Rising concerns about unmet mental health needs in South Sudan.
The legacy of conflict, displacement and lack of mental health services in South Sudan gives cause for rising concern in the country. In Upper Nile suicides and suicide attempts have been recorded especially among young adults in Malakal Protection of Civilians (PoC) site and Malakal town.
Ninety-five suicide and self-harm cases were reported from Malakal between January 2018 and July 2019. Of those, the majority were attempted suicides and self-harm cases, with more than half of those attempts done by women. Two thirds were people between the age of 19 and 35.
Whilst systematic research hasn’t yet been undertaken, focus group discussions with internally displaced persons from the PoC and with residents from Malakal town, conducted by the Upper Nile Mental Health and Psychosocial Support (MHPSS) Working Group, attribute the high number of attempted suicide and self-harm cases to the long-term effects of years of conflict, violence and displacement. Mental health problems, family disputes and interpersonal conflicts, domestic violence, socio-economic hardship, unemployment and challenging living conditions are some of the contributing factors. Furthermore, drug abuse increases the risk of suicidal tendencies.
The mental health care system in the country is weak. South Sudan has only three psychiatrists serving the entire population, and only one psychiatric inpatient ward with a 12-bed capacity in Juba. The situation is much worse in the most conflict-affected parts of the country, including Upper Nile.
Yet suicide is preventable. Prevention is one of the most effective ways to reduce the burden.
Different MHPSS actors have scaled up their suicide prevention strategies. Key messages are being passed to individuals, families and communities. Aid agencies are conducting awareness-raising sessions, addressing the stigma and taboo attached to suicide, and are working with other humanitarian organizations to improve access to socio-economic opportunities for the site’s young population. In addition, community leaders in the site have been trained as mental health first aiders and are disseminating key messages on suicide prevention to communities.
In 2013, conflict forced most of the population in Malakal town and surrounding areas to flee their homes, with some seeking shelter in the UNMISS protected site in Malakal. The site population peaked at just under 48,000 individuals in August 2015 and has since reduced to some 30,000 people, per the population head count conducted by humanitarians at the end of September 2019. Nearly 52 per cent of the people currently sheltering in the site are women who face risks of violence daily. Women and girls who must leave the camp in search of firewood are particularly at risk.