Mental health implications of suicide rates in South Africa

Table 1 Summary of suicide-related and mental health studies in South Africa

Ref.	Objectives	Methodology	Participants	Results
Goldstone et al[8], 2018	To explore mental health-care providers’ context- and population-specific suggestions for suicide prevention when providing services or PWSUDs in the Western Cape, South Africa	Qualitative data were collected via in-depth, semi-structured interviews with 18 mental health-care providers providing services to PWSUDs in the public and private health-care sectors	18 mental health-care providers were interviewed	Effective treatment of substance use disorder and other psychiatric conditions would significantly decrease suicidality, transforming the mental health-care system and training in suicide prevention for mental health-care providers help to prevent suicide
Naidoo et al[11], 2012	To determine the prevalence of severe mental disorders in a prison population in Durban, South Africa	This was a cross-sectional point prevalence study	193 prisoners were interviewed, and questionnaires were administered	There is a high prevalence of mental disorders among prisoners in the prison population in Durban, South Africa
Jack et al[15], 2014	To identify and review research from South Africa and sub-Saharan Africa on the direct and indirect costs of mental, neurological, and substance use disorders and the cost-effectiveness of treatment interventions	Narrative overview methodology		Reviewed studies indicate that integrating mental health-care into existing health systems may be the most effective and cost-efficient approach to increasing access to mental health services in South Africa
Khasakhala et al[17], 2011	To examine the relationship between lifetime mental disorders, subsequent suicide ideation, and suicide attempts in South Africa	A national survey of 4185 South African adults who were interviewed	4185 South African adults	There is a relationship between several mental disorders and suicidal behavior
Mokitimi et al[21], 2018	To examine the current state of child and adolescent mental health policy development and implementation in the nine provinces of South Africa and to perform a policy analysis of all CAMH-related policy documents	In order to identify all publicly-available policy documents related to CAMH, two search strategies were used	Health website searches	No South African province had a CAMH policy or identifiable implementation plans to support the national CAMH policy
Vawda et al[25], 2018	To establish what percentage of females admitted following a suicide attempt to a government tertiary hospital were pregnant and to establish associated clinical and sociodemographic factors	A retrospective review of medical and psychological charts of all female patients admitted to a tertiary hospital in Durban following a suicide attempt over one randomly chosen year (January 01, 2014 to December 31, 2014)		Participants diagnosed as having an MDD had also made previous suicide attempts while pregnant; no mental health help had been sought even when they showed a prior history of suicide attempts and depressive symptoms, which are risk factors for future suicide attempts
Petersen and Lund[32], 2011	To identify progress and challenges in mental health-care in South Africa and future mental health services research priorities	A systematic review of mental health services research. Literature searches were conducted in Medline, PsychInfo, and Sabinet databases	Of 215 articles retrieved, 92 were included	There is a paucity of intervention and economic evaluation studies. Common mental disorders remain primarily undetected and untreated in primary health-care
Steyn et al[33], 2013	To examine a possible link between PTSD and suicidal ideation and to examine whether any specific posttraumatic symptoms predict suicidal ideation	A cross-sectional survey design on South African police officers assessed utilizing the Posttraumatic Diagnostic Scale and a short version of the Adult Suicide Ideation Questionnaire	217 South African police officers	Hyperarousal was the primary predictor of suicidal ideation
Orri et al[34], 2022	To investigate childhood risk factors for suicidal ideation in adolescence and young adulthood	A longitudinal study used data from the largest and longest-running birth cohort in Africa, the Birth to Twenty Plus (Bt20+) study in South Africa Bt20+ cohort	Mothers and their singleton children born during 7 wk in 1990 in Soweto, South Africa	Prevalence rates peaked at age 17 and decreased continuously until age 28. Prevalence rates were higher among females than males; there are sex differences in the association of childhood individual, familial, and environmental factors with youth suicidal ideation
Bantjes et al[35], 2016	To investigate the 2-wk prevalence of suicidal ideations and their associations to symptoms of posttraumatic stress, depression, and anxiety among South African university students	Hierarchical regression analysis was used to investigate the relationship between suicidal ideation and symptoms of posttraumatic stress, depression, and anxiety	Data were collected from 1337 students between May and August 2013	Rates of suicidal ideation are higher among university students in South Africa than among the general population of the country and student populations in other parts of the world
Khuzwayo et al[36], 2018	To investigate key demographic factors and behaviors associated with planning and attempting suicide among high-school learners	A cross-sectional study in uMgungundlovu District, KwaZulu-Natal Province, South Africa	All Grade 10 learners (n = 1 759) at these schools completed a self-administered questionnaire	The suicide attempt prevalence rate is high in South Africa. The risk of planning suicide increases with age
Burgess et al[37], 2022	To pilot and evaluate the effectiveness of a complex intervention – Courage-Plus on symptoms of depression in Gauteng, South Africa	This pilot study used a non-randomized, repeated-measures design	47 depressed women	Courage-Plus was highly effective at reducing symptoms of depression across the spectrum of severities in this sample of women facing adversity in Gauteng, South Africa

CAMH: Child and Adolescent Mental Health; PWSUD: People with substance use disorder; PTSD: Posttraumatic stress disorder.