Heritage Day 2025

As South Africans we celebrate the rich tapestry of cultures, traditions, and histories that unite us as one nation. On this HeritageDay, we honour our shared identity and the diverse roots that shape our collective story.

We wish all our members a meaningful Heritage Day filled with pride and togetherness.

Memories enable us to relive the past and preserve special moments that play a defining role in who we are. Every year we commemorate those who live with Alzheimer’s disease and other forms of dementia. The world honors World Alzheimer’s Day.

World Alzheimer’s Day is an opportunity to celebrate loved ones who live with Alzheimer’s disease but it is also an opportunity to:

• create awareness
• initiate research and collaboration for early detection and improved treatment
• highlight the value of support and
• honor the caretakes, healthcare staff and professionals, researchers and family members who care for their loved ones

You can make a difference:

• Volunteer
• Donate
• Educate yourself and others
• Support

Read more about World Alzheimer’s Day and Alzheimer’s:

• Alzheimer’s disease – Old friends and new promises: https://www.up.ac.za/research-matters/news/post_2995717-alzheimers-disease-old-friends-and-new-promises
• Alzheimer’s Association: https://www.alz.org/about/awareness-initiatives/world-alzheimers-day
• Mahomed A, Pretorius C. Availability and utilization of support services for South African male caregivers of people with Alzheimer’s disease in low-income communities. Dementia. 2020;20(2):633-652. doi:10.1177/1471301220909281
• Manderson L, Brear M, Rusere F, Farrell M, Gómez-Olivé FX, Berkman L, Kahn K, Harling G. Protocol: the complexity of informal caregiving for Alzheimer’s disease and related dementias in rural South Africa. Wellcome Open Res. 2022 Aug 25;7:220. doi: 10.12688/wellcomeopenres.18078.1. PMID: 37538406; PMCID: PMC10394391.
• orczyn, A.D., Grinberg, L.T. Is Alzheimer disease a disease?. Nat Rev Neurol 20, 245–251 (2024). https://doi.org/10.1038/s41582-024-00940-4

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition with a course that often extends beyond childhood. Prevalence estimates suggest that 2–16% of children meet criteria for ADHD (Boshomane, Pillay, & Meyer, 2020; Botha & Schoeman, 2023). In adulthood, rates decline to 2.5–4.2% (Schoeman & Leibenberg, 2017), yet research shows that 60–70% of children diagnosed with ADHD continue to experience symptoms into adulthood (Belanger et al., 2018). This continuity highlights the importance of recognising ADHD as a lifespan condition. For practitioners, an accurate and nuanced understanding of how ADHD evolves is critical for supporting children, adolescents, and adults alike.

Challenges in Diagnosis

Prevalence estimates vary widely due to differences in methodology, assessment tools, and practitioner expertise. Overdiagnosis in children, underdiagnosis in adults, and limited training in ADHD assessment contribute to these discrepancies (Schellack & Meyer, 2016). Given the impact of an ADHD diagnosis on an individual and their family, assessment should not be made hastily. A holistic approach, integrating developmental history, collateral information, and careful differential diagnosis, is essential before assigning the ADHD label.

ADHD Across Development: Children and Adults

ADHD is not static; its presentation changes with age. Symptoms that are visible and behavioural in children may become more internalised and functional in adults. The DSM-5-TR accommodates these shifts by adjusting diagnostic thresholds and providing developmentally relevant examples.

Increasing Demands, Decreasing Supports

Children often benefit from external structure, parental oversight, and consistent school routines. Transitioning into adulthood, however, brings greater demands—academic, occupational, financial, and relational—alongside a decrease in support. For individuals with ADHD, this can create a “perfect storm” where difficulties become more pronounced.

Opportunities in Adulthood

Despite these challenges, adulthood offers new possibilities for adaptive functioning. Adults can select environments that align with their strengths—roles that value creativity, movement, or rapid problem-solving. They may also develop personalised strategies, such as flexible scheduling, seeking supportive relationships, or outsourcing tasks that are consistently challenging (e.g., administrative tasks).

Areas of Vulnerability

Across the lifespan, ADHD is associated with a higher risk of impairment compared to the general population. In adulthood, consequences often become more significant and wide-ranging:

• Social: Interpersonal conflict, higher rates of separation and divorce.
• Emotional: Stress reactivity, emotional dysregulation, co-occurring depression, anxiety, and substance use disorders.
• Behavioural: Risk-taking, earlier initiation of substance use, higher relapse rates.
• Legal: Increased traffic offences, arrests, and recidivism.
• Academic/Occupational: Lower academic attainment, higher dropout rates, inconsistent employment, and negative performance reviews.
• Financial/Health: Lower lifetime earnings, impulse spending, increased rates of obesity, sleep disturbance, chronic illness, and a reduced life expectancy (by an estimated 9–10 years).

Best Practice in Diagnosis

A robust ADHD assessment should include:

1. Comprehensive History: Clinical interview, developmental history, and input from multiple informants.
2. Differential Diagnosis: Ruling out conditions that can mimic ADHD, including sleep deficits, vision problems, nutritional issues, epilepsy, trauma, anxiety, depression, or learning disorders.
3. Application of DSM-5-TR Criteria: Symptoms must be persistent, developmentally inappropriate, present in multiple settings, and impairing.
4. Consideration of Trauma: Adverse childhood experiences and traumatic stress can exacerbate or resemble ADHD symptoms. Careful screening is essential.

Managing ADHD: A Multimodal Approach

Treatment planning should be holistic and individualised, often combining:

• Medication: Stimulants and non-stimulants remain first-line pharmacological options. Regular monitoring for side effects and interactions is essential.
• Psychological Interventions: Cognitive behavioural therapy, psychoeducation, and skills training to address emotional regulation, planning, and interpersonal functioning.
• Environmental Supports: Classroom accommodations for children, workplace adaptations for adults, and structured routines across the lifespan.
• Lifestyle Factors: Adequate sleep, balanced nutrition, hydration, and physical activity significantly influence symptom management.
• Support Systems: Parents, teachers, therapists, mentors, and support groups can all play a vital role in scaffolding functioning.

Reframing ADHD

While ADHD presents challenges, it is equally important to acknowledge its strengths. Creativity, innovation, high energy, and unique problem-solving skills are common among individuals with ADHD. By moving beyond a deficit-focused perspective, practitioners can help clients harness these strengths while managing difficulties, thereby fostering resilience and self-efficacy.

ADHD does not simply “end” with childhood. It is a lifelong condition that evolves across developmental stages. For registered counsellors, psychometrists, and other health practitioners, recognising these changes is vital for effective screening, supportive intervention, and timely referral for diagnosis and treatment by psychologists or psychiatrists. By combining early identification, holistic support, and a strengths-based approach, practitioners can play a critical role in empowering individuals with ADHD to move beyond survival and toward thriving.

On a warm afternoon in Lehurutshe, Zeerust, a young boy named Thabo sat under a marula tree, rhythmically tapping a stick against the soil. At the same time, his teacher grew increasingly frustrated at his “restlessness.” Thabo’s inability to “sit still” or follow long instructions was quickly labelled as defiance, poor discipline, or even laziness by many around him. Yet, what Thabo was living with was not a character flaw; it was Attention Deficit Hyperactivity Disorder (ADHD).

Thabo’s story is not unique. Across our towns, villages, and cities, countless children and adults live with ADHD, often misunderstood and mischaracterised in ways that deepen stigma and silence. This is why National ADHD Awareness Day on 14 September 2025, commemorated under the theme Sea of Yellow for ADHD Awareness, is not only a call to wear colour, but also a call to open our eyes, to see ADHD through lenses that make sense in our South African realities.

DECOLONISING OUR UNDERSTANDING OF ADHD

When we speak about decolonising ADHD, we should not dismiss or reject the valuable knowledge that global research has provided. Instead, it ensures that our understanding of ADHD resonates with people’s lived experiences, languages, and cultural frameworks.

In many communities, behavioural signs of ADHD are easily interpreted through moral, spiritual, or disciplinary lenses. A child is “naughty,” “bewitched,” or “undisciplined,” rather than neurodivergent. These cultural meanings matter because they shape how families seek help or whether they seek help at all. Decolonising ADHD means situating the condition in our own socio-cultural realities, making space for multiple ways of knowing, while also ensuring evidence-based psychological care is accessible.

ADHD does not occur in isolation. In South Africa, its impact is magnified by intersecting realities of poverty, overcrowded classrooms, and limited access to healthcare. For children like Thabo, ADHD is often compounded by hunger, trauma, or unsafe environments.

Our teachers are often the first to notice signs, but individualised support becomes near impossible with class sizes of 45 to 70 learners. Many families rely on traditional explanations of behaviour, while medical and psychological resources remain concentrated in urban centres. Raising awareness is not enough; we need to translate awareness into contextually appropriate, culturally sensitive, and socially just support systems.

As psychologists, our role is twofold:

1. Early Intervention: Advocating for accessible assessments and interventions that can be delivered not just in urban clinics, but in community-based and school-based settings.
2. Public Awareness: Engaging in public education that reduces stigma, communicates in all official languages, and affirms that ADHD is not a moral failing but a neurodevelopmental difference.

In this light, we invite our colleagues to reflect on psychology’s role in supporting individuals and families affected by ADHD, to advocate for early intervention, and to advance public awareness and care strategies. We collectively highlight PsySSA’s commitment to human rights, dignity, and social justice.

WAY FORWARD

On this National ADHD Awareness Day, let us wear yellow not only as a symbol of solidarity but also as a pledge: to listen more carefully, contextualise more deeply, and act boldly. Thabo and the many children and adults like him deserve to grow up in a society that understands them on their own terms, in their own contexts, with dignity and hope.

Together, as psychologists, educators, parents, and community members, we can ensure that ADHD is not a hidden struggle but a recognised difference that calls for compassion, understanding, and care.

Dr Momi Kemoneilwe  Metsing
Chairperson: Society for Educational Psychology of South Africa (SEPSA)

“When one voice is silenced, a whole community loses its song,” Archbishop Desmond Tutu.

This article is intended to contribute towards 2025 World Suicide Prevention initiatives, which aim to raise awareness and provide support to members of our diverse communities. It is intentionally written in plain language, in an attempt to make knowledge more accessible.  Our call to action is that readers share and discuss with those within their care. We all have a role to play in building safe spaces.

Feel free to discuss with your trusted healthcare professional if you notice any of the risk factors listed, to seek help for yourself or loved ones. We have also shared a few contact details of some of the toll-free call centers where you may get help, in the event that you find yourself in a dark place, wanting to end your suffering by taking your life or harming yourself or others.

Authors: South African Society of Clinical Psychology (SASCP), a Division of PsySSA.

Access to Care Sub-Committee Contributors: Bridgette Dlanjwa, Mariam Salie, Thabang Tlaka, Barry Viljoen and Kgomotso Sekhute

About World Suicide Prevention (2024-2026)

The theme for World Suicide Prevention for 2024-2026 is “Changing the narrative on suicide”. (Source: World Suicide Prevention Day 2025).

With the rising levels of suicide attempts and suicides among our youth and young adults and adults, we believe it is critical to put heads together and share knowledge with our communities, as broadly as possible.

What do we know about risk factors that may lead to suicide?

Suicide does not emerge from a single cause. Rather, it reflects a complex interplay of psychological, social, and environmental vulnerabilities that, when left unaddressed, can overwhelm an individual’s ability to cope.

1. Unresolved trauma and violence are often at the heart of deep psychological pain. Survivors of childhood abuse, gender-based violence, or ongoing traumatic experiences may struggle with psychological conditions such as Post-traumatic stress disorder (PTSD), which in turn may heighten vulnerability to suicidal thoughts (Richardson, 2024).
2. Similarly, the experience of loss, whether of a loved one, employment, health, or even a sense of dignity, can disrupt one’s sense of stability and belonging, leaving individuals feeling adrift and hopeless (WHO, 2023).
3. Experiencing bullying can become an unbearable burden for the majority of people. Whether it happens in classrooms, on playgrounds, in the workplace, or in digital spaces through cyberbullying. The shame and isolation may erode self-worth and increase suicidal risk.
4. Mental health conditions, such as recurrent depressive episodes and other mood conditions (e.g. bipolar disorder, which in simple language, is associated with fluctuations in moods), are well-established risk factors (Carballo et al, 2020). These conditions, when left untreated or misunderstood, may deepen feelings of despair and disconnection.
5. Socio-economic challenges such as unemployment, poverty, or the inability to provide for one’s family weigh heavily in the South African context, where financial stress is a daily reality for many. This burden of responsibility may result in feelings of worthlessness and helplessness, which may perpetuate suicidal thoughts.
6. Loneliness and isolation also carry profound risk. It is not only about being alone, but about feeling unseen or disconnected, even in the presence of others. Deep isolation may cause a person to believe their pain is invisible or that their lives do not matter (McCallum, 2022).
7. The absence of psycho-social support and limited access to primary mental healthcare services, particularly in rural areas, means that many who struggle silently are unable to receive professional help (Canbaz & Terzi, 2018).
8. Substance use further complicates the picture. Substances have the ability to cloud judgment, lower inhibitions, and even induce psychosis in some cases, which dramatically increases the risk of impulsive suicide attempts (Carballo et al, 2020).
9. Chronic medical conditions, such as debilitating pain or illness that negatively impacts one’s quality of life, also place individuals at higher risk, particularly when one believes they are a burden to others (WHO, 2023).

Understanding these risks is not about creating fear, but rather about equipping us all with the knowledge to respond differently. If we notice these warning signs in ourselves or in others, the most powerful first step is to reach out to a trusted family member, a teacher, a healthcare professional, or one of the support lines listed below. Together, by breaking the silence and responding with compassion, we can reduce the weight of these risk factors and offer hope where there is despair.

Changing the narrative around suicide requires a range of daily acts of mindfulness, which enable us to:

1. Observe and listen without judgement.
2. Find practical ways of making it normal to discuss a range of topics within family and school settings such as fears, feelings, thoughts, disappointments, without fear of judgement and rejection.
3. Proactively challenge unconscious bias and the stigma associated with mental health conditions.
4. Create safe spaces to discuss disheartening issues even when not fully understood.
5. Choose the thoughts, words and actions towards those who find themselves in dark places, who are thinking about suicide or have attempted to end their lives.
6. Create and leverage the power of community support systems, within our high-pressured contexts where adults, parents, caregivers and grandparents do not always have the resources to adequately support young ones with mental health challenges such as anxiety and depression.

How can we all get involved in proactive suicide prevention?

1. Challenging unconscious bias: For example, systemic socio-cultural perceptions, beliefs and biases that perpetuate stigma and discrimination against persons with mental health conditions.
2. Creating safe spaces in homes: Daily acts of compassion (e.g. making it the norm for families to talk about both the good, tough and troubling elements of their days with young ones, to role model that it is normal not to be okay from time to time. This also helps with reinforcing that families are there to support one another with unconditional love and compassion. Research shows that families that spend regular time engaging in conversations with their young ones or a range of topics, create safe spaces for the young persons to be able to discuss anything they find uncomfortable, stressful or traumatic with the adults in their lives (Source: Robyn Fivuch, Ph.D.). Multiple cultural groups across the world, that have similar practices (e.g. story telling with parents and grandparents or caregivers, family meal sharing times (where circumstances allow), family meetings where everyone irrespective of age gets a turn to speak and share their thoughts and ask questions, have provided rich data in support of human connections as a critical pillar of resilience.
3. Creating safe spaces in communities: “It takes a village to raise a child.” This African, Igbo phrase especially applies to child headed homes. It is essential to find creative ways of building psycho-social networks, comprising of professionals and trusted community members to check in on the young ones regularly and serve as their guides, mentors and pillars of emotional support.
4. Creating safe spaces in schools: Examples include zero tolerance policies and relevant legislation to root out abuse and bullying and group therapy sessions, facilitated by professionals.
5. Advocacy work for suicide prevention: Legislation, policies, psycho-social interventions provided through Public-Private-Partnerships (i.e. community based organisations, NGOs, private companies and government departments as strategic partners).
6. Leveraging technology for teen safety: Without promoting any specific Application (APPs), it is safe to say that a variety of APPs are available for parents to choose from, to protect young ones online and flag when they show risks of suicide attempts).
7. Parenting Support Groups: To learn from one another, share experiences and coping mechanisms to confidently support their young ones who struggle with mental health conditions or other challenges that may predispose them to suicidal ideations or attempts.

Relevant South African Life-Lines

• A trusted family member or teacher or place of worship leader:

Family members may choose these ahead of crises moments and share them with young ones within the home.

• Childline: Home Page – Childline South Africa
• Lifeline: Home – LifeLine South Africa
• National Counselling Line: 0861 322 322
• Gender Based Violence Line: 0800 150 150
• South African Depression and Anxiety Group (SADAG) 0800 567 567
• PsySSA: Psychological Society of South Africa https://www.psyssa.com to access a range of Divisions that provide psychological services to community members.