The Impact of Protests, Riots and Looting on Mental Health

The Impact of Protests, Riots and Looting on Mental Health

Written by Genevieve Burrow, Lauren Blommetjies, Daniel Bode, Ashrene Rathilal, and Shannon Tollman [1]

With the high tensions and unrest occurring across the country, it is imperative to take care of our mental health during these uncertain times. As such, the PsySSA SD brings forward critical information focused on key mental health illnesses aiming to assist and inform individuals. 

Collective action such as riots, protests and looting has occurred in over 180 countries (Banks & WIlson, 2017). First-hand experiences of these actions can have lasting effects on the mental health of individuals. Large-scale crises, such as unrest and collective action, are associated with increases in symptoms of mental health disorders such as panic attacks, anxiety, post-traumatic stress disorder (PTSD) and depression (Wong et al., 2021). Risk factors for psychopathology due to collective action include individual characteristics such as female, socioeconomic status, social support, the nature of the event experienced such as exposure of violence and media coverage, and post-event circumstances such as unemployment and loss of resources (Goldmann & Galea, 2014; Lau et al., 2017). Due to unrest, many individuals across the country feel anxious, scared, betrayed and isolated. As such, there is a dire need to address mental health illnesses that many individuals may face. 

Collective Trauma

Collective trauma is the psychological effect of a traumatic event that affects groups, families or entire societies (Morin, 2020). Traumatic events include pandemics such as COVID-19, natural disasters, riots and protests. Individuals do not have to witness the events first-hand to be negatively affected (Morin, 2020). The extent of trauma symptoms may be affected by several factors such as prior trauma, current stressors, and mental illness. However, collective trauma may precipitate conditions such as PTSD and anxiety. Research indicates that community members exposed to unrest have an increased risk of adverse mental health consequences (First et al., 2020).

Community Mental Health

Community mental health care comprises the principles and practices necessary to promote mental health for a local population by a) addressing population needs in ways that are accessible and acceptable; b) building on the goals and strengths of people who experience mental illnesses; c) promoting a wide network of support services and resources of adequate capacity; and d) emphasising services that are both evidence-based and recovery-oriented (Thornicroft et al., 2011). Given that South Africa grapples with social issues that also affect mental health negatively, such as violence, discrimination, poverty, unemployment, lack of access to housing, social safety nets, and health services – an appropriate treatment plan is needed.

According to the World Health Organisation (WHO) (2021), community-based mental health care is not a single entity. Still, it involves a range of services and interventions to provide for the different support needs of people, in particular crisis support, ongoing treatment and care, and community living and inclusion. Furthermore, the goal is for countries to create their own system of mental health services to methodically address the main functions of crisis support, ongoing treatment and support and community inclusion (WHO, 2021).

Examples of community-based mental health services include mental health crisis services, hospital-based mental health services, community mental health centres, peer support mental health services, community outreach mental services and supported living services for mental health. Citizens can also be proactive by volunteering at organisations that foster mental health, help dispel any stigmatising beliefs about mental illness, check in on their loved one’s emotional state and engage in altruistic behaviour. Local organisations that provide mental health services are listed in this article for your benefit and for the benefit of all who are based in South Africa and may be struggling mentally.

Coping with Grief After Community Violence

Grief reactions typically follow community violence (Substance Abuse and Mental Health Administration [SAMHSA], n.d.). During unrest, communities may experience mistrust and a loss of sense of safety. Anger is a prevalent response to community violence, and grief reactions include trembling or shaking, muscle weakness, nausea, insomnia, nightmares, flashbacks, dry mouth, and difficulty returning to regular activities (SAMHSA, n.d.). 

The grieving process is highly individual, with no correct or incorrect way of grieving (American Psychological Association [APA], 2020). Grieving depends on numerous factors, not limited to personality, age, beliefs, and support network (Der Sarkissian, 2020). Furthermore, there is no concrete time frame for when the grieving process will begin or end. However, there are some ways assist the grieving process.

Tips Include:

• Limit the amount of time spent on consuming information about the crisis, whether it be social media/local news or word of mouth. Constant exposure to community crises can lead to downstream effects on health (Garfin et al.).
• Talk to others who you trust, who understand and respect your feelings and point of view. Avoiding the situation may lead to isolation, and possibly disrupt the ability to heal with your support system (APA, 2020).
• Do your best with what you have to take care of yourself, both physically and mentally, be it diet, sleep, or exercise. Exercising and getting an adequate amount of sleep can help improve emotional and physical health (APA, 2020).

PTSD and Depressive Symptoms Following Social Unrest

While intrinsic vulnerabilities play a considerable role in determining adverse mental health effects, Wong et al. (2021) highlight that a crucial determinant in predicting the development of PTSD and depressive symptoms, lies in the external events affecting a community. Here, Wong et al., (2021) — in conducting surveys among a community in Hong Kong suffering from social unrest- related traumatic events and pandemic events — found that where there were two or more stressful events, the community displayed a high prevalence of PSTD and depressive symptoms, along with frequent rumination. The researchers concluded that other risk factors include low resilience, high smartphone reliance and financial concerns following the aftermath of social unrest, particularly alongside pandemic events (Wong et al., 2021). Paying particular attention to smartphone use during these times, the researchers highlighted the severe impact media coverage and exposure had on inducing rumination and so worsening or triggering PTSD and depressive symptoms.  

Ni et al. (2020) echo these sentiments in their findings, highlighting key stressors on mental health as media exposure, witnessing a personal attack, and proximity to violence. They postulate that direct or vicarious victims of looting, arson and physical injury were most consistently linked with an increased risk of developing PSTD and depressive symptoms (Ni et al., 2020). However, the researchers’ study also revealed that collective actions or the coming together of communities were associated with better resilience post-events as they provided a pervasive and persistent buffer to adverse mental health symptoms, once traumatic events subsided and communities started rebuilding. 

Tips to Cope with PTSD Anxiety:

• Progressive muscle relaxation may effectively reduce stress and anxiety by alternating between tensing and relaxing different muscle groups (Tull, 2020). 
• Mindfulness allows one to remain in the present moment, potentially quelling anxiety.
• Social support from others has a significant effect on alleviating the symptoms of anxiety. 
• Self-soothing skills focus on the five senses to assist with lessening symptoms of PTSD and memories of traumatic events (Tull, 2020). 
• Reach out for help by contacting one of the numbers below.

HELPLINE NUMBERS:

• Dr Reddy’s Help Line 0800 21 22 23
• Cipla 24hr Mental Health Helpline 0800 456 789
• Adcock Ingram Depression and Anxiety Helpline 0800 70 80 90
• Suicide Crisis Line 0800 567 567
• Cipla Whatsapp Chat Line (9am-4pm, 7 days a week)
• SADAG (for depression and anxiety): 0800 20 50 26

[1] Authors write in their capacity as leadership of the PsySSA Student Division’s Media and Marketing Subcommittee. The PsySSA Student Division is a division of the Psychological Society of South Africa (PsySSA).

References

American Psychological Association. (2020). “Grief: Coping with the loss of your loved one.”  https://www.apa.org/topics/families/grief# 

Banks, A. S. and Wilson, K. A. (2017) Cross-National Time-Series Data Archive. Jerusalem: Databanks International.

Der Sar Kissian, C. (2020). “What is normal grieving, and what are the stages of grief?” https://www.webmd.com/balance/normal-grieving-and-stages-of-grief  

First, J., Danforth, L., Frisby, C., Warner, B., Ferguson, M., Houston, J. (2020). Post-traumatic Stress Related to the Killing of Michael Brown and Resulting Civil Unrest in Ferguson, Missouri: Roles of Protest Engagement, Media Use, Race, and Resilience. Journal of the Society for Social Work and Research. https://doi.org/10.1086/711162 

Garfin, D. R., Silver, R. C., & Holman, E. A. (2020). The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychology, 39(5), 355-357. http://dx.doi.org/10.1037/hea0000875 

Goldmann, E. and Galea, S. (2014) Mental health consequences of disasters. Annual Review of Public Health 35: 169–183.

Lau, J., Kim, Y., Wu, A., Wang, Z., Huang, B., & Mo, P. (2017). The Occupy Central (Umbrella) movement and mental health distress in the Hong Kong general public: political movements and concerns as potential structural risk factors of population mental health. Social psychiatry and psychiatric epidemiology, 52(5), 525–536. https://doi.org/10.1007/s00127-017-1340-x

Ni, Kim, McDowell, Wong, Qiu, Wong, Galea and Leung. (2020). Mental health during and after protests, riots and revolutions: A systematic review. Australian and New Zealand Journal of Psychiatry, 54(3), 232-243. DOI: 10. 11710004867419899165. 

Thornicroft, G., Szmukler. G., Mueser, K., & Drake, R. (2011). Oxford textbook of community mental health. New York: Oxford University Press.

Tull, M. (2021). 9 Healthy Ways of Coping With PTSD Anxiety. https://www.verywellmind.com/ways-of-coping-with-anxiety-2797619

Wong, S. M., Hui, C. L., Wong, C. S., Suen, Y. N., Chan, S. K., Lee, E. H., … & Chen, E. Y. (2021). Prospective prediction of PTSD and depressive symptoms during social unrest and COVID-19 using a brief online tool. Psychiatry Research, 298, 113773.

World Health Organization. (2021). Guidance on community mental health services: promoting person-centred and rights-based approaches. https://www.who.int/publications/i/item/9789240025707