It is fair to assume that we have come a long way from the post-World War I days when British soldiers were executed for having “shell shock,” now recognized as post-traumatic stress disorder. During that time, mental health awareness for people in traumatic, violent situations was almost non-existent. Now, we have extensive research on the various ways in which trauma can affect our lives for years and years. Considering Syria has become synonymous with conflict, it really is not surprising at all that years of violence in the form of bombings, airstrikes, public executions and chemical attacks would leave a population mentally scarred.
Yet, mental health remains one of the most overlooked concerns, not only within the borders of Syria, but also for refugees who have managed to flee to neighbouring countries. In February 2016, the Syrian Center for Policy Research announced in a report that 470,000 Syrians had been killed. The United Nations High Commissioner for Refugees conducted research that estimated the concomitant average life expectancy being reduced from 75.9 years in 2010 to an estimated 55.7 years at the end of 2014 in Syria. The International Medical Corps has found that this trauma has left at least 54 percent of the internally and externally displaced people with severe emotional disorders and 26.6 percent of children with intellectual and developmental challenges. A 2015 study by the German Federal Chamber of Psychotherapists estimated that half of all Syrian refugees in Germany had mental issues.
Additionally, one of the biggest causes of mental disorders is sexual and gender-based violence. Many women and girls are exposed to gender-based violence due to the breakdown of law and order inside Syria, increased poverty, lack of basic needs and safe services, and family separation. The UNHCR notes that women and girls fear sexual abuse from kidnappers and extremists as well as domestic abuse from men in the family. Increased stress due to conflict has been seen to increase violent tendencies in men in the region.
While 57 percent of Syria’s public hospitals need to be repaired while an additional 37 percent are out of service, doctors are fleeing the country, and the remaining male doctors are often not allowed to tend to female patients. Hospitals often get attacked and caught in the fire between opposing sides in the war, and the same is happening in Syria. All volunteers, aid workers and law keepers should get basic training in dealing with people who have suffered through trauma. Humanitarian actors are trained to keep this in mind while implementing their programs. But this should not be at the expense of addressing risks for longer-term consequences due to the profound losses and ongoing daily stressors that many displaced persons and refugees have experienced. Some of the most important factors in producing psychological morbidity in refugees may be alleviated by planned, integrated rehabilitation programs and attention to social support and family unity. In order to effectively support the mental health and psychosocial well-being of people affected by the Syrian crisis, it is essential that mental health treatment activities are formulated in a broad and inclusive way.
There should also be increased training of specialized mental health providers. This is especially possible in the countries which host refugees, since they aren’t in the middle of a war. Host countries are now responsible for a larger population of patients. These countries need to be provided with resources through international aid. The mental health crisis in Syria is going to be a difficult battle to fight, with multiple generations being affected. The international community needs to rally around them to better their health in the short run and to allow them to rebuild Syria in the long run.
