Education And Debate

South Africa's Health: New South Africa's mental health

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6989.1254 (Published 13 May 1995) Cite this as: BMJ 1995;310:1254
  1. Rajendra Kale, editorial registrara
  1. a BMJ, London WC1H 9JR
  1. Correspondence to: Laxmi-Kunj, 37 Shanwar, Pune 411 030, India.

    The environment in South Africa has been characterised by a long history of abuse of human rights, repression, racial segregation, forced physical removal, pass laws, laws preventing interracial marriages, violence, alcohol related problems, malnutrition, and poverty. If environment is a major determinant of mental health, then the mental health of South Africans might be expected to be poorer than that of people elsewhere.

    Dr Brian Robertson, professor of psychiatry at the Groote Schuur Hospital in Cape Town, agreed: “A lot depends, however, on how mental health is defined, what indicators of mental health are used, and the effects of protective factors. If mental health is defined broadly as symptoms rather than categorical illnesses, there are clear indicators that the mental health of South Africans has been seriously damaged: I am referring to indicators such as the high levels of substance abuse, crime, and violence.

    “There is no evidence of a higher incidence of functional psychoses in South Africa than elsewhere. Functional psychoses, however, are generally regarded as being less influenced by environmental factors than ‘neurotic' disorders.”

    Dr M B Magner is a psychiatrist attached to the Lentegeur Psychiatric Hospital in Cape Town and also in private practice. He felt that the range of psychiatric problems in South Africa was similar to those in other countries. “But the symptomatology may be different at ‘non pathologic' levels,” he added. “We lack, however, valid data on the mental health profile of South Africans. While most psychiatric services have analysed their own patient data, nationally or provincially coordinated data are lacking.”

    Health Trends in South Africa (1993), published by the department of health and population development, makes no mention of psychiatric morbidity. Melwyn Freeman of the Centre for Health Policy in the University of Witwatersrand agreed that reliable data on the mental health of …

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