Mental health clinics in violence-prone South Sudan are rare and
endangered
[August 11, 2025]
By FLORENCE MIETTAUX
MUNDRI, South Sudan (AP) — Joy Falatiya said her husband kicked her and
five children out of their home in March 2024 and that she fell apart
after that. Homeless and penniless, the 35-year-old South Sudanese
mother said she thought of ending her life.
“I wanted to take my children and jump in the river,” she said while
cradling a baby outside a room with cracked mud walls where she now
stays.
But she's made a remarkable recovery months later, thanks to the support
of well-wishers and a mental health clinic nearby where she's received
counseling since April.
She told The Associated Press that her suicidal thoughts are now gone
after months of psycho-social therapy, even though she still struggles
to feed her children and can’t afford to keep them in school.
The specialized clinic in her hometown of Mundri, in South Sudan’ s
Western Equatoria state, is a rare and endangered facility in a country
desperate for more such services. Now that the program's funding from
Italian and Greek sources is about to end, its future is unclear.
___
EDITOR’S NOTE — This story includes discussion of suicide. If you or
someone you know needs help, the national suicide and crisis lifeline in
the U.S. is available by calling or texting 988. There is also an online
chat at 988lifeline.org. Internationally, many governments and other
organizations offer help and information on how to contact them is
available online.
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The clinic is in one of eight locations chosen for a project that aimed
to provide mental health services for the first time to over 20,000
people across this East African country. Launched in late 2022, it
proved a lifeline for patients like Falatiya in a country where mental
health services are almost non-existent in the government-run health
system.
Implemented by a group of charities led by Amref Health Africa, the
program has partnered with government health centers, Catholic parishes,
local radio stations.
Massive displacement
Across South Sudan, there has been massive displacement of people in the
civil war that began in 2013 when government troops loyal to President
Salva Kiir fought those loyal to Vice President Riek Machar.
The eruption of fighting was a major setback for the world's newest
country, which became a major refugee-producing nation just over two
years after independence from Sudan. Although a peace deal was reached
in 2018, the resumption of hostilities since January led the U.N. to
warn of a possible “relapse into large scale conflict.”
The violence persists even today, with Machar under house arrest and
government forces continuing with a campaign to weaken his ability to
wage war. And poverty — over 90% of the country's people live on less
than $2.15 per day, according to the World Bank — is rampant in many
areas, adding to the mental health pressures many people face, according
to experts.
In a country heavily dependent on charity to keep the health sector
running, access to mental health services lags far behind. The country
has the fourth-highest suicide rate in Africa and is ranked thirteenth
globally, World Health Organization figures show. Similar challenges in
access to mental health services are seen elsewhere in places facing
conflict, from eastern Congo to Gaza.
In South Sudan, suicide affects mostly the internally displaced, fueled
by confinement and pressures related to poverty, idleness, armed
conflict, and gender-based violence, according to the International
Organization for Migration.
“Mental health issues are a huge obstacle to the development of South
Sudan,” said Jacopo Rovarini, an official with Amref Health Africa.
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People participate in a Self Help Plus session at St. Peter Parish
in Mundri, South Sudan, June 25, 2025. (AP Photo/Florence Miettaux)
More than a third of those screened
by the Amref project “show signs of either psychological distress or
mental health disorders,” he said. "So the burden for the
individuals, their families and their communities is huge in this
country, and it has gone quite unaddressed so far.”
Mounting suicide cases
Last month, authorities in Juba raised an alarm after 12 cases of
suicide were reported in just a week in the South Sudan capital.
There were no more details on those cases.
Dr. Atong Ayuel Longar, one of South Sudan’s very few psychiatrists
and the leader of the mental health department at the health
ministry, said a pervasive sense of “uncertainty is what affects the
population the most" amid the constant threat of war.
“Because you can’t plan for tomorrow," she said. “Do we need to
evacuate? People will be like, ‘No, no, no, there’s no war.' Yet you
don’t feel that sense of peace around you. Things are getting
tough."
In Mundri, the AP visited several mental health facilities in June
and spoke to many patients, including women who have recently lost
relatives in South Sudan's conflict. In 2015, the Mundri area was
ravaged by fighting between opposition forces and government troops,
leading to widespread displacement, looting and sexual violence.
Ten years later, many have not recovered from this episode and fear
similar fighting could resume there.
“There are many mad people in the villages," said Paul Monday, a
local youth leader, using a common derogatory word for those who are
mentally unwell. “It’s so common because we lost a lot of things
during the war. We had to flee and our properties were looted.”
“In our community here, when you’re mad you’re abandoned,” Monday
said.
NGOs try to bridge the gap
As one of the charities seeking to expand mental health services,
the Catholic non-governmental organization Caritas organizes
sessions of Self Help Plus, a group-based stress management course
launched by WHO in 2021. Attended mostly by women, sessions offer
simple exercises they can repeat at home to reduce stress.
Longar, the psychiatrist, said she believes the community must be
equipped with tools “to heal and to help themselves by themselves,
and break the cycle of trauma."
But she worries about whether such support can be kept sustainable
as funds continue to dwindle, reflecting the retreat by the United
States from its once-generous foreign aid program.
The project that may have helped save Falatiya's life, funded until
November by the Italian Agency for Development Cooperation and the
Athens-based Stavros Niarchos Foundation, will come to an end
without additional donor funding. Specialized mental health services
provided at health centers such as the Mundri clinic may collapse.
“What happened to me in the past was very dangerous, but the thought
of bad things can be removed,” Falatiya said, surveying a garden she
cultivates outside her small home where a local man has allowed her
to stay after taking pity on her.
She said that she hopes the clinic will still be around if and when
her “bad thoughts” return.
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