South African entrepreneurs are facing a mental health crisis as they struggle to manage financial pressure, business instability and emotional burnout, according to new research released by Old Mutual SMEgo in support of World Mental Health Month.
The Entrepreneurs Health and Wellbeing Survey, the first of its kind in South Africa, paints a stark picture of the psychological cost of running a business. The findings reveal that many business owners are working under extreme emotional and financial strain, which has implications for both their personal wellbeing and South Africa’s wider economy.
The survey gathered insights from 138 entrepreneurs across multiple industries and income groups. It found that 41% of respondents earned below R500,000 annually and often experienced deep isolation due to being excluded from business networks and funding opportunities.
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Meanwhile, those earning between R500,000 and R1 million (29.7%) reported anxiety linked to growth pressure, decision making and balancing reinvestment in their business with personal financial security. Entrepreneurs earning between R1 million and R5 million (15.9%) faced cognitive overload and competition anxiety, while 10.2% of those earning above R5 million said they struggled with intense stakeholder and performance pressures.
The study also exposed sector-specific mental health challenges. Entrepreneurs in the food and beverage sector highlighted regulatory stress, the risks of food perishables and fluctuating revenues as key triggers. Those in health and wellness industries reported ethical dilemmas, such as balancing professional integrity with business survival. The construction sector revealed that systemic corruption and pressure to compromise ethics created significant mental strain.
Alarmingly, nearly half of the surveyed businesses were unregistered, with many entrepreneurs citing administrative complexity and system breakdowns at the Companies and Intellectual Property Commission (CIPC) as major stressors. The lack of formal registration also affected their access to funding and banking services, compounding their anxiety.
Technology use emerged as another key theme in the report. About 60% of entrepreneurs rely on basic tools like WhatsApp, notebooks and calculators to manage their businesses. While these tools reduce learning stress, they also create inefficiency. In contrast, the 5% using advanced tools such as CRM systems or SMEgo’s business management software reported a 40–60% reduction in administrative burdens, giving them more mental space to focus on strategy.
However, reliance on WhatsApp for business communication created new challenges. Entrepreneurs reported blurred boundaries between work and personal life, with constant message notifications and pressure to respond instantly leading to “availability stress.”
Despite the challenges, the survey revealed several positive coping mechanisms. Many entrepreneurs said they relied on faith-based practices, including daily prayer, meditation and support from church communities. Others cited exercise, walking, and traditional healing as their preferred methods of managing stress. Only 5% of respondents reported substance use as a coping mechanism.
Old Mutual’s Director of SME, Nobesuthu Ndlovu, said the findings show that mental health support for entrepreneurs must be treated as a key part of economic development.

“The 138 entrepreneurs who shared their mental health experiences deserve systems that recognise the full scope of psychological infrastructure required for sustainable business development,” Ndlovu said. “They are building economic resilience while sacrificing personal wellbeing in ways that ultimately threaten both individual success and community growth.”
The report underscores the need for stronger mental health interventions, business support systems and easier access to administrative tools that can reduce stress and help entrepreneurs focus on innovation and growth.
olga@vutivibusiness.co.za