One member of the South African Police Service (SAPS) dies by suicide every week on average, highlighting the mental health toll on South Africa’s overworked and under-resourced first responders.
The latest data presented by SAPS in the first half of the year reveals a sharp increase in both suicide attempts and deaths over the past three financial years.
During the 2022/2023 period, two SAPS members attempted suicide, and 45 died by suicide. In 2023/2024, these numbers rose to four attempts and 62 deaths. For 2024/2025, suicide deaths slightly decreased to 54, while attempts increased to six. In the current financial year, there has been one suicide attempt and three confirmed deaths so far.Police members are not alone. South African paramedics and ambulance personnel, emergency care nurses and doctors, firefighters and rescuers experience depression, anxiety, post-traumatic stress disorder (PTSD) and burnout at rates far higher than the general population, according to a study of the mental health of first responders in the South African Journal of Psychology.
The South African Society of Psychiatrists (SASOP) warns that chronic exposure to trauma, coupled with limited resources and lack of mental health support, puts the lives of first responders at risk, along with the lives of those they work to help and protect.
A study released earlier this year among South African police members and paramedics showed that 47.3% would qualify for a diagnosis of depression.
Board member of SASOP, Dr Alicia Porter, said workers on the frontline of responding to crime, domestic violence, large-scale road accidents, medical emergencies and natural disasters are disproportionately susceptible to adverse mental health outcomes.
“A study released earlier this year among South African police members and paramedics showed that 47.3% would qualify for a diagnosis of depression, 37.8% for generalised anxiety disorder, and 48.5% for post-traumatic stress disorder,” says Porter.
These levels of mental distress far exceed the prevalence in the general population, of depression and mood disorders estimated at 9.8%, anxiety disorders at 15.8%, and PTSD at 2.3%.
South Africa losing frontline talent
Other studies have found that 30% of Western Cape ambulance personnel experience PTSD, and recorded high levels of burnout in advanced life support paramedics in Gauteng with 30% suffering total burnout and 63% experiencing burnout related to work, patient care or personal stress.
“Underneath the uniforms are people facing the same mental struggles as many of us, but their work environment is unique in that they are among few professions where the very nature of their jobs repeatedly and consistently puts them in extremely stressful and high-risk situations, endangering not only their physical safety but also mental well-being.
“Untreated mental health conditions among first responders hamper their ability to do their jobs effectively, and impacts negatively on their quality of life and personal relationships,” she says.
“Unless we improve mental health support for first responders, and tackle the root causes of depression and burnout, South Africa risks losing this frontline talent and further weakening our capacity for disaster and emergency response – putting more lives at risk. With many public services already under-staffed and under-resourced, the country can ill afford this.”
Leading cause of disability
Mental health disorders are a leading cause of disability both worldwide and in South Africa, where a mental health treatment gap of between 75% and 90% means the majority of people go untreated, according to a study that was outlined in the National Library of Medicine.
Porter says this was due to the country’s low provision of resources for mental health treatment, particularly in the public sector where most first responders are located, coupled with pervasive stigma around mental health issues.
Employee assistance programmes (EAP) and wellness interventions are of “uneven quality” among emergency services, and employees are reluctant to seek help in the workplace because of actual or perceived lack of confidentiality.
The Parliamentary Portfolio Committee on Police highlighted its concerns last year about the lack of adequate employee health and wellness interventions for SAPS members, after SAPS management advised that the entire SAPS structure has only 621 health and wellness employees to service over 187 000 SAPS personnel.
Resilience depleted by long hours
“Stigma is particularly heightened in uniformed work cultures, worsened by a lack of confidentiality which raises fears that workers who show signs of trauma or ask for help will be found unfit for duty, impacting negatively on their careers and income.”
She said that the mental health risks to first responders were worsened by an imbalance between job demands and support resources.
“Their jobs demand constant physical, mental and emotional involvement, over long working hours, which takes a toll on their mental and physical health, and depletes their internal resources of resilience and coping skills.
She concludes by advising emergency healthcare and first response providers to provide “confidential, independent pathways” to encourage help-seeking, and to contract registered trauma and mental health clinicians to provide support clearly separated from employees’ line management reporting.
