Mental health and conflicts

The COVID-19 pandemic reminds everyone of the importance of taking mental health into account in our societies. Regarding humanitarian context, what consequences can conflicts have on populations?

©Sadak Souici | Dans un hôpital de la région de Donetsk

©Sadak Souici | In a hospital in Donetsk region 

To begin with, it is important to remind that mental health is an essential component of health. The Constitution of the World Health Organization (WHO) defines health as follows: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

According to the WHO: “Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.”

For Mélissa Robichon, psychologist and mental health advisor at Première Urgence Internationale: “Mental health must be considered as a continuum that includes a state of well-being, psychological suffering, distress and mental disorder. It is a continuum where there are multiple forms of symptoms and intensity and on which we, as individuals, constantly move according to the events of our lives, our ability to cope, our environment and our biological factors.”

The Donbass situation

Première Urgence Internationale has been working for several years in the field of mental health and psychosocial support, particularly in the Donbass mining basin.

The population’s mental health has been extremely impacted as a result of the conflict in eastern Ukraine. This includes both internally displaced people in Ukraine and people who have remained at the borders of the conflict zones,” explains the mental health referent.

An elderly woman supported by the NGO testifies: “I live on the front line. I have survived all the explosions; I know all the types of weapons. I live on the second floor, everything is destroyed by the bombs. Sure, there is light, there is water, and nowhere to go. My husband needs an operation, but there is no medicine. Despite this, I will overcome this ordeal even though it is very hard.”

© Sadak Souici | At Mayorsk checkpoint where Première Urgence Internationale intervenes in health

© Sadak Souici | At Mayorsk checkpoint

In 2018, the NGO conducted an upstream assessment of its activities there. The data collected determined the factors of psychological distress within the community.

These factors are most often related to family separation, loss of property and employment, disruption of access to basic services: health, education, transportation, communication, worsening economic conditions including rising prices, low incomes, and distress due to anticipation of further consequences of the conflict.”

A need for training

The field of mental health is emerging in many countries, therefore, the use of a psychologist or specialist is extremely limited and when it exists, often focused on severe mental disorders and stigmatized.

Moreover, the people living in the areas of intervention of Première Urgence Internationale in Ukraine mostly inhabit rural and remote areas. Access to health services is therefore more complex there than in the large cities.

“Mental health services themselves are limited and the health personnel have little training in identifying and caring for people in psychological distress”, adds the psychologist.

To counter this lack, the NGO trains, among others, health professionals in the field of mental health and psychosocial support in Donbass.

Valeriia Volkova, in charge of mental health and psychosocial support interventions for Première Urgence Internationale in Ukraine, explains: “We teach them how to diagnose the main mental disorders, how to define depression, mourning, post-traumatic stress disorders… We insist on knowing how to diagnose all these disorders in order to refer patients to specialized health centers when appropriate.”

The topics of these trainings cover various themes such as “individual care, psychological first aid, the use of clinical assessment tools and behavioral activation for the elderly”.

© Sadak Souici | In Donetsk region where the NGO Première Urgence Internationale has been working since 2015

© Sadak Souici | In Donetsk region

The effect of conflicts on mental health

According to WHO data dating from 2019, in conflict zones “one in five people live with some form of mental disorder, ranging from mild depression or anxiety to psychosis.” In addition, “nearly one in ten people live with a moderate or severe mental disorder.”

The same study analyzed five recurrent disorders in conflict zones: “depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia”.

Conflict situations and humanitarian crises create a series of issues encountered at different levels: individual, family, community and social,” explains Mélissa Robichon, she adds, “At all levels, situations of adversity weaken the support systems usually available in normal circumstances and tend to exacerbate pre-existing health problems – including mental health, social inequality and poverty.”

“In this context: humanitarian aid which benefit social and community functioning, as well as the mental health of individuals is crucial,” she says.

Première Urgence Internationale teams have been helping civilians in the Donetsk region since 2015. The NGO’s areas of intervention are: health, access to water, sanitation and hygiene.

By making a donation to Première Urgence Internationale, you allow the teams to continue their work on site and to raise awareness about mental health among communities and health professionals.

The NGO regularly draws attention to the seven-year conflict in Donbass. Therefore, from the 15th to the 27th of March 2021, a photo and video exhibition entitled “Ukraine: the faces of conflict” will take place in Paris.

The above-mentioned projects are carried out with the support of the European Civil Protection and Humanitarian Aid (ECHO).

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