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 t his violence on mental health, concentrating mainly on post-traumatic stress disorder (PTSD), and its symptoms, including reliving aspects o f 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 p ut to 3 870 respondents aged 16 to 64 years on their mental health sta tus, feelings of powerlessness, exposure to violence and other traumat ic situations, symptoms of PTSD and access to health care for these sy mptoms. Weighted survey results indicate that approximately five milli on adults (23% of the population aged 16 to 64 years) had been exposed to one or more violent events, for example, being attacked, participa ting in violence and witnessing one's home being burnt. Just under fou r-fifths (78%) of those who had experienced at least one traumatic eve nt had one or more symptoms of PTSD. This syndrome was found to be rel ated 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, con fronting the effects of this violence, and establishing both professio nal and community structures to deal with it on a large scale, for exa mple, the training of lay people to give counselling.