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how victims of war are treated by their communities can determine their mental health

socially vulnerable people are at an increased risk for anxiety, depression and post-traumatic stress disorder.

how victims of war are treated by their communities can determine their mental health
many refugees escaping horrific treatment at home deal with racism and xenophobia when they arrive in a new country, including canada. getty
it’s worthwhile to remember, as we watch the disturbing footage of russia’s invasion of ukraine, the positive effects of social acceptance on people dealing with war trauma. the psychological impact of living through war can be devastating. the effects of war are “catastrophic,” as a 2006 study put it, both in terms of immediate health and safety and for long-term health of communities, economies and social systems.
symptoms of post-traumatic stress disorder (ptsd), anxiety and depression can be common even long after a conflict has ended, or a person has resettled in a new country. according to the centre for addiction and mental health, this can involve intrusive thoughts and flashbacks, nightmares or disturbed sleep, hopeless feelings, hyper-vigilance, and physical symptoms including headaches, muscle tension, and high blood pressure.
everyone is vulnerable to mental health deterioration during or after a war, but some groups are more vulnerable than others, including women, children, the elderly, and people with disabilities. we know for sure that children are greatly impacted by ongoing conflict or war, although studies differ on just how much. for example, research on children impacted by the israeli-palestinian conflict has rated their levels of ptsd everywhere from 18 per cent to 69 per cent. another study found that more than 60 per cent of children impacted by the syrian civil war have at least one psychological illness.
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the positive impacts of social acceptance

in one 2019 study, researchers spoke to more than 500 people over 15 years who were forced to participate in sierra leone’s civil war when they were children. these child soldiers were between the ages of 10 and 17 when they were separated from their families — often abducted — and forced to participate in violence.
most of them (72 per cent) were boys. sixty-seven per cent had been the victims of “life-threatening violence,” and nearly one-third (32 per cent) reported the death of at least one parent. five per cent of the boys and 45 per cent of the girls reported being raped.
following the war, many of these teens or young adults were ostracized for their “participation” in the violence, even when it had been forced — 28 per cent exceeded the therapeutic threshold for likely ptsd, while nearly half (47 per cent) exceeded the threshold for anxiety or depression.
based on how they were treated by their communities, researchers identified three groups: people who had some degree of social acceptance or community supports; people whose level of social acceptance was low, but had some gradual improvement; and people without any meaningful social acceptance. the third group of socially-vulnerable people fared significantly worse than the other two groups, with an increased risk for anxiety, depression and ptsd. they were also three times more likely to attempt suicide.
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“sierra leone’s child soldiers experienced violence and loss on a scale that’s hard to comprehend,” the study’s author dr. stephen gilman told the national institute of health. “[but there may be steps we can take to modify the post-war environment to alleviate mental health problems arising from these experiences.”

mental health treatment for victims of war

one helpful form of therapy for both kids and adults is narrative exposure therapy (net). it involves constructing a “trauma narrative,” the international review of the red cross explains. net allows the patient to contextualize their experience in a way that “serves to recapture the patient’s self-respect and acknowledges their human rights,” the american psychological association says. the therapy has been shown to help children orphaned by the rwandan genocide, former child soldiers in uganda and the democratic republic of the congo, and refugees to germany, among others.
trauma-focused cognitive behavioural therapy (tf-cbt) can also help people process trauma. a study of 52 congolese girls aged 12 to 17 who had either witnessed or experienced rape during war found that the tf-cbt patients experienced a major improvement when it came to symptoms of ptsd, anxiety and depression, as well as psychosocial issues — even when their practitioners weren’t clinically trained.
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social acceptance in a new country

many refugees escaping horrific treatment at home deal with racism and xenophobia when they arrive in a new country, including canada. while most canadians are supportive of immigrants, one-third of our population thinks “there is too much immigration.” and a 2015 pew research centre study found that the american public has rarely welcomed refugees — in 1938, for instance, just before wwii, 67 per cent of americans opposed immigration from “german, austrian and other political refugees.”
that kind of discrimination, especially in people who so recently experienced trauma, can be harmful to refugees’ health. a 2020 study of refugees and asylum seekers who moved to australia found that 22 per cent of participants said they had experienced discrimination in their new country. that group had “significantly worse mental health” outcomes than the others. the researchers found that discrimination was also associated with less sense of belonging, lower levels of trust, a reduced sense of control and less hope in general.
these topics are front of mind for many canadians now, as we watch with horror at what’s happening in eastern europe. but it’s worth remembering that in the 77 years since wwii, the world has seen hundreds of armed conflicts.
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maija kappler is a reporter and editor at healthing. you can reach her at mkappler@postmedia.com
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