London School of Hygiene & Tropical Medicine

The first study of mental health in post-conflict Southern Sudan has found high levels of mental distress, and revealed evidence of continued exposure to traumatic events.

The signing of the Comprehensive peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Although studies revealed high levels of post-traumatic stress disorder (PTSD) during the conflict, no studies have been conducted on mental health in post-war Sudan.

A team led by Bayard Roberts of the London School of Hygiene & Tropical Medicine, in collaboration with the Ministry of Health of the Government of Southern Sudan, sought to measure PTSD and depression in the population in the Juba, the capital town of Southern Sudan, and to investigate the association of demographic, displacement, and past and recent trauma exposure on the outcomes of PTSD and depression. The team's findings are published in the journal BMC Psychiatry (see provisional version)*.

1,242 adults aged 18 and over were surveyed. Over a third (36%) of respondents met symptom criteria for PTSD and half (50%) met symptom criteria for depression. Strong associations were found between gender, marital status, forced displacement and trauma exposure and outcomes of PTSD and depression. Men, internally displaced persons, refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events.

In the twelve months running up to the survey date, almost one third (29.2%) of respondents reported lacking food or water and one quarter (24.5%) reported having been very ill without access to medical care.

Bayard Roberts comments: 'Southern Sudan continues to struggle with overwhelming health needs, limited capacity to provide essential health services, and poor infrastructure. . Health services need to be urgently scaled up, and to have mental health activities built into them. In addition, without better access to basic goods and services and improved protection, these high levels of mental distress are likely to continue'.

• Post-conflict mental health needs: a cross-sectional survey of trauma, depression and associated factors in Juba, Southern Sudan. Bayard Roberts, Eliaba Yona Damundu, Dr. Olivia Lomoro, Egbert Sondorp. BMC Psychiatry 2009, 9:7doi:10.1186/1471-244X-9-7