Feeling depressed or hopeless in Gauteng

In recent years there has been growing global and national interest in mental health. The GCRO included a number of questions related to mental health in its fifth Quality of Life survey (QoL V) conducted across Gauteng in 2017/18. In this survey, 24 889 adult respondents were asked how often they felt depressed or hopeless in the two weeks preceding their participation in the survey. The questions came from the Patient Health Questionnaire-2 which is used as a very short screening tool for the frequency of depressed mood and hopelessness. Response options were: 'nearly every day', 'more than half the days', 'a few days' or 'not at all'. Since the sample included respondents in every ward in Gauteng we are able to provide an indicative map of the distribution of feelings of depression or hopelessness. The map shows the percentage of respondents who indicated prolonged feelings of depression and hopelessness (nearly every day or more than half the days) per ward.

Much of the province is coloured pale blue or yellow. In pale blue areas, including many middle class suburbs of Tshwane, Ekurhuleni and Johannesburg, and some rural parts of the province, 20-38% of responses reported having felt depressed or hopeless nearly every day or more than half the days during the previous two weeks. In the wards shaded yellow, between 39 and 57% said that they had felt depressed or hopeless during the same period. The wards in this category include those in inner city areas, some townships, some middle class suburbs, and some rural parts of the province. In the areas shaded pink, 58-76% of people said that they had experienced feeling depressed or hopeless. This includes wards in relatively low income places such as Alexandra, Sebokeng, parts of Soweto, Soshanguwe, and Westonaria, which is located to the east of Carletonville. Prolonged periods of feeling depressed or hopeless are most prevalent in some wards in Orange Farm and Vereeniging in the Emfuleni Local Municipality. Here, 77-95% of respondents said they felt depressed or hopeless nearly every day or more than half the days in the two week period prior to being surveyed.

The wards with a relatively high proportion of respondents reporting regular depression and hopelessness were mostly located on the edges of the Gauteng province. However, being located on the edge of the Gauteng province does not necessarily mean that respondents will experience prolonged feelings of depression and hopelessness. This can be seen in the wards near Carletonville, where respondents reported some of the lowest levels of depression and hopelessness.

The analysis below details the interaction between various socio-economic variables and feelings of depression and hopelessness.

As can be seen in figure 1, men were more likely than women to report that they had not felt depressed or hopeless at all, and higher percentages of women reported having felt depressed or hopeless nearly every day or more than half the days in the preceding two week period.

Figure 2 shows that 61% of respondents identified as white said that they did not feel depressed or hopeless in the previous two weeks. The percentage declined amongst other groups, with a markedly lower 52% of African respondents saying that they did not feel depressed or hopeless. Respondents who identified as coloured were marginally more likely than other groups to report that they felt depressed or hopeless on more than half the days or nearly every day.

Respondents with higher levels of education were less likely to report feeling depressed or hopeless. The completion of secondary school is an important threshold in that more respondents reported that they had not experienced feelings of depression or hopelessness than those who did. Respondents who had not completed high school were more likely than not to have reported feeling depressed/hopeless for at least some days, and those with no education indicated the highest levels of depression/hopelessness.

As indicated in figure 4, the QoL survey results suggest a strong relationship between average monthly household income and feelings of depression or hopelessness. Depression/hopelessness decreased significantly as income increased. The important threshold here was in the region of the minimum wage of R3 500. Those earning below this threshold were more likely than not to have at least some feelings of depression and hopelessness.

Mental health has become a key focus in the global public health arena. As a result it is critical that we map out the spatial distribution of depression and hopelessness amongst Gauteng residents in a bid to better develop policy responses to depression. Furthermore, it is vital to better understand the various factors that contribute to the prevalence of depression in the province in order to better address its debilitating and sometimes tragic consequences.

Comments and editing by Richard Ballard, Julia de Kadt and Graeme Götz.