As Mental Health Professionals, we wish to place on public record our grave concern at the Psychological, Psychiatric and sociological sequelae of the current levels of violence in South Africa.

Under the new constitution, citizens of this country were led to believe that their right to the integrity of person and the lawful possessions would be upheld and entrenched. The perceived or actual loss of this right poses a serious threat to the Mental Health of South Africans and is having a negative impact on our ability to transform and rebuild the nation.

Violent crime appears to have been accepted as part of the nation's social landscape. The most vulnerable sectors of the population, children and the elderly, are no longer spared, but intentionally targeted. Crimes, whose brutality and senselessness would in any civilized country, cause a national outcry, are so frequently here as to warrant only a line or two in the local newspaper. A culture of violence has become entrenched to a degree that is increasingly difficult to eradicate. The natural and universal taboo against needlessly taking the life of another human holds little power in our communities. Some respond by growing apathy, others emigrate in desperation; Some take the law into their own hands in an attempt to achieve justice through revenge, others jump on the bandwagon, encouraged by the apparent impunity with which criminals operate.

Violence is not a new phenomenon in South Africa, but the sense of helplessness in the face of the apparent failure of all efforts to combat the current pandemic is. Violence can no longer be regarded as part of an oppressive system or as a problem in certain areas only. It is disrupting the lives of all citizens, from the homeless alcoholic to the President himself. Law enforcement agencies are seen as either impotent or part of the problem.

Our clinical research suggests that in some areas as many as one out of every five persons id suffering from violent related Mental Health problems. These problems range from posttraumatic stress disorder through anxiety and depressive disorders to exacerbation and precipitation of Schizophrenic or Bipolar breakdowns. Victims frequently attempt to relieve their psychological distress with alcohol, leading to further endangerment of the community. Our children, some of whom are effectively living in a war zone, have been found to have excessively high levels of chronic anxiety. This contributes to problems such as youth suicide, early onset of substance abuse, and, in fact, juvenile criminal activity. It is natural for young persons who feel insecure to identify with and emulate those groups they perceive to be powerful, successful and in control.

The effects of violence do not only threaten the individual, but also families, the fabric of communities, and the very future of our country. However good the intentions and the policies of a government, it is impossible to build a healthy nation with damaged people, especially when that damage will, in many cases, lead to the victims becoming perpetrators themselves.

The damage violence inflicts on survivors and witnesses is being compounded by burnout in the limited number of mental health workers available. The absorption of other's terror, agony and frustration on a daily basis, with little hope of improvement in the situation, slowly destroys the capacity of the helper to help, and leads many to seek employment in other countries, where the levels of professional stress are perceived to be lower. This adds further burdens to those remaining, and freezing of vacated posts is bringing the mental health services to the point where staffing will soon be below critical mass, and total collapse will be inevitable.

The plight of our country should not be used for political ends to discredit any group, ruling or opposition, wealthy or poor, black or white. We encourage the Government to acknowledge publicly that violent crime in South Africa has taken on the proportions of a national disaster. We support the Government stance of zero tolerance for crime, and priority funding for both crime prevention and an effective and strengthened justice system. We suggest, in addition, that adequate capacity within the mental health system be ensured so that victims, many of whom will require long term support and/or treatment, can be assisted.

We believe that it is important that both the extent of the problem and the efficacy of measures taken to resolve it should receive continuous high profile publicity until such time as the citizens of this country have reclaimed their constitutional rights. It is only in this way that the public and the Government who, in sharing responsibility for the problem, can effectively take joint responsibility for its resolution.

Dr Margaret Nair

Prof Brain Robertson

Prof Clifford Allwood