When an armed conflict breaks out, both the donor community and charity organisations rush to respond to humanitarian needs. Emergency funds are typically issued rather quickly and consequently, the projects that get funded are also developed quickly. Unquestionably, funds are needed urgently and the usual lengthy process of applications would get in the way of proper emergency responses. But is rushed support based on people's actual needs and priorities, or rather on the organisations’ and donors’ priorities?
Basic emergency responses usually include the provision of humanitarian needs and services, such as food, shelter, rebuilding destroyed neighbourhoods and demilitarising armed groups. These are essential. But how do we define these needs? Are services like food and shelter enough?
Organisations cannot answer these questions without taking the time to include the communities they are working with in their planning. Any intervention should be done alongside and hand in hand with the communities they are working for. And proper attention must be given to their physiological and psychological needs - which must include a trauma sensitive approach. We cannot do this work and help victims of trauma without them. Whether it’s working on advocacy, justice, access to the labour market, rebuilding homes, reuniting families, it has to be developed based on people's actual needs.
Unfortunately, given resource constraints and the uncoordinated and imbalanced rush to provide services to war-ravaged communities, the sequencing and prioritisation of the provision of these services rarely - if ever - include the provision of mental health support.
One might wonder, in the aftermath of conflict, whether basic physiological and psychological needs should be as much a priority as food and shelter. I would go even further and question whether the lack of mental health support might lead to re-traumatisation of the communities we purport to help.
Consider, for instance, the concept of human security, which provides a framework that invites post-conflict humanitarian interventions to look at what makes people feel safe. The concept is based on the recognition that the need for safety underlies all other aspects of the healing process and thus should be a priority in emergency interventions.
This could be very important for interventions that focus on rebuilding destroyed neighbourhoods. Perceived and real threats of violence, created during and after conflict, generate suspicion and deepen mistrust and may continue to exist in the undercurrents between individuals and communities. This means that people might need psychosocial assistance before being able to go back to their previous lives within their previous communities. Otherwise, rebuilding their houses is not just insufficient, but can put them at risk of re-traumatisation.
Another example of post-conflict intervention is the reintegration of former fighters into civilian life, where following the demilitarisation of armed groups, former fighters would get support to build skills so that they can re-enter the labour market. A lot of new research and guidelines have been developed on how to make sure former fighters are rehabilitated in order to reduce the risk that they will take up arms again.
Some research also shows the importance of the work needed within communities and societies to accept former fighters. But what about their own ability to go back to a normal life after the atrocities they have witnessed, or even committed? Research has shown, unsurprisingly, that former fighters often experience various mental health problems including post-traumatic stress disorder (PTSD), depression, suicidality, and substance use disorder. Investing in developing their skills and providing them with jobs without providing mental health support might be a lost investment.
Some other projects focus on access to justice for victims and their families. In the aftermath of a conflict, promising such justice to victims could provide a sense of hope and comfort. But legal processes often put the victims in situations where they need to face their oppressors and relive the events - while not always leading to a conviction nor recognition of the crimes committed. If psychosocial support is not provided to the victims throughout the process and proper attention is not given to making sure they understand the lengthy and complex process they are about to embark on, these projects might have an adverse effect.
It is undeniable today that mental health is an important public health issue and must be incorporated in peacebuilding projects and post-conflict strategies. Otherwise rebuilding societies and economies affected by conflict will be an uphill battle.
The question remains, how do we make sure that we provide a timely response to people's needs without risking aggravating their trauma or re-traumatisation?
The emerging concept of adding a trauma lens to any peacebuilding intervention can provide a framework that helps answer the question. It may seem obvious that the fields of peacebuilding and mental health and psycho-social support should work closely together in their respective efforts and that they will be supported by the donor community, however, this is not yet the case. Assumptions, stereotypes, lack of knowledge about the other field and stigma about mental health continue to hamper integration of both fields.
Sabine Saliba works in the field of armed conflict, peacebuilding and human rights. Recently, she served as the Executive Director of ACT for the Disappeared, a Lebanese human rights organization. Sabine has been working on human rights for over 15 years, including 12 years on children's rights, in Lebanon, the Middle East and internationally with the London based Child Rights International Network (CRIN) and the International Labour Organisation (ILO) in Geneva. She has worked as a consultant for various institutions including Parliamentarians for Global Action and Small Arms Survey. She holds a Law degree and an MA in International Law.