Violent conflict and war have serious adverse implications for the mental health of populations. If left unattended, the mental health burden of conflict impedes positive engagement by affected populations in post-conflict reconstruction and undermines the social sustainability of communities recovering from conflict.
Our experience and analysis shows us that the legacy of violence in Northern Ireland and elsewhere poses an immediate humanitarian and public health need that warrants attention as a core part of political peace processes, as well as on humanitarian, political, social and economic grounds. In the context of serious civil conflict, fear and mistrust makes this problem worse, and conventional services (where they exist) will not be adequate for the task of identifying, reaching and responding to those who are suffering trauma-related mental health needs.
In many divided or contested societies affected by conflict, the victims of violence may become victims of the peace and if this remains unrecognised, appropriate services and support are unlikely to develop. This may mean that those with enduring needs may not overcome the experience of violence in their lives, and can find it difficult to become active participants in the social sustainability of their communities in the longer term. Further, there are the risks of ongoing trans-generational burdens on families and wider society or adverse experiences of conflict. Strategic and imaginative thinking as a key part of peace building will be needed to address such outcomes and risks, specifically to ensure that appropriate and effective policies, along with innovative services, are developed. This is especially true in the context of sectarian or protracted civil conflict, as the legitimacy and definition of victims and survivors may be contested. Where this is so, and agreement cannot be reached on definitions, solutions for interventions will also be contested. This may lead to difficulties in accessing services by those in need.
ICRT’s experience shows that psychological and mental health needs should be a critical concern for the task of peace-building so as to promote and support engagement with the emerging civic society and to encourage stakeholding in the post-conflict community. Peace processes both create, and depend upon, social sustainability. Political interests can be more focused on constructing the necessary political systems and processes needed to end violence and manage the peace. This focus means that insufficient consideration is given to other mechanisms that will help with the task of post-conflict peace building, such as recognising and dealing with the mental health consequences of conflict. Highlighting this and integrating it into the peace building process as early as possible will bring longer term benefits, and lead to improvements in health and social sustainability. Moreover, without recognition of this, and, in the absence of appropriate services and support, there will remain an on-going challenge of helping those with enduring needs to overcome the experience of violence in their lives, in order that they can become active participants in their communities.
To ensure that effective services are routinely and readily accessible, attention needs to be given to the meanings communities have of their experience of violence and to understanding trauma-related population needs, policy development, service design and delivery arrangements, as well as practice standards, workforce development and training requirements. Also, funders and service commissioners will have an interest in ensuring that investments will reach those most in need and produce the best possible outcomes for humanitarian relief and positive social impact
