South Africa has 22 suicides a day, and 10 times as many attempted suicides, according to the South African Depression and Anxiety Group.
That's why Zane Wilson-Julius of Hilton Head Island stepped in.
Splitting her time between her home in Palmetto Dunes and her office in Johannesburg, Wilson-Julius established the group, which has become South Africa's largest mental-health initiative.
Last month, Wilson-Julius received the Order of the Baobab from South African president Jacob Zuma in recognition of "her outstanding contribution as a mental health care practitioner, and a leader in the struggle to create awareness" of mental illness, according to a SADAG news release.
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The award is the country's highest civilian honor, bestowed upon South Africans who have made "exceptional and distinguished" contributions toward community service, business, science, medicine and technology.
SADAG was started in 1994 to help those with mental health problems, such as depression, bipolar and anxiety, find care. The organization has become the leading mental health advocacy group in Africa, according to Dr. Michael Berk, a psychiatrist and professor who helped Wilson-Julius form SADAG.
Wilson-Julius has led teams to work in areas that have little access to psychiatric care for millions. Her organization trains care workers, teachers, nurses, police, church groups and others to identify mental illness and treat sufferers, according to a news release.
It has formed 160 support groups across South Africa and launched a program aimed at reducing the high rate of teen suicide. The group also offers 15 toll-free crisis and support lines, providing counseling and referrals.
About 75 percent of South Africans delay seeking help for mental illness and about 85 percent depend on government facilities where often there's only one psychologist for 100,000 people, Wilson-Julius said.
"With a population of about 50 million, it's a huge problem," she said. "It's a hellish job out here."
In 2005, she created the "Speaking Book" program to enable low-level literacy communities to receive vital health care messages. The books are interactive and multilingual, so they can be read, heard and understood regardless of reading ability, Wilson said. The books address mental illness, as well as infectious diseases such as malaria, tuberculosis and HIV/AIDS.
"This award is a huge honor and a tribute, not just to SADAG, but to all those people who have suffered in silence, scared and alone," she said. "Mental illness has always had the power to separate people. With this award, we feel like there is hope -- that the path traveled by mental health practitioners will be more supported and accepted."