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

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

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

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

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

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

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