purposive and snowball sampling. Participants were isiXhosa-speaking youth aged 18–34 years residing in Nelson Mandela Bay. Data were analysed manually using thematic coding analysis, guided by the Health Belief Model to interpret perceived susceptibility, barriers and benefits related to mental health and help-seeking. Ethical standards were maintained throughout the research process and ethical approval was received through the University of the Western Cape Biomedical Research Ethics Committee (BM24/10/10). Results: Four key themes emerged: (1) youth’s understanding of mental health and illness; (2) beliefs and attitudes towards mental health and illness (3) participants’ personal experiences with mental health issues; and (4) social and structural influences on mental health. Spiritual frameworks of understanding mental health and illness often took precedence over biomedical ones. Stigma, limited literacy and resource barriers reduced help-seeking, although participants expressed willingness to seek care when services were accessible and culturally sensitive. Perceptions of mental health among isiXhosa-speaking youth are deeply shaped by sociocultural and economic contexts. Conclusion: Efforts to strengthen youth mental health must integrate culturally responsive, faith-inclusive and community-based approaches that promote literacy, accessibility and trust in care.