Mental Health Services Imperative in War Torn Countries

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woman crying with her hands over her head
bomb blasts

“It is difficult to describe the mental suffering you see when you go to a war zone and you meet people affected by conflict or war.  Sometimes you think it can’t get any worse. And then you go to another conflict situation and it is worse - another kind of hell,” says Dr. Mark van Ommeren of the Department of Mental Health at the World Health Organization.

People living in war torn countries strive every day for the most basic of life’s necessities – food, water and shelter.  These interminable acts of desperation to sustain life, wreak havoc on the strong and weak alike – edging ever so much closer to a psychological breaking point as they watch their world crumble and diminish.  Schools, churches, local food stores, medical centres, playgrounds and neighbourhoods – are unrecognizable.  Witnessing your village, town or city fall prey to constant, thunderous bombings and piercing blasts of machine guns, bleeds every ounce of familiarity and security from your senses.  Only when the shelling has stopped, do you realize that the echoes of destruction reverberate from within.

One in five people living with armed conflict suffers from depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia.  Anxiety and depression, more common in women than men, increase with age in conflict settings.

woman crying with her hands over her head

Afghanistan, Iraq, Nigeria, Myanmar, Somalia, Sahel, South Sudan, Sudan, Syria, Libya, Yemen, Bangladesh, Jordan, Lebanon, Turkey, Ukraine, Philippines, the West Bank and Gaza Strip are affected by large-scale emergencies – as well as many other countries.

  • In 2019, nearly 129 million people in 42 countries need humanitarian assistance resulting from conflict or disaster.
  • In 2016, there were 53 ongoing conflicts in 37 countries with 12% of the world’s population living in an active conflict zone. 68.6 million people worldwide were forcibly displaced by violence and conflict – the highest number since WWII.

Published by the Lancet an article entitled, New WHO Prevalence Estimates of Mental Disorders in Conflict Settings: a systematic review and meta-analysis petitions the, “…need for increased, sustained investment in the development of mental health services in areas affected by conflict.”

boy in war torn country

Past studies underestimated the burden of mental health conditions in conflict-affected areas.  Revised research was comprised of 129 studies and data from 39 countries published between 1980 and August 2017, including 45 new studies published between 2013 and August 2017. 

“I am confident that our study provides the most accurate estimates available today of the prevalence of mental health conditions in areas of conflict,” said lead author of the study Dr. Fiona Charlson of the University of Queensland, Australia and the Institute for Health Metrics and Evaluation in Seattle, Washington.

children lining up for food

“In conflict situations and other humanitarian emergencies, WHO provides support in many ways: firstly, by supporting coordination and by assessing the mental health needs of populations affected; secondly, by determining what existing support is available on the ground and what more is needed; and thirdly, by helping provide the capacity for support when it isn’t sufficient, either through training or bringing in additional resources.  Despite their tragic consequences, when the political will exists, emergencies can be catalysts for building quality, sustainable mental health services that continue to help people in the long-term,” says study author Dr. Mark van Ommeren.

“The uptake of mental health care during conflict and other emergencies, in countries where such support has been limited, can lead to the identification of people who are tied up, locked in cages and hidden from society,” says Ommeren.

mental illness

Emergencies and major conflicts are catalysts that have brought awareness and an increase in psychological treatment and care to the forefront, providing a more dignified life for those suffering from mental illness indicates Ommeren.

Aside from the mental health hospitals in Aleppo and Damascus in Syria, minimal mental health care was available before major conflicts occurred but now due to a growing recognition, psychosocial support has been introduced in primary and secondary health facilities, women’s centres and school-based programmes.

One million refugees have crossed the border from Syria to Lebanon.  The Lebanese government identified the need for mental health services and increased their support.

After the tsunami in Sri Lanka and Indonesia in 2004 and the typhoon in the Philippines in 2014, government and medical officials increased mental health care at the community level.  The infrastructure remains in place today.

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