High rate of police suicides points to mental health crisis among SA’s first responders

One member of the SA Police Service dies by suicide every week on average, highlighting the mental health toll on South Africa’s overworked and under-resourced first responders. Fifty-four SAPS members took their own lives in the 2024/25 reporting period, a rising trend which has seen 300 police suicides reported in the past seven years.

Police members are not alone. South African paramedics and ambulance personnel, emergency care nurses and doctors, firefighters and rescuers experience depression, anxiety, post-traumatic stress disorder (PTSD) and burnout at rates far higher than the general population.

This Mental Health Month in October, the South African Society of Psychiatrists (SASOP) warns that chronic exposure to trauma, coupled with limited resources and lack of mental health support, puts the lives of first responders at risk, along with the lives of those they work to help and protect.

Board member of SASOP spokesperson, Dr Alicia Porter, said workers on the frontline of responding to crime, domestic violence, large-scale road accidents, medical emergencies and natural disasters are disproportionately susceptible to adverse mental health outcomes. 

A study released earlier this year among South African police members and paramedics showed that 47.3% would qualify for a diagnosis of depression, 37.8% for generalised anxiety disorder, and 48.5% for post-traumatic stress disorder.

These levels of mental distress far exceed the prevalence in the general population, of depression and mood disorders estimated at 9.8%, anxiety disorders at 15.8%, and PTSD at 2.3%. 

Other studies have found that 30% of Western Cape ambulance personnel experience PTSD, and recorded high levels of burnout in advanced life support paramedics in Gauteng – 30% suffering total burnout and 63% experiencing burnout related to work, patient care or personal stress. More than two-thirds of public hospital emergency room doctors in Gauteng, working shifts of up to 24 hours at a time, were assessed at high risk of burnout.

“Underneath the uniforms are people facing the same mental struggles as many of us, but their work environment is unique in that they are among few professions where the very nature of their jobs repeatedly and consistently puts them in extremely stressful and high-risk situations – endangering not only their physical safety but also mental well-being. 

“Untreated mental health conditions among first responders hamper their ability to do their jobs effectively, and impacts negatively on their quality of life and personal relationships.”

“Unless we improve mental health support for first responders, and tackle the root causes of depression and burnout, South Africa risks losing this frontline talent and further weakening our capacity for disaster and emergency response – putting more lives at risk. With many public services already under-staffed and under-resourced, the country can ill afford this,” Dr Porter said.

Mental health disorders are a leading cause of disability both worldwide and in South Africa, where a mental health treatment gap of between 75% and 90% means the majority of people go untreated.

She said this was due to the country’s low provision of resources for mental health treatment, particularly in the public sector where most first responders are located, coupled with pervasive stigma around mental health issues.

Employee assistance programmes (EAP) and wellness interventions are of “uneven quality” among emergency services, and employees are reluctant to seek help in the workplace because of actual or perceived lack of confidentiality.

The Parliamentary Portfolio Committee on Police highlighted its concerns last year about the lack of adequate employee health and wellness interventions for SAPS members, after SAPS management advised that the entire SAPS structure has only 621 health and wellness employees to service over 187 000 SAPS personnel.

Dr Porter said that the social stigma surrounding mental health, making people reluctant to seek help, is magnified in the healthcare professions and first responders, who face expectations of unwavering physical and mental strength, fear that perceptions of weakness will impact their job security, and feel they are expected to “be able to fix themselves”.

“Stigma is particularly heightened in uniformed work cultures, worsened by a lack of confidentiality which raises fears that workers who show signs of trauma or ask for help will be found unfit for duty, impacting negatively on their careers and income.

She said that the mental health risks to first responders were worsened by an imbalance between job demands and support resources.

“Their jobs demand constant physical, mental and emotional involvement, over long working hours, which takes a toll on their mental and physical health, and depletes their internal resources of resilience and coping skills.

“At the same time, a lack of resources for mental health support and a lack of training in how to safeguard their own health while helping others, particularly for the majority of first responders who work in the public sector, aggravates the adverse effects of their high job demands and increases the risks to their mental health,” she said.

Protecting and improving first responders’ mental health

Dr Porter said emergency healthcare and first response providers should provide “confidential, independent pathways” to encourage help-seeking, contract registered trauma and mental health clinicians to provide support clearly separated from employees’ line management reporting.

This should include options for off-site or telephone consultations in order to improve confidentiality.

She further advised:

• Regular, proactive screening for PTSD, depression, anxiety and sleep disturbances, particularly after critical incidents. Employees exhibiting “warning signals” should be fast-tracked into evidence-based care, she said.

• Training and awareness on “mental health first aid”, psychological safety and paths for help and referrals will enable peer support amongst colleagues, as well as improved skills for supervisors in screening for work-related stress.

• Reducing potential for burnout should take place “at source”, through debriefings after incidents, access to support for sleep and fitness, and “rostering hygiene” – allowing for predictable work and rest schedules, and rotating shifts between low and high trauma settings.

References

1. ProtectionWeb. June 2025. Referencing SAPS statistics, 54 SAPS members committed suicide in 2024/25 financial year. South African Police Service Faces Mental Health Crisis as Suicides Continue to Rise. https://www.protectionweb.co.za/police/south-african-police-service-faces-mental-health-crisis-as-suicides-continue-to-rise/

2. ProtectionWeb. June 2025. Referencing SAPS statistics, 54 SAPS members committed suicide in 2024/25 financial year. South African Police Service Faces Mental Health Crisis as Suicides Continue to Rise. https://www.protectionweb.co.za/police/south-african-police-service-faces-mental-health-crisis-as-suicides-continue-to-rise/

3. DefenceWeb. July 2024. POPCRU: 300 SAPS Suicides Since 2017. https://defenceweb.co.za/security/civil-security/popcru-300-saps-suicides-since-2017/

4. Padmanabhanunni A, Pretorius TB. February 2025. An exploratory study of the mental health of first responders: depression, anxiety, and post-traumatic stress disorder. South African Journal of Psychology. 2025;55(2):257-269. doi:10.1177/00812463251317901

5. Padmanabhanunni A, Pretorius TB. February 2025. An exploratory study of the mental health of first responders: depression, anxiety, and post-traumatic stress disorder. South African Journal of Psychology. 2025;55(2):257-269. doi:10.1177/00812463251317901

6. Herman AA, et al. The South African Stress and Health (SASH) Study: 12-month and lifetime prevalence of common mental disorders. SA Medical Journal, Vol 99, No. 5. 2009. https://pmc.ncbi.nlm.nih.gov/articles/PMC3191537/

7. Ntatamala I, Adams S. February 2022. The Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress. Int J Environ Res Public Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC8871647/

8. Stassen W, Van Nugteren B, Stein C. Burnout among advanced life support paramedics in Johannesburg, South Africa. Emerg Med J. 2013 Apr;30(4):331-4. https://pubmed.ncbi.nlm.nih.gov/22505296/

9. Rajan S, Engelbrecht A. 2018. A cross-sectional survey of burnout amongst doctors in a cohort of public sector emergency centres in Gauteng, South Africa. African Journal of Emergency Medicine. Vol 8, Issue 3. https://www.sciencedirect.com/science/article/pii/S2211419X17301581

10. Morar T, Breedt JE, Mdaka N, Maaroganye K, Robertson L. Is mental health in South Africa moving forward? BJPsych Int. 2024 Feb;21(1):1-3. https://pmc.ncbi.nlm.nih.gov/articles/PMC10803769/

11. Parliament of SA. August 2024. Statement by chair of Portfolio Committee on Police. Media Statement: SAPS Members’ Mental Health Should Be Prioritised to Enhance Effective Policing.  https://www.parliament.gov.za/press-releases/media-statement-saps-members-mental-health-should-be-prioritised-enhance-effective-policing