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ERRB Scientific Publications: Mental Health in Conflict-Affected Populations: Fact Sheet

What is the Public Health Problem?

Mental disorders account for about 14% of the global burden of disease.1

Violent conflict is an important contributing factor in the origin of mental illness.

Approximately 25 million people worldwide are displaced due to violent conflict.2

Hundreds of millions are affected by war worldwide.

The prevalence of mental illness is much higher among war-affected populations than the general population.

30-70% of people who have lived in war zones suffer from symptoms of post traumatic stress disorder (PTSD) and depression.3

What has the CDC Accomplished?

Psychological damage has traditionally not been addressed during humanitarian emergencies and its extent and impact have not been well studied.

In an effort to fill some of the gaps in knowledge of the psychological consequences of humanitarian emergencies, CDC has conducted a number of epidemiologic investigations of mental health and psychosocial issues among populations affected by war and natural disasters.

At the request of President Clinton, CDC took part in a delegation to Kosovo to assess psychosocial issues after the war ended in 1999. CDC carried out two mental health surveys in Kosovo: one immediately after the war in 1999, with a follow-up in 2000.

These surveys documented the psychological damage of the war, identified risk factors for mental illness, and made recommendations which have lead to increased awareness and funding for mental health programs in complex humanitarian emergencies.

In 2000, at the request of the International Rescue Committee, CDC conducted a mental health survey among refugees in Thailand.

In 2002, CDC conducted the first nationwide mental health survey in Afghanistan, in conjunction with a national disability and injury survey. Results were used to guide Afghanistan’s Ministry of Public Health and the United Nations in their efforts to mitigate the psychological consequences of 20 years of war.

In 2003, CDC collaborated with the Harvard Program in Refugee Trauma to conduct mental health and landmine injury surveys among the general population in Siem Reap Province in Cambodia, many of which were displaced during the Khmer Rouge Period.

In 2005, the Thailand Ministry of Public Health and the Department of Mental Health requested assistance from CDC to conduct a rapid assessment among the survivors of the 2004 Tsunami. A mental health survey among adults and children was conducted 5 weeks after the disaster, with a follow-up survey 6 months later.

What are the Next Steps?

The prevalence and long-term global effects of psychological trauma in war and conflict need to be determined, and a strategy for addressing the problem needs to be developed.

  • Restoring psychological health is critical to restoring conflict areas to normal social and economic functioning.
  • Addressing feelings of hatred and a desire for revenge in a mental health context may be key to preventing future conflicts.

There is an urgent need for evidence-based mental health and psychosocial interventions in emergencies.

  • Evaluation and outcome studies of mental health programs will determine the impact and effectiveness of mental health and psychosocial interventions in complex emergencies.

CDC will continue to provide technical assistance to the United Nations and non-governmental organizations in their efforts to address the extent and impact of psychological damage on those involved in humanitarian emergencies.

1 Prince M, Patel V, Saxena S, et al. No health without mental health. Lancet 2007; 370: 859–77.

2 Internal Displacement Monitoring Centre. Global Overview of Trends and Developments in 2006. April 2007.

3 RF Mollica, B Lopes Cardozo, H J Osofsky, B Raphael, A Ager, P Salama. Mental health in complex emergencies. The Lancet 2004; 364, 2058-2067.

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