On October 10, World Mental Health Day, the U.S. government should make a firm commitment to expand access to mental health and psychosocial support services in their humanitarian responses.
The current number of forcibly displaced persons globally -- estimated to be over 50 million -- is astonishing and is expected to keep rising while war and conflict persist in places where no civilian is left unaffected, including children.
Though violence rages in the Central African Republic, South Sudan, and elsewhere, the civil war in Syria has been cited as a main cause of the recent massive increase in refugees.
With more than 3 million Syrian refugees registered by the UN High Commissioner for Refugees and millions more displaced internally, António Guterres, the UN High Commissioner for Refugees, has called the Syrian crisis "the biggest humanitarian emergency of our era." Over half the refugees are under the age of 18.
The experiences of any refugee can be terrifying and traumatic. Many flee in fear, often leaving behind all that they have. They may have escaped from their homes amid a constant barrage of shelling and indiscriminate killing. Some have been threatened with or subjected to arbitrary arrests, indefinite detention, torture, and/or sexual and gender-based violence.
Visiting last month with survivors in Jordan, I heard repeated accounts of multiple abuses. After going out of her house in Aleppo to find food, one mother told of her return home to find her four daughters -- aged 17 to 21 -- all dead from a bomb dropped on their house. Eighty years of mothering wiped out in an instant. She no longer had a reason to live, she said, and had attempted suicide several times. She is now receiving care from CVT and wanted her story told.
Far too many children have survived extreme violence and destruction, and are now in desperate need of mental health and psychosocial support.
We see that nearly every day at our international healing site in Jordan, where a large number of the Syrian refugee survivors we extend rehabilitative care to are under the age of 18.
Survivors of violence in Syria might have nightmares, other sleep disorders, headaches, physical pain, deep depression, severe anxiety, suicidal thoughts, and a full range of post-traumatic stress disorder (PTSD) symptoms. Affected children suffer from similar disorders but don't always present symptoms in the same way adults do. They can have nervous and/or aggressive behaviors, anxiety, fear, anger, and have a much harder time regulating and expressing their emotions. Bedwetting becomes common. Some stop speaking or eating or both.
This is all extremely distressing to their parents who often feel their most important job is protecting their children from harm. Many parents, themselves, are also severely traumatized and have a difficult time providing a safe and stable environment for their children.
Without access to vital mental health and psychosocial support services, such as those provided by CVT, these children's psychological problems could last for years. Their healing, recovery, and futures depend on a greater international prioritization of these services, increased quality and availability of care, and a global commitment to better integrate mental health with other programs along with the necessary financial resources.
For its part, the U.S. government should adhere to key objectives listed in the World Health Organization's Mental Health Action Plan 2013-2020. Among its objectives for Member States is: "When planning for humanitarian emergency response and recovery, it is crucial to ensure that mental health services and community psychosocial supports are widely available."
The U.S. Senate Committee on Appropriations recently directed the U.S. Department of State and the U.S. Agency for International Development, in cooperation with relevant UN agencies and organizations, to include mental health and psychosocial support services as a core component in programs addressing the needs of Syrian refugees.
This is a welcome development and it is our hope the U.S. government will adopt this directive as a matter of official policy for its responses to all refugee humanitarian crisis situations.
Likewise, the U.S. government should increase its contributions to international organizations that support mental health, especially the UN Voluntary Fund for Victims of Torture. The Fund makes critical grants to torture survivor rehabilitation programs globally for psychological and other assistance. The U.S. government should also encourage other governments to pledge or increase their contributions to the Fund as well.
With counseling and psychosocial support, young lives devastated by war and childhoods violently taken away can be reclaimed. We see it happen when they begin to smile again, laugh again, and play again.
On World Mental Health Day, let us insist upon the international community coming together with the will, resolve, and resources to make mental health and psychosocial support services available. By doing so, they can facilitate the possibility of bright, healthy, and productive futures for these children and for millions of other people and communities around the world.