Amidst the continuing armed conflict, the population of South Sudan – the youngest country in the world – is experiencing a multitude of traumatic events, encompassing the loss of family members, displacement, hunger, and violence. The ongoing intercommunal violence between the Nuer and Dinka ethnic groups is exposing the population to fear, loss, and brutality, leading to psychological trauma. The harsh realities of the violence are exposing South Sudanese to mental health complications such as post-traumatic stress disorder (PTSD), anxiety, and depression. Despite this ‘epidemic’ of mental distress, the health infrastructure in South Sudan has limited resources to deal with it.
Furthermore, these mental health issues are morphing into a humanitarian crisis as they are impairing the functionality of individuals and societies and therefore hindering the recovery, rebuilding, and reconciliation efforts in communities. The World Health Organization (WHO) estimates that during humanitarian crises in South Sudan, the rate of mental health issues increases by 4% for severe conditions and up to 20% for mild to moderate disorders. Despite the efforts of donors to provide humanitarian interventions to reduce the prevalence of conflict-related trauma, treatment gaps persist with entrenched stigma about mental health issues, attacks on civilian aid workers, poverty, violence, and inadequate financial and human resources impeding humanitarian interventions for mental health issues.
This DevelopmentAid article explores the mental health issues of the South Sudanese, particularly PTSD, anxiety, and depression, that have been provoked by the current inter-communal violence and the post-civil war environment. It will highlight that urgent mental health and psychological support are integral elements of sustainable growth to enhance healing and rebuild resilience.
Emergence of mental health issues in South Sudan
The prolonged period of conflict, which continues to this day, has exposed the civilian population of South Sudan to many atrocities, including physical and sexual violence, looting, displacement, and murder. Intercommunal tensions between the Dinka and Nuer ethnicities are perpetuating cycles of trauma, violence, and displacement in the country. The displaced South Sudanese are facing yet more problems in refugee camps, such as discrimination and community violence, which are contributing to trauma-related mental issues. The nation’s civil instability is undermining the provision of health services, particularly mental health care, despite the civil war being linked to mental health issues.
The prevailing psychological traumas are also being perpetuated by stigmatization as South Sudanese patients with mental health disorders are labeled with derogatory terms such as “crazy” or “separated from their head”. This stigmatization focuses on behavioral disturbances and delusional thoughts rather than advocating for treatment options or counseling. Ignored by the health system and facing entrenched stigma, many South Sudanese confront their mental health challenges in silence and solitude. As a result, the surging prevalence of psychological trauma in South Sudan at present is associated with stigmatization, prolonged conflict, displacement, and limited healthcare resources. Key statistics shed light on the swelling rates of mental health issues and the urgent need for intervention strategies in the country.
Mental health statistics in South Sudan
Globally, South Sudan is ranked as one of the nations with the greatest mental health gaps, with approximately 1.2 million people in need of support. Despite the glaring statistics of the astounding level of psychological needs, just 1% of the population access mental health services, leaving an intervention gap of almost 99%. The inaccessibility of intervention services is attributed to violence and internal displacement which overshadows mental health issues.
According to Doctors Without Borders/Médecins Sans Frontières (MSF) in South Sudan, most mental health patients suffer from PTSD, depression, and postpartum issues. A 2024 study determining the prevalence of war-related trauma and PTSD among South Sudan refugees revealed that almost 37% of participants satisfied the symptom criteria of probable PTSD. The study findings depict a high prevalence of trauma-related disorders of populations in conflict regions, necessitating urgent interventions.
In ascertaining the prevalence of trauma-related mental issues among South Sudanese, a meta-analysis found that participants experienced nine conflict-associated traumatic events. By examining data from studies involving 6138 participants, the prevalence rates of anxiety, depression, and PTSD were almost 25%, 24%, and 34%. In general, the increasing levels of psychological distress are common among South Sudanese displaced adults and children, and the stressors associated with residing in refugee camps, experiences during the conflict, and hardships during displacement are increasing the psychological trauma.
Another cross-sectional research involving 574 South Sudanese Internally Displaced Persons (IDPs) found 18%, 20%, and 14% of respondents manifesting symptoms of depression, PTSD, and anxiety (Figure 1). The same research concluded that almost half of the IDPs questioned were in poor physical health.
Figure 1: Respondents with depression, PTSD, and anxiety, based on research in South Sudan
Source: A 2023 Cross-Sectional Research on Prevalence of Mental Health Issues Among IDPs of Sudan.
The ongoing conflict in South Sudan is disrupting the healthcare infrastructure and contributing to an unsafe environment in which psychiatrists are prevented from providing health services. Also, mass displacement, political instability, and abject poverty are exacerbating the existing humanitarian strain and creating a mental health burden in South Sudan.
Humanitarian efforts for addressing Mental Health issues in South Sudan
WHO, the International Organization for Migration, and USAID’s Bureau for Humanitarian Assistance (BHA/USAID) are among the major donor organizations tackling mental health issues in South Sudan.
The International Organization for Migration (IOM) is implementing the Mental Health and Psychosocial Support (MHPSS) program in response to the humanitarian crisis affecting victims of the 2013 civil war. The program provides non-specialized psychosocial services such as counseling services and raising community-associated awareness of mental health issues. In 2021, the MHPSS initiative at Balient Count in South Sudan provided psychological support to nearly 1,200 at-risk persons, over 2,300 persons with psychosocial first aid (PFA), and more than 44,000 participated in social and creative activities.
In addition, in collaboration with WHO and BHA/USAID, IOM is implementing the Mental Health Gap Action Programme (mhGAP). The initiative is addressing inadequate psychiatric care in South Sudan states by training healthcare workers to manage and refer mental health issues in healthcare centers and is equipping non-specialized health staff to offer critical care for psychosocial, neurological and substance abuse disorders, a step in improving mental healthcare accessibility.
BHA/USAID has provided health care services in South Sudan via a life-saving health care initiative by providing approximately US$9 million in 2021 to support community health institutions and Mobile Medical Units (MMUs). Through the MMUs, donors provide a variety of primary care, mental health and maternal health services to the vulnerable South Sudan population (Editor’s note: U.S. President Donald Trump ordered a 90-day freeze on U.S. foreign assistance from January 20, 2025. As a result, USAID issued stop-work orders to all implementing partners and organizations).
Challenges faced by humanitarian interventions
Despite donors’ interventions to reduce the prevalence of mental health issues in South Sudan, increased violence, poverty, displacement, and stigma are impeding these efforts. Awareness of mental health is low among South Sudanese which contributes to stigma and reduced mental health-seeking behavior due to shame and ignorance of treatment options. Civilian aid workers are also vulnerable to attacks during intercommunal violence which is causing shortages in human capacity and poor mental health literacy.
Final thoughts
Ongoing intercommunal violence, displacement, limited access to psychological services, and stigmatization are exacerbating mental health issues in war-torn South Sudan, the youngest country in the world. The high prevalence of disorders such as PTSD, depression, and anxiety demonstrates the urgent need for humanitarian efforts. Despite financial and technical aid from donors to reduce the prevalence of psychological traumas, treatment challenges exist. Mental health treatment gaps remain due to inadequate resources, attacks on civilian aid staff, and poor health infrastructures. Strengthening health systems, increasing humanitarian aid, and incorporating culturally effective mental health services will help to address the mental health issues in South Sudan.
