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It is difficult to describe the mental suffering you experience when you visit a war zone and meet people affected by conflict or war. Sometimes you think it can not be worse. And then you go to another conflict situation and that is worse, another kind of hell.
This week, new WHO estimates published in the Lancet show that there are more people with mental disorders in conflict-affected areas than previously thought – much more. One in five lives with some form of mental disorder, ranging from mild depression or anxiety to psychosis. Even worse, almost 1 in 10 people are living with a moderate or severe mental disorder.
These people desperately need to be able to get treatment and care. Their troubles often affect their ability to function. Access to care is not just about improving mental health, it can also be about survival.
Today, countries in conflict are not lacking. UN estimates suggest that in 2019, nearly 132 million people in 42 countries worldwide will need humanitarian assistance resulting from a conflict or disaster . Nearly 69 million people around the world have been forcibly displaced by violence and conflict, the highest number since the Second World War.
Fortunately, we can do a lot to help them. Indeed, we have a lot of are Make.
In 2019, WHO deals with mental health in countries and territories whose populations are affected by major emergencies around the world: Bangladesh, Iraq, Jordan, Lebanon, Nigeria, South Sudan, Syria, Turkey , Ukraine, West Bank and Gaza Strip. among others.
When we are asked to support the coordination of mental health interventions in emergencies, whether during a conflict or after a natural disaster, our first task is to quickly clarify what people need.
Our second task is to identify as soon as possible the resources already available – what government services, local non-governmental organizations and international partners have the capacity and knowledge to manage mental health issues. They must be able to support people in acute stress and grief and to evaluate and treat mental disorders, from the mildest to the most serious.
The third task is to help provide the support capacity when what exists is not enough. This usually involves coordination with partners and rapid capacity building of local providers.
Over the last decade, in collaboration with our partners, we have developed a series of practical guides to help establish and develop psychosocial and mental health support in emergency situations. We have also adapted our "mhGAP program", whereby general health workers are trained to recognize and provide front – line support for common mental disorders so that they can be used in the event of a humanitarian emergency.
In many countries of the world, ignorance about mental health and mental illness remains widespread. Taking care of mental health care during conflict and other emergencies, in countries where this support is limited, can help identify those who are tied up, locked up in cages, hidden from society. In many cases, it is this very support that dispels myths about mental illness and leads to treatment, care and a path to a more dignified life.
We also learned that when political will exists, emergencies can be catalysts for the development of quality mental health services.
In Syria, for example, prior to the conflict, there was virtually no mental health care outside the psychiatric hospitals of Aleppo and Damascus. Now, however, with growing recognition of the need for support, psychosocial and mental health support has been introduced in primary and secondary health facilities, community and women's centers, and school programs.
In Lebanon, the population of 4 million inhabitants has risen another million in recent years as refugees cross the border from Syria. Recognizing the rapidly rising need for mental health services, the government is taking this opportunity to strengthen its mental health services so that they now benefit not only newcomers but also the local population.
The 2004 tsunami in Sri Lanka and Indonesia and the 2013 typhoon in the Philippines were the catalyst for the decentralization of mental health care at the community level where it was most needed. In most cases, the infrastructure set up remained once past crises.
In fact, if we look at the global landscape of mental health services development over the last 20 years, it is fair to say that some of the greatest progress has been made after emergencies.
All countries have the obligation to invest in mental health. But it is particularly important in conflict-affected populations where the rate of mental health problems is more than double that of the general population.
The examples provided above show how investing in mental health is yielding results, not only to help people survive in extreme distress, but also to support the country's recovery.
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