Distress, desperation and despair: anxiety, depression and suicidality among rural South African youth.

Common mental disorders (CMDs) affect millions of people worldwide and impose a high cost to individuals and society. Youth are disproportionately affected, as has also been confirmed in South Africa. Mental disorders and substance use disorders often occur as concurrent disorders. Although youth in rural South Africa grow up in difficult social and economic conditions, the study of mental disorders in South Africa has focussed primarily on urban populations. One such rural area in South Africa is the Harry Gwala District, where rates of interpersonal violence and self-inflicted injuries among 15-24-year-old men, are extraordinarily high. Suicide is an important proxy measure of severe emotional distress, predominantly depression and hopelessness. This study reports on rates of fatal self-harm among 15-24-year-old men in the Harry Gwala District. We determined the rates and severity of CMDs and their correlates among 355 young males ranging in age from 14 to 24 years in the Harry Gwala District community. High rates of depression, anxiety, hopelessness and worthlessness were reported. One in four of the young men and boys reported current suicidal thoughts associated with depression, anxiety, feelings of worthlessness and binge drinking. Reports of alcohol use were high, as were those of daily cannabis use. Our findings show high rates of CMDs and alcohol use, and highlight the impact of collective dysphoria on the mental well-being of rural youth in South Africa, who are likely coping through drug and alcohol use.