The Turkish-led incursion into North-East Syria placed images of conflict, burning horizons and columns of people fleeing their homes back on the media’s front pages.
It also coincided with World Mental Health day where more than ever there is global recognition as to the depth and scale of the ‘invisible’ challenges of mental health across the planet.
Mental health issues in peaceful, developed countries are being debated like never before. Employers, families and society at large are all becoming more sensitive in countries like the UK, to the impact of stress, depression or more chronic mental health issues on people’s lives. Lots of this sensitivity is driven by improved understanding of the workings of the human mind; an area of human physiology that continues to benefit from research and investment.
Yet in conflict zones or for people forced from their homes these issues can be significantly exacerbated and can struggle to receive adequate care. The International Committee of the Red Cross estimates that if you live in crisis affected areas you are three times more likely to suffer from mental health issues.
This is hardly surprising but often the most established and urgent humanitarian response to these crisis’ is a focus on water, shelter and nutrition. The state of peoples’ minds comes as a distant after thought, partly due to a global incapacity of trained responders, to cultural conditions in crisis affected countries where mental health is seen as a private issue not to be surfaced outside of the home or due to a lack of funding.
What’s more, whilst more immediate needs naturally get the most attention, the trauma of witnessing the horrors of conflict or natural disasters can lead to issues that require longer term care - for periods that go far beyond the period of first phase disaster. This is especially the case if we continue to witness the trend towards protracted conflicts. The war in Afghanistan is 18 years old, the war in Syria almost nine - those living, and particular those growing up in the countries - may face a unique challenge to their mental health.
One particular issue is that of ‘toxic stress’. Harvard University define this as the “excessive or prolonged activation of stress response systems in the body and brain”. Having to live for entire childhoods under the threat of death can wire the brain to a very different set of conditions compared to those children who have safe spaces to learn and play.
With some 24 million children in conflict affected areas estimated to have some form of mental health issue it is critical that international and domestic governance adjusts to reflect a better understanding of the scale of the issue and a roadmap towards a response.
Speaking this month at a conference on mentally health in Holland, the UN’s chief humanitarian, Mark Lowcock, explained that “we also need to look at the long-term recovery of people affected by crises. We are examining how our programmes can restore social capital for communities in crisis; the links, the shared values and understandings in society that enable individuals and groups to trust each other and collaborate”.
Trust is an essential component of this response that will twin with the increased awareness we now see to open up conversations across different societies to tackling this issue. If we see mental health as a pyramid with the daily stress faced by the majority at the bottom and smaller numbers needing a more clinical referral at the top - all of this starts with a wider acceptance that this is a public health issue not a private domestic one.
The next step is to realise that considering the scale of the challenge - especially at the bottom of the pyramid - that is makes practical sense to integrate mental health support into other aspects of a humanitarian response rather than to invent and resource a whole new discipline. This means education responses with pathways to mental health support for people who need it for instance.
This year’s World Mental Health day focused on suicide prevention after 2018 saw a sharp increase in the trend. Whilst suicide is of course the extreme outcome of mental health issues it sits on top of a huge pyramid of need that the world appears to be waking up to.
Disclaimer: Views expressed by writers in this section are their own and do not necessarily reflect the views of 7Dnews.