Trauma, vulnerability and mental health problems in South Africa and Sweden

Globally, mental illness is more responsible for extreme distress than poverty or unemployment, and, to compound the problem, mental illness interacts with poverty and unemployment in socially and economically impactful ways that create reinforcing cycles. People struggling with mental illness experience the highest rates of unemployment among people with disability. Unemployment is associated with poverty, and both unemployment and poverty are in turn associated with poor mental health, leading to a reinforcing cycle. Contributing risk factors include infectious diseases, social conflict, crime, violence, stigma, self-harm, and substance abuse. The project will provide evidence to guide health policies and social programs to provide better support to individuals who need to process traumatic events and improve the available assistance and treatment for those with mental health problems. It will enable us to identify sub-populations at higher risk and to link trauma exposure to downstream adverse social consequences. Identifying these groups, including immigrants, the poor and the vulnerable, will assist policy planners and implementers to target interventions to improve the welfare of these vulnerable groups.
The project will generate new work on mental health trends in Sweden, but because the research lacuna is much larger in South Africa, the research focus will be skewed towards mental health in South Africa. It is well established that South Africa has high rates of trauma and relatively high rates of mental health problems, but there is little evidence for the link between the two. More broadly, there is a relative paucity of South African research using publicly available datasets to explore ecological and other relationships between social factors and mental health outcomes, especially for studies that track individual and community level changes over time. Our work will address this lacuna, considering ecological and individual level linkages between exposure to trauma, vulnerability, social exclusion and depressive symptoms over time.