Over one billion persons have been affected by war, internal conflict and mass violence in recent years in the world. About 50 countries in the world to-day are affected by massive conflict/post conflict health problems. Out of these, many have developed mental health related problems, disorders and disabilities affecting their well beings, productivity and peaceful existence.Social conflict (Internal conflict) was going on for more than eleven years in Nepal. Fortunately, there is more hope now for a peaceful political solution in the coming years. However, more than twelve thousand people have been killed during this period. Whereabouts of many people is still not known. We have no idea of the number of conflict affected people suffering from mental health problems as no such studies has been done in Nepal.
It is well known that mental health consequences arise in all countries where conflict, mass violence, disaster and destruction of social and physical infrastructures have occurred. Psychological trauma, loss and dislocation in conflict and post conflict settings significantly interfere with the capacity for recovery and development. Long term mental health policies and programmes are needed to deal with these problems.
Mental health impacts of conflict occur mainly due to loss of family, physical injury and disability, physical and psychological torture, loss of home and property, displacement, sexual abuse and loss of community and may be country for some.
The most common mental health problems seen are post – traumatic stress disorder, depression, anxiety, headache and sleep disturbances. Research conducted in several conflict affected countries show high rates of mental health problems as mentioned above.
It is also known that mental health problems continue for long time, even after the conflict has ended. Mental health problems not only affect the grown up people, they are also seen in children and adolescents. Exposure to traumatic events like injury to self, injuries of parents or other loved ones, death of parents or loved ones, sights of torture or killings and frightening images in the media are often the cause of such mental health problems. The affected children may suffer from post-traumatic stress disorder, depression, anxiety, guilt, outburst of anger, fighting, antisocial behavior, hatred and revenge. Affected children and adolescents can lead to academic failures which in turn may lead to the use of drugs or alcohol.
The question of providing mental health care to the affected people is a major challenge. The main aim should be to identify people suffering from various psychological problems and provide psychological “First Aid” which comprises of listening, ensuring basic needs, mobilizing support, and protecting the survivor from further harm. It also includes providing information about the situation and families, social support, group meetings and shared activities. Main aim of these activities is to enhance the abilities of the sufferers to cope with the demands of life.
As there are lots of constraints in our country, for example, poor mental health service network, lack of human resources in the field of mental health and also the required funds, intervention is not easy. However, there is relatively better health service infrastructure in general health services and this human resource can be utilized for psychological first aid. Health care professionals and all the health care workers working in the conflict affected areas can be oriented and trained on various mental health related problems, so that they can identify and provide psychological first aid. For difficult cases, they can refer to a place where specialized service is available.
