While mental health concerns have received increased awareness in some post-conflict locations, there has been an inclination to implicitly assume that the impact of trauma caused by mass violence may be transitory and non-disabling and that involvements in the emergency stage are adequate. However, there have been doubts cast on both presumptions by a small but expanding body of research on factors affecting mental health and effective treatment in post-conflict settings. Recent research indicates amongst displaced populations and refugees, Post-Traumatic Stress Disorder (PTSD) and major depression are chronic and prevalent. The impact of trauma as research also shows can be long term and often intergenerational. Following their traumatic experience, child survivors of the Nazi holocaust and Japanese concentration camps were found to experience PTSD symptoms as late as 40-50 years of age. Studies on Nazi Holocaust and Cambodian Pol Pot survivors show that their children and their children’s children are also affected by the psychosocial impact of conflict.
Countries that have suffered from enduring conflict such as Somalia have the highest prevalence of mental illness in the world, according to a study run by the World Health Organization (WHO). For example, one in three Somalis are suffering from psychological conditions, but this extremely high statistic is staunchly juxtaposed by the sheer lack of resources needed for mental health in the nation. The country is unable to deliver the most basic of care to those in need – many of whom are chained to hospital beds, isolated or even jailed. All the violence and killings which are currently taking place in Somalia could be the manifestation of a broader crisis. There are concerns that the magnitude of unaddressed mental health issues, is so large it may be contributing to the country’s instability. Therefore the link between individuals who experience conflict-related trauma and go on to commit further acts of violence must not be ignored.
Poor mental health is also a crucial element of radicalization and violence, from a security standpoint. Individuals become vulnerable to radicalization and violent extremism when they have no way to deal with the trauma they have encountered. Furthermore, mentally ill people who are already susceptible to delusions, are usually preyed upon in much of the recruitment in extremism. Going back to Somalia, the mental health crisis has the capacity to negatively impact regional and international security, if left unaddressed. Even if structures can be rebuilt, they will not stand for long if the wellbeing of individuals in society is ignored.
On the contrary, Japan, despite constantly being ranked as one of the most peaceful countries in the world, also has a severe mental health crisis and long battled one of the highest suicide rates in the industrialized world. In Japan, isolation is the number one precursor for depression and suicides says Wataru Nishida, a psychologist at Tokyo’s Temple University. Japan is famous for a condition called ‘hikikomori’, a type of social withdrawal. It was first familiarized to refer to young people in the 1990s with disdain of social norms around obtaining an education and pursuing a career by displaying extreme, long‐term social withdrawal. Population prevalence data indicate that it is an important public health issue, although it is currently viewed as a sociocultural mental health phenomenon rather than a standard mental illness.
We have also discovered that conflicts can be a catalyst for building quality mental health services when the political will exists. For example, before the conflict in Syria, outside of the mental hospitals in Aleppo and Damascus, there was limited mental health care. Now, mental health and psychosocial support have been introduced in primary and secondary health facilities, in community and women’s centres, and in school-based programmes, thanks to an increased response to the need for help. In fact, it’s fairly reasonable to say that some of the greatest progress in mental health have been made after emergencies if one looks at the global landscape of mental health service developments over the last 20 years.
Deaths each year
People with a mental disorder
Spent on mental health budget
What is Mental Health?
Mental health consists of our emotional, social and psychological well-being. It influences how we feel, act and think. It also helps regulate how we make choices, handle stress and relate to others. From childhood and adolescence through to adulthood, mental health is vital at every period of our lives. Family history of mental health problems and life experiences such as trauma or abuse are some of the many factors that contribute to mental health problems as well as biological factors, such as genes or brain chemistry.
To what extent are Mental Health issues impacting people on a global scale?
Worldwide Mental Health conditions are increasing. The disparity between people needing care and those with access to care, remains considerably large, even though many mental health conditions can be efficiently treated at a reasonably low cost. Depression and anxiety which are two of the most frequent mental health problems, cost the global economy $1 trillion each year. In Spite of this figure, the global average of government healthcare expenditure that goes towards mental health is less than 2%.
How does conflict affect Mental Health?
The risk of Mental Health conditions is exacerbated by emergency situations such as humanitarian crisis, natural disasters and armed conflicts. Some form of distress will be felt by most people affected by conflict distress (e.g. difficulty sleeping, fatigue, hopelessness, irritability or anger and/or aches and pains, feelings of anxiety and sadness). In a humanitarian crisis, the prevalence of common mental disorders such as depression and anxiety is expected to more than double. Among people who have experienced war or another conflict in the previous 10 years, WHO’s review of 129 studies in 39 countries showed that one in five people (22%) will have depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia.
- 1 in 5 people affected by conflict is estimated to have a mental health condition
- Mental Health conditions affect 20% of the world’s children and adolescents
- The mortality rate of those with mental disorders is significantly higher than the general population, with a median life expectancy loss of 10.1 years.
The Key Actors
To improve the mental health of individuals and society at large, WHO works with Member States and partners. This involves efforts to expand access to mental health care that recognizes people’s human rights, the prevention of mental disorders and the promotion of mental well-being. In 2019, WHO launched the WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health to ensure access to quality and affordable care for mental health conditions in 12 priority countries to 100 million more people.
Technical advice on mental health in emergency situations is received by the WHO. Since 2019 WHO is working on mental health in a variety of different countries and regions affected by large-scale emergencies such as the Syrian Arab Republic, Nigeria, Bangladesh, Ukraine, Iraq , Lebanon, Turkey, West Bank and Gaza Strip, Jordan, and South Sudan.
- (Mental) Health Crisis
- Coming soon
- Coming soon
New Zealand is being failed by our mental health systems. These systems have been failing us in a steady decline for many years, leading up
This page was written and is currently being updated by Abdurahman Warsame – Global Health Crises Advisor.
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