The South African Stress and Health Study (SASH)

Allen Andrew Herman, David R Williams, Dan J Stein, Soraya Seedat, Steve Heeringa, Hashim Moomal


Background: This paper gives an overview of the South African Stress and Health (SASH) Study.
Methods: SASH is part of the World Mental Health Survey and is the first large-scale population-based study of mental disorders in a nationally representative sample of 4351 adults. Mental health disorders were assessed with the Composite International Diagnostic Interview (CIDI). An extensive survey questionnaire detailed contextual and socio-demographic factors; timing of mental disorders; key risk factors for mental illness; human rights violations; and 12-month use of mental health services. Simple weighted cross-tabulation methods were used to estimate prevalence and logistic regression analysis was used to study correlates of 12-month and lifetime prevalence and 12-month treatment.
Results: The lifetime prevalence for any disorder is 30.3%; the most prevalent 12-month and lifetime disorders are the anxiety disorders. The Western Cape has the highest 12-month and lifetime prevalence rates and lowest rates were in the Northern Cape. In the 12 months prior to the interview, 15.4% of respondents used mental health services, including 25.5% of those with DSM-IV disorders and 13.4% of those without.
Conclusions: The SASH study shows 12-month and lifetime prevalence rates that are among the highest in the World Mental Health series. South Africa also has a poor record in the treatment of mental disorders; less than a third of those with a diagnosis of mental illness received treatment. However a large proportion of South Africans with no diagnosis of mental illness receive mental health care.

Authors' affiliations

Allen Andrew Herman, Healthcare Management Solutions, LLC

David R Williams, Harvard University

Dan J Stein, University of Cape Town

Soraya Seedat, University of Stellenbosch

Steve Heeringa, University of Michigan

Hashim Moomal, University of Witwatersrand

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Epidemiology, Mental Disorders, Prevalence

Cite this article

South African Medical Journal 2009;99(5):339.

Article History

Date submitted: 2009-03-18
Date published: 2009-05-11

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