Trauma and mental health in South Africa

Prior to the first democratic elections, South Africa had experienced severe political violence. In this paper, we describe the effects of this violence on mental health, concentrating mainly on post-traumatic stress disorder (PTSD), and its symptoms, including reliving aspects of the trauma, avoiding situations which remind one of the experience, and heightened irritability. As part of a nationwide survey on health inequalities covering 4 000 South African households, questions were put to 3 870 respondents aged 16 to 64 years on their mental health status, feelings of powerlessness, exposure to violence and other traumatic situations, symptoms of PTSD and access to health care for these symptoms. Weighted survey results indicate that approximately five million adults (23% of the population aged 16 to 64 years) had been exposed to one or more violent events, for example, being attacked, participating in violence and witnessing one's home being burnt. Just under four-fifths (78%) of those who had experienced at least one traumatic event had one or more symptoms of PTSD. This syndrome was found to be related to feelings of powerlessness, anxiety and depression and fair or poor self-ratings of emotional well-being. The authors concluded that healing the people of South Africa involves revealing the full extent of political violence that was committed during the apartheid era, confronting the effects of this violence, and establishing both professional and community structures to deal with it on a large scale, for example, the training of lay people to give counselling.