(Brussels) – Governments, UN agencies, and humanitarian organizations should take concrete steps to develop and invest in mental health support for people affected by armed conflict, Human Rights Watch said today. In line with the motto of World Mental Health Day 2022 on October 10, “Making mental health and well-being for all a global priority”, the focus should be on community-based, rights-respecting services in both conflict-affected and conflict-affected countries , to which people flee.
Conflict-related violence can lead to psychological distress, depression, anxiety and post-traumatic stress. Human Rights Watch research in countries such as Afghanistan, Cameroon, the Central African Republic, Ethiopia, Gaza, Iraq, South Sudan and Syria has shown that people, especially women and people with disabilities, often face barriers to accessing mental health services.
“Millions of people around the world are experiencing the devastating effects of war on their mental health, yet few are getting the support they need,” said Shantha Rau Barriga, director of disability rights at Human Rights Watch. “The war in Ukraine is the latest reminder that governments and humanitarian organizations must prioritize mental health and expand mental health support services for all affected by conflict.”
The Global Mental Health Summit, taking place in Rome on October 13-14, 2022, is an opportunity for leaders to reaffirm the impact of armed conflict on mental health and to commit to empowering all affected, including women and people with disabilities, to provide appropriate psychosocial support. Governments, donors and humanitarian agencies should prioritize community-based, rights-respecting services that uphold people’s autonomy and dignity.
An estimated 22 percent of people living in areas affected by armed conflict suffer from some mental illness, compared to about 13 percent in the general population. But the services offered are often not enough.
In Syria, where about 7.5 million children and young people currently need mental health support, parents interviewed by Human Rights Watch described the conflict’s devastating impact on their children’s mental health. All but one person indicated that they and their children had no access to mental health and psychosocial support services.
The father of a 13-year-old boy with a developmental disability said: “This situation has made him more withdrawn. He sits alone and doesn’t want to interact with other children.” The father of a 10-year-old boy with intellectual disabilities said that the multiple military offensives in the area have particularly affected his son: “He has changed a lot. He’s always afraid, even if it’s something he shouldn’t be afraid of.”
In Afghanistan, devastated by 40 years of armed conflict, it is estimated that more than half of the population, including many survivors of conflict-related violence, suffer from depression, anxiety and post-traumatic stress, but less than 10 percent receive adequate psychosocial support from the state, it said the documents of the previous government.
A man, who was 23 when Human Rights Watch interviewed him in 2019, was not offered psychological counseling after a suicide bombing that killed at least 20 people. He was treated for injuries at the military hospital, but “no one came to ask my opinion,” he said. “They just treated my body.” Two years later, he sought help, but the trauma remained: “I still have flashbacks, I can’t sleep all night. I get angry easily [especially] when people make noise. But I kept that anger inside and I was very sad. I don’t know what kind of treatment should be provided but there should be people asking about our needs.”
The ongoing war in Ukraine is already having a profound impact on the mental health of those affected, including those who were able to escape. Needs in Ukraine remain high, and in other crisis situations that receive less attention, psychosocial support is often overlooked.
More than 100 million people have been forcibly displaced worldwide, including refugees, asylum seekers and internally displaced persons. In addition to the psychological damage caused by the traumatic events that drive people from their homes, research shows that forcibly displaced people, both during and after the flight, often experience additional stress while adjusting to an unfamiliar place.
Receiving countries also have an obligation to provide psychosocial support as part of their international commitment to the right to health. This is recognized in international human rights treaties, including the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Rights of Persons with Disabilities (CRPD).
When the Taliban took control of Afghanistan in August 2021, many Afghans fled the country at short notice, sometimes leaving their families behind. Research by Human Rights Watch in France showed that despite major efforts to welcome, promptly house and assist Afghan evacuees, many still faced significant barriers to accessing psychosocial support. One woman told Human Rights Watch, “I was in shock mode and now I’m still in shock mode. I keep forgetting things, I even forget my name.”
Research by Human Rights Watch in countries such as Ethiopia and Iraq documented the impact of conflict-related sexual violence on women’s mental health. A woman from Tigrayan said she was raped by a gang of soldiers and civilians three months before she spoke to Human Rights Watch. This moment comes to my mind every day…. I always remember that day.”
“It is fundamental to improve the availability of mental health services for survivors of conflict-related violence,” Barriga said. “It is important to prevent further suffering and long-term consequences for individuals, their families and entire communities.”