Improving mental health through sport in Africa

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Mental health encompasses the overall well-being, the prevention of mental disorders, and the treatment and rehabilitation of people with mental health issues. While the positive impact of sport on physical health is well established, physical activity-based interventions to promote mental health and well-being are becoming more common.

Mental health, the overlooked aspect of public health in Africa

Most African countries have one psychiatrist for every 500,000 people, and less than 10% of the continent’s population has access to mental health care. However, 10% of the African population is affected by a mental disorder. In areas that have been marred by conflict, the prevalence of mental health issues is increased, with one in five people suffering from mental disorders like depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia (UN News, 2020). Additionally, other issues such as forced displacement, poverty, communicable diseases and malnutrition have had a negative impact on mental health in the continent.

While it is up to each country to formulate a mental health policy based on its own realities, the WHO advocates for the integration of a mental health component into primary health care. This could be an essential lever for the implementation of a management strategy to treat mental disorders in a continent “divided between tradition and modernity and in the grip of political, social and cultural changes” (Mbodie N’Guimfack, 2001, p. 466).

Promoting mental health through physical activity

Recent epidemiological studies attest to the growing interest in physical activity for mental health promotion and prevention of common mental disorders (INSPQ, 2015, p.2). Mental health promotion is about maximising and protecting the well-being of an entire population, addressing individual, social or structural conditions. Prevention focuses on reducing risk factors associated with mental health issues among groups deemed vulnerable.

Physical activity would, thus, act on three main mechanisms:

• Biological mechanisms, by stimulating monoamines and endorphins secretions, known for their antidepressant, analgesic and de-stressing effects;
• Psychological factors, by enhancing self-esteem and the feeling of self-efficacy;
• Social mechanisms, by reinforcing social integration and the sense of belonging, notably through sport and play activities practiced in groups.

Several African countries have recently developed mental health strategies. While the potential of sport is not mentioned, some civil society organisations are focusing on physical activity to improve mental health. For example, Sport for Us, through its Sport Party initiative, promotes the inclusion of disadvantaged populations in Cameroon and uses sport to combat idleness and psychoactive substances abuse. Fight for Dignity offers a karate program specifically adapted to the physical, psychological and social condition of women survivors of sexual violence in the Congo. In partnership with the Panzi Foundation, this sports program contributes to their reintegration into society.

Sport and mental health: From resilience to empowerment

From 2012 to 2016, the Swiss Academy for Development (SAD) and Community Psychosocial Support Organisation (CPSO) ran the Women on the Move program, aimed at the psychosocial rehabilitation of displaced women victims of the civil war in South Sudan. By participating in adapted sports and recreational activities, participants were able to overcome their anxieties, restore their self-confidence and share their experiences in a safe environment. Outside the playground, they received trauma therapy and were able to address issues resulting from war, such as alcoholism and domestic violence.

Since 2009, Waves for Change has been running an evidence-based surf therapy programme for South African youth from disadvantaged backgrounds who are more likely to experience traumatic events (witnessing or experiencing violence and poverty). The program aims to address their psychological, developmental and wellness needs, prevent risky behaviours and address the lack of access to mental health care. Weekly surf therapy sessions connect youth with caring adults, help them build a positive self-image, and offer respite from the stress caused by the adversity they experience daily.

Based on physical activity, these programs contribute to improve the overall health of their beneficiaries and strengthen their resilience, thus working to empower them. As the COVID-19 pandemic increases the demand for mental health services, in Africa as elsewhere, sport represents a low-cost, universal means of promoting physical and mental health, and by extension, human development.