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Sudan’s two decades of civil war, which ended in 2005, involved widespread violence and large-scale forced migration. This had traumatic impacts on the mental health of a large part of the general population. High levels of depression and post-traumatic stress disorder in post-conflict Southern Sudan warrant the rapid scaling-up of mental health services.

A joint study from the UK and the Sudan assesses the mental health status of a sample of the general population in post-conflict Southern Sudan. Mental health is a key public health issue for people affected by conflict. People with poor mental health suffer distress, and may be more vulnerable to violence, suicide, poor physical health and substance abuse. High levels of mental health problems can affect the ability of individuals, communities and societies to function during and after conflict. Exposure to traumatic events and high levels of mental distress may influence attitudes to reconciliation in post-conflict societies.
Studies found high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. How has the mental health status of the people there evolved since the Comprehensive Peace Agreement was signed in January 2005? In November 2007, researchers from the London School of Hygiene and Tropical Medicine surveyed 1242 adults in Juba, the capital of Southern Sudan. They recorded levels of exposure to 16 traumatic events, measured PTSD and depression, and investigated their links to a variety of factors.

Key findings include:

• Of those surveyed, 92.4 percent have suffered one or more trauma event, including combat, murder of family or friends, beatings or torture.
• The most common trauma events in the past year were a lack of food or water, being seriously ill without access to medical care, and a lack of shelter.
• Men, internally displaced persons, refugees and persons displaced more than once are all more likely than others to have experienced eight or more traumatic events.
• Over one third meet the criteria for PTSD (42.5 percent of women and 29.7 percent of men) and half have depression (58.7 percent of women and 40.9 percent of men).
• Trauma events strongly linked with both PTSD and depression include being forcefully separated from family, falling very ill without access to medical care and being injured.
• Gender, marital status, forced displacement and trauma exposure are strongly associated with PTSD and depression.

There are almost no mental health services in Southern Sudan. Highlighting ongoing exposure to traumatic events in Juba, the researchers recommend that decision-makers:

• scale up health services rapidly and incorporate mental health activities into a basic health package
• train healthcare staff and community workers to provide basic support and referral services and to organise community-based self-help groups
• improve security and provide other urgently needed social and economic services to reduce exposure to factors that may worsen mental health.

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