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What a few Rands more can buy for
mental health and violence
prevention?
By Nomfundo Mogapi
Centre for the Study of Violence and Reconciliation 09 November 2011
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AIM
• Highlight what the value investing in violence prevention
• SA based on our experience in responding to mental health needs of victims of violence in lat two decades
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INTRODUCTION
• SCOPE OF VIOLENCE IN SA • 2 121 887 serious crimes were committed in the
2009/2010 calendar year. • Over 30% of these were contact crimes, and over
25% were property related crimes. • 30% of all crimes were assault with grievous
bodily harm, • 10.1% were sexual offences (I in 9 report). • Violence is the second largest cause of death on
SA
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CONSEQUENCES OF VIOLENCE
• HEALTH ▫ Disability ▫ Chronic illness related to stress-high blood, diabetes ▫ Injuries
• MENTAL HEALTH ▫ Post Traumatic stress ▫ Impact on indirect victims ▫ Other cormobid: depression, other mental problems
• ECONOMIC ▫ Trauma and violence are seen as the single largest loss of productivity in
SA (work days loss, PTSD at work affecting performance) ▫ Worse in it is a death of a bread winner
• OTHER SIGNIFICANT AREAS OF FUNCTIONING ▫ Parenting ▫ Education and schooling ▫ Workplace functioning
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THE COST • BURDEN ON THE DEPARTMENT OF HEALTH
▫ Trauma Unit- Groote Schuur Hospital study on 969 patients with gun shot injuries in 1993 showed a cost of R3 858 331 to the hospital (van der Spuy and M Peden ,1997)-13% of the cost
▫ 87% cost due to disability, premature death (R 10,828,219 ).
▫ Total cost of about: R 12,446,229 in that area only • PSYCHOSOCIAL AND MENTAL HEALTH: Civil society
service provision vs. development and democracy • SOCIAL DEVELOPMENT: Victim empowerment
programme, funding NGOs • COST OF POLICING: (trauma training, victim
empowerment centers, burnout, police violence) • PRIVATE SECURITY: Multibillion industry
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TICKING BOMB
• From our experience: Country is unable to sustain the investment in addressing the consequences of crime ▫ Civil society closing down ▫ Overburden health system ▫ Over loaded social dev-shortages of social workers and
psychologists ▫ Increasing frustration from victims who resort to ultra
legal systems (mob justice) ▫ Current focus on policing as the key driver of violence
prevention is not helpful ▫ Overburdened prisons (universities for hard core
criminality) ▫ Overburdened police
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SOMETHING NEEDS TO SHIFT
• Desperately need to invest in a public health approach violence prevention initiatives that look at: ▫ Research: protective and risk factors ▫ Linking research with interventions ▫ Investing in localised interventions that could be scaled up ▫ Evaluation and impact studies on what works
• Benefits of this: - Reduce the health, CJP costs towards other developmental priorities such as education, job creation - Reduced focus on mental health problems of mental health
functioning that promotes successful and thriving individuals - Higher numbers of economically active people who
contribute to the growth of the economy