War produces trauma. The psychological fallout of war can linger much like the fallout of an atomic bomb. People who have experienced frontline combat, survivors of conflict-induced gender violence, families of missing people and people fleeing their homes and livelihoods, and those who have lost body parts face major psycho-emotional challenges.
Trauma is a whole-body reaction that stays with a person long after the immediate trauma-inducing experience passes. The body’s stress responses to trauma have lasting effects from muscle tension, migraines, cardiovascular problems, inflammation and weakened immune responses. Elevated stress raises cortisol levels, which is linked to the onset of heart disease.
Trauma’s physical symptoms merge with emotional and psychological symptoms. It’s well established that war has catastrophic effects on mental health. Conflict and humanitarian disasters cause rates of mental health conditions to double. Experiences of anxiety, depression, psychosis, self-harm, emotional detachment and unhealthy coping mechanisms, such as substance abuse, and phobias, all increase.
Post Traumatic Stress Disorder (PTSD) is one major, insidious, subtle and damaging psychological reaction that people have to traumatic stresses. PTSD is common among those who experience war from civilians and combat soldiers; it often involves involuntary flashbacks and ruminations on the trauma-inducing experience, compounded with nightmares, hyper-vigilance and a sense of hopelessness.
Conflict-produced trauma affects interpersonal relationships, debilitating a person’s ability to form and maintain them. Avoidance of triggers may cause further isolation and social withdrawal. Traumatized people may struggle to trust others and have intimacy and communication issues that fuel unhealthy or unstable relationships.
In addition to the psychological hell it causes, conflict-induced trauma hinders a person’s ability to function and provide the essentials they need for themselves and their families. Managing daily life in the brutality and insecurity of war and post-conflict insecurity is difficult, but doing so with an untreated mental health condition can make it much harder.
Buildings and roads can be rebuilt anew. However, trauma is generational as traumatized parents pass on heightened anxiety, emotionally unstable attachment styles, emotional dysregulation, and unhealthy coping behaviours to their children, creating lasting negative consequences long after the initiating traumatic experience.
Damaged people stunt community rebuilding, healing, and reconciliation. the conflict-traumatized community faces many challenges. These include economic decay, social fragmentation, increased violence, crime, family breakdown, reduced trust, and less willingness to engage with social or civic institutions. Endemic poverty exacerbates further social decline and mental health conditions. High rates of Mental health issues can overwhelm an already debilitated and fragile health system.
The critical role of mental health support in conflict settings: Empowerment, resilience and healing.
Evidence is clear that access to mental health support for people traumatised by war is critical to healing and building resilience as part of humanitarian and development responses. Access to psychosocial support is essential to post-war community-wide rehabilitation.
Effectively supporting the mental health needs of individuals and communities affected by conflict requires multifaceted approaches. This may involve re-establishing and strengthening community-based support networks and advocating for policies that address the root causes and injustices of conflict.
Specialist mental health experts can support the training of local experts and community groups and work to strengthen mental health care services and remove cultural and economic barriers to evidence-based care. In conflict situations where mental health issues are little understood or stigmatized, channelling support through existing community and religious groups may be necessary and most effective.
At the same time, public awareness and education programs can play a crucial role in enabling effective support and understanding for individuals and families affected by conflict. Parental education programs that focus on identifying and addressing the psychological effects of conflict on children and adolescents, for example, can be particularly valuable.
Psychological therapy, such as trauma-focused cognitive behavior therapy (TF-CBT) or narrative exposure therapy(NET), can also help people process trauma. Training in non-self-destructive coping strategies can strengthen resilience and healing. Identifying and managing the negative psychosocial symptoms of conflict can lead to greater self-awareness, self-acceptance, and tolerance of others.
Mental health care can also be community-driven and facilitated by non-specialists. Group discussions, interventions, peer-to-peer support, and individualized counseling improve well-being outcomes and coping abilities. These community-driven services must operate in contexts where conflict occurs and contexts where people flee. Refugees often report discrimination and social organisation, which impact mental health. Women and people with disabilities need to be a priority, as these people are the most likely to have the greatest need but more limited access to support.
Ultimately, meaningful and sustainable mental health support should work in tandem with the social, political, and economic needs of individuals and communities. It is essential to prioritize mental health support as a crucial element in humanitarian development responses that address health and essential needs, such as shelter, water, economic security, education, vocational training, and ongoing protection.
Lasting healing from trauma requires empowerment and autonomy. Advocacy on behalf of victims is critical in minimizing the mental health consequences of war. Empowering survivors, validating their suffering, and enabling them to hold accountable those who have devastated their families and communities is of utmost importance. Their voices and experiences contribute to a better understanding of the root causes of the conflict and the needs of those most affected by it. It supports them in addressing the social, political, and systemic issues that led to the conflict and reduces the likelihood of it occurring again. Empowerment includes providing access to education, vocational training, and healthcare, which create opportunities and livelihoods beyond subsistence living. Fostering a person’s potential and opportunities helps individuals move beyond feelings of grief, apathy, and hopelessness that conflicts often foster.
Initiatives providing mental health support to victims of conflict.
Several humanitarian organizations focus on delivering psychosocial support to those affected by war and conflict. These programs aim to assist individuals in coping with the trauma of violence and displacement, rebuilding their lives, and restoring a sense of normalcy and stability in their daily routines.
For example, the International Medical Corps (IMC) prioritises preventing and treating mental health conditions in crisis situations. Through their Mental Health and Psychosocial Support initiative, the IMC deploys mental health support to people displaced through conflict. They provide emergency problem-solving counseling, behavioral interventions, group therapy and implement relevant community-based interventions.
The lack of mental health professionals in population-wide crisis situations has prompted the IMC to develop resources, including apps and guidebooks, that are accessible to non-experts. These resources can be utilized in community-led or self-guided approaches to assist individuals enduring prolonged adverse situations.
The IMC aims to foster long-term resilience and coping strategies. In pursuit of this goal, they have partnered with the World Health Organisation (WHO) to develop sustainable mental health responses. These responses involve various initiatives, such as training local mental health professionals, building mental health care systems, and enhancing community capacity to address and respond to mental health needs. They achieve this by collaborating with and strengthening culturally relevant community-based support groups.
The United Nations Development Programme (UNDP) supports mental health and psychosocial well-being within conflict-affected populations. In Ukraine, the Mental Health and Psychosocial Support Network (MHPSS) is a collaborative network of organizations that offer mental health and psychosocial support to individuals impacted by the conflict. The network's programs encompass various community-based interventions, including support groups and outreach activities, as well as individual counseling and therapy.
The United Nations Development Programme (UNDP) works to support mental health and psychosocial well-being among conflict-affected populations. The Mental Health and Psychosocial Support Network (MHPSS) in Ukraine is a network of organisations that provide mental health and psychosocial support to those affected by the conflict. The network's programs include community-based interventions, such as support groups, outreach activities, individual counselling, and therapy.
Similarly, at Helping War Victims, we are currently fundraising for a center for psychosocial rehabilitation in Kyiv. This center is dedicated to providing holistic assistance to address the conflict-related trauma that at least 40 percent of Ukraine's population is predicted to experience. Specialized care will be provided by psychologists and mental health professionals who will diagnose and treat individuals, helping them process their suffering and readjust to daily life. In addition to acute healthcare, the center will offer individuals and families continuous social and psychological support.
These programs and initiatives highlight the critical significance of prioritizing mental health support for individuals impacted by conflict. By ensuring access to mental health services and fostering local capacity to address mental health needs, we can foster healing, resilience, and recovery in response to the inhumane devastation caused by war and violence.
THIS ARTICLE WAS CREATED BY TIM MCVICAR