Mosibudi Mangena

[intro]In the 2017 academic year, students at different universities have died of unnatural causes. The alarmingly high suicide rate has drawn attention to the lack of adequate mental health, social and academic support. Sarah Henkeman argues that institutions of learning must make links between trans-historical, trans-national and intra-personal mechanisms that invisibly produce the high rates of suicides, homicides and social harm in society.[/intro]

Suicides committed by university students, and particularly six deaths due to unnatural causes at UCT during 2017, have occurred without causing a major outcry in society. In general, the professional or lay interest of most commentators, investigators and the criminal justice system is not on the interaction between individual propensity and structural factors that produce harm. Instead, attention is mainly focused on an assumed lack of inner resources to withstand environmental factors, but not that these factors co-produce violence that is either self-inflicted or inflicted on others. Suicide can therefore not be delinked from South Africa’s historically unequal, and thus structurally violent context that permeate its institutions.

Invisible aspects of violence are symbolic, structural and psychological, and these can and do in many instances lead to visible acts of violence such as suicide, assaults and homicide as set out in this guide. These invisible aspects of violence will remain intact if attention is not also focused on how and that micro-macro factors interact daily to produce self-harm in a structurally violent society. Interventions should therefore not be limited solely to individual level mental health support (which should be increased), but must also be systemic to create institutions and a society that promotes overall thriving.

In the absence of a holistic approach, the best that mental health workers can do, is to help already distressed individuals to cope and to build resilience against uninterrupted structural violence. While quantitative research is helpful to show a picture of how widespread the problem is, qualitative research that places visible violence in context will put society in a better position to prevent and reduce unacceptably high rates of deaths.

In a recent article on death by suicide published by Africa Check on 16 October 2017 facts about suicide are reported. This does not however offer a deeper, wider and longer analysis of the invisible mechanisms that produce these facts. For example, they focus on:

– An estimated number of deaths by self-harm and caution that suicides are under-reported.
– A comparison between the number of estimated suicides during different years.
– A comparison according to race and gender sans context.
– A hierarchy of causes of death amongst young people.
– South Africa’s global ranking with regard to suicide rates regardless of historical context, but with a caution from the WHO about under-reporting related to country comparisons.

Granted, facts in the form of numbers, categories and comparisons are important – but Africa Check confess that they do not have all the facts. In this article and many scholarly works on suicide, we learn nothing about why under-reporting occurs, what the possible reasons are for under-reporting, and how these factors might obscure possibilities for prevention or reduction of both invisible and visible aspects of violence beyond a focus on individual propensity.

The impression we get is that these deaths are unavoidable. This provides strength to the dominant and enduring argument that nothing can be done to prevent high rates of suicides and homicides, save to lament the former and to incapacitate perpetrators of the latter with lengthy prison sentences. This does not explain why society continues to produce high numbers of individuals who commit suicide and homicide under similar conditions.

This raises several questions: Why are we as a society not paying closer attention to societal conditions/invisible mechanisms that co-produce visible violence that end in so many deaths? How do we even begin to do this without being accused of playing the blame game? What is structural violence anyway?

An understanding of structural violence begins with an appreciation of how states, and by extension most people within those states, are hierarchically positioned in the unjust global world order. These unjust structures, according to Iadicola & Shupe, ‘manifest themselves in differences in life chances’ largely for people who are considered as inferior.

(Ascribed and internalised inferiority/superiority constitute symbolic violence which precedes and accompanies structural, psychological and physical violence, as discussed in the guide linked to above). Within these states, and as a result of a largely racialised global economic system, a further division occurs between previously excluded have nots, as a small number are allowed to give the impression that the middle class is being deracialised. Zizek argues that structural violence is inherent in the system as the counterpoint to violence perpetrated by individuals. Paul Farmer and others explain what constitutes structural violence by suggesting that:

The arrangements are structural because they are embedded in the political and economic organisation of our social world; they are violent because they cause injury to people. […] Structural violence is visited upon all those whose social status denies them access to the fruits of scientific and social progress.

An understanding of structural violence and the role it plays in co-producing suicides will help us to (i) ask different questions and (ii) apply different remedies to prevent and reduce suicides, homicides and other social ills. Our first port of call is thus to examine and correct how educational institutions educate and prepare professionals and society to make the links between trans-historical, trans-national and intra-personal mechanisms that invisibly produce the high rates of suicides, homicides and social harm.

Who is holding our educational institutions to account to facilitate concrete rather than only conceptual social justice?