Yousuf*, 13, and his younger sister Sumaia*,10  are pictured with a Save the Children worker in Yemen in August 2019. Yousuf* was injured in an explosion, and Sumaia*  spoke to Save the Children about her fears of her siblings getting injured again. *Names have been changed. Credit: Antonia Roupell/ Save the Children.

Yousuf*, 13, and his younger sister Sumaia*,10  are pictured with a Save the Children worker in Yemen in August 2019. Yousuf* was injured in an explosion, and Sumaia*  spoke to Save the Children about her fears of her siblings getting injured again. *Names have been changed. Credit: Antonia Roupell/ Save the Children.

More than 24 Million Children Affected by Conflict Need Mental Health Support

FAIRFIELD, Conn. (Sept. 10, 2019)—Millions of children living in high-intensity conflict zones or forced to flee as refugees will require support to address mental health concerns, according to a new briefing, “Road to Recovery: Responding to Children’s Mental Health in Conflict,” released by Save the Children ahead of critical meetings at next week’s United Nations General Assembly.

The latest figures show that 142 million children live in conflict zones with more than 1,000 battle-related deaths in a year.1 It is thought that nearly one fifth of people living in and displaced by conflict will need mental health support, with an additional 5 percent likely to experience a severe mental health disorder.2  Save the Children estimates that more than 24 million children affected by conflict today will require mental health support.

Children under extreme stress may show a range of mental health and psychosocial problems. Boys and girls may also show aggression and withdrawal in their interactions with peers and family members. 

Fatima*, 12, was in her home in Hajjah, Yemen, when an airstrike killed both of her parents and five siblings. Fatima’s leg was also badly injured and she needed operations to remove the shrapnel.

“I was unconscious and buried in the sand, and rescue people were only able to help me and my sister,” Fatima* said. “They took us to the hospital. My leg was injured very badly to the extent that it was with no flesh. They [seven members of her family] were buried in the village.”

Fatima* now lives with her sister and aunt, Arwa*, who worries about her niece’s mental state.

“Both girls wake up at night talking to us unconsciously. They are so sensitive. At night, they become angry and start crying unconsciously,” Arwa* told Save the Children.

Beyond their immediate effects, mental health issues and distress can have a lasting impact on children’s development long term. When children experience strong, frequent, or prolonged adversity without adequate caregiver support, this can have serious and enduring negative consequences on cognitive development and emotional regulation, potentially resulting in life-long impact on a child’s mental and physical health. In 2017, approximately 173,800 children were unaccompanied or separated from their families as a result of conflict. However, children in conflict also show remarkable resilience and can recover if appropriate support is provided.

Current support for children’s mental health needs in conflicts is woefully inadequate. Save the Children’s analysis found that between 2015 and 2017, just 0.14 percent of all official development assistance was for programming related to child mental health support. The United Nations General Assembly—and the upcoming mental health summit in the Netherlands—represent a vital opportunity to increase funding to deliver critical mental health support for children in humanitarian disasters.

“Boys and girls in conflicts see their family and friends die and their homes and schools bombed,” said Save the Children CEO Carolyn Miles. “They are denied necessities and can be separated from those that care for them. If they experience mental health issues and distress, this is a completely normal reaction to extreme, abnormal circumstances.

“This war on children has to stop. We call on states meeting at the UN General Assembly and all parties to conflict to uphold and enforce international rules and standards designed to stop children being harmed in the first place—and to commit to increasing funding so children in conflicts can recover.”

To respond to the vast needs among children in conflict, Save the Children is also calling for donors to pledge financial support for the development and roll-out of a child and adolescent mental health diploma for mid-to-senior professionals in conflict settings. Given the number of children affected by ongoing conflicts in the Middle East region, it will likely be developed and piloted in this region. The diploma is expected to commence in 2021, however funding is crucial to enable this.

Through the Stop the War on Children global campaign, Save the Children is campaigning to keep schools safe, avoid the use of explosive weapons in populated areas, seek accountability for crimes against children, and pursue new ways to support their recovery from the horrors of conflict.

*Name has been changed.

1 142 million children are living in high-intensity conflict-zones; that is, in conflict zones with more than 1,000 battle-related deaths in a year, according to research done by the Peace Research Institute Oslo, who were commissioned by Save the Children for the Stop the War on Children report.

2 In 2019, the World Health Organization estimated that 17 percent of adults living in conflict zones have mild to moderate mental health disorders, which would require non-specialized mental health support. Assuming that similar rates apply to children and adolescents, it is estimated that approximately 24 million children living in conflict today have mild to moderate mental health disorders needing an appropriate level of support.

Children are bearing a disproportionate burden of conflict, with the effects of war affecting their mental health and wellbeing in several ways. Since 2010, the number of children living in conflict zones has increased by 37 percent, yet the number of verified grave violations against them—including killing and maiming, recruitment into armed forces, and sexual violence—has increased by 174 percent. Each grave violation, airstrike, and siege can have serious and negative consequences on children’s mental health and well-being. 

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