Where a person lives has a profound and often unseen impact on their mental well-being. For many South Africans, the very layout of their towns and cities, a direct consequence of historical injustices, continues to shape their emotional state. This connection between location and mental health is a critical factor in understanding the nation’s growing mental health challenges.
Research increasingly shows that our surroundings — from the quality of our housing to the safety of our neighbourhoods — are not merely backdrops to our lives but active participants in our mental state.
According to the World Health Organisation (WHO), mental health is a state of well-being that enables people to cope with life’s stresses.It is influenced by a combination of individual, community, and structural factors. People exposed to adverse circumstances, including poverty and inequality, are at a higher risk of developing mental health conditions.
This is particularly relevant in South Africa, where a study by the Wits/Medical Research Council Developmental Pathways for Health Research Unit (DPHRU) found that more than a quarter of South Africans suffer from probable depression, a rate significantly higher than in many other countries. The study highlights that factors like socio-economic status and geographic location are key contributors to the prevalence of mental illness.
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The Lingering Trauma of Apartheid’s Geography
The historical and ongoing effects of spatial inequality are at the forefront of new research seeking to understand South Africa’s mental health landscape. Salmah Chopdat, a Ph.D. candidate at the University of Edinburgh and a research assistant, is investigating this very issue.
“What I’m currently working on is looking at how does spatial inequality impact mental health? And put simply, it’s exploring the relationship between where people live and how they feel,” Chopdat explained in an interview with Salaamedia. “I’m particularly interested in how historical and ongoing spatial inequalities, many of which are rooted in forced removals and apartheid planning, continue to influence emotional well-being.”
Chopdat, who grew up in Lenasia, a formerly ‘Indian’ settlement on the outskirts of Johannesburg, notes that the psychological toll of displacement was often unacknowledged by the generations who first experienced it. “Our parents and grandparents who came to Lenasia through forced removal never really spoke about the psychological toll of the experience. They didn’t see it as trauma. They simply lived through it,” she said.
While these communities built resilience and vibrancy, the trauma did not vanish. “From our findings, we see that that trauma hasn’t really disappeared. It merely just lingered down to generations… the psychological effect of being forcibly removed and resettled, often far from economic opportunity and support systems, silently lingers.”
This intergenerational trauma is now manifesting in younger people. Chopdat’s research indicates that “low socioeconomic status, unemployment, lack of educational opportunities, [and] language barriers all stem from apartheid as a history… and all of it results in a higher prevalence of both depression and anxiety amongst youth.”
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Urban Stressors and the Housing Dilemma
The challenge is not unique to South Africa. Global research confirms the powerful link between environment and mental state. A study on urban living in India identified five key stressors negatively affecting mental health: housing issues, traffic, neighbourhood characteristics, cost of living, and employment stress. Similarly, a study in Hong Kong found that both housing and neighbourhood quality were significantly associated with mental health, noting that a high-quality neighbourhood could help alleviate the detrimental effects of poor housing.
The UK-based mental health charity, Mind, states that not feeling “safe, secure or comfortable where you live” can severely affect mental health. Others point out that factors like clutter, noise, poor lighting, and conflict-ridden relationships within the home can create feelings of anxiety and overwhelm.
For many, the most significant environmental stressor is the home itself. Chopdat highlights that the legacy of apartheid planning directly influences this. This placement on the “periphery of the urban city” often correlates with higher rates of mental health challenges.
The issue of spatial inequality is compounded by a critical lack of access to mental health care, particularly in these marginalised communities. “Growing up in Lenasia, access to mental health care… was not easily accessible, nor was it affordable,” Chopdat recalled. “And that sits at the heart of the issue.”
She acknowledges that therapy is an intensive and costly profession, and practitioners’ fees are valid. However, the reality is that the “majority of South Africans live under significant financial strain. And many simply cannot afford private therapy at current rates.” This creates a devastating cycle where those most affected by environmental and historical stressors are the least able to access the help they need. The deterioration of youth mental health, she argues, is directly linked to this gap. “It’s simply because we just do not have better access to mental health care.”
Ultimately, addressing the mental health crisis requires a multi-faceted approach that looks beyond the individual to the environment they inhabit. It necessitates tackling the enduring legacies of the past and building communities that are not only economically viable but also designed to foster mental well-being for all their residents.
Image credit: The Inc Magazine
