Since its start more than five years ago in March 2011, the Syrian civil war has been marked by death, carnage and dislocation — with no real end in sight.
More than 470,000 people have been killed in the conflict, 6.6 million were internally displaced and more than 4.8 million refugees have fled the country, according to various estimates.
With signs that a February truce negotiated by the U.S. and Russia is collapsing, there are certain to be more casualties as civilians flee the violence from aerial attacks, car bombings, chemical warfare and extreme brutality and killings by ISIS.
While much has been made of the suffering and traumatization of the victims, either trapped in Syria or struggling to survive in Europe and elsewhere, relatively little attention has been given to the mental health catastrophe wrought by the conflict.
Now, a new analysis by the Brookings Institution takes stock of the terrible toll the civil war has taken in that regard.
Despite the roughly $5 billion in humanitarian aid poured into the region since 2012, the response does not begin to meet the growing demand for mental health treatment, let along the scores of other needs for food, shelter and general health care, the report indicates. Generations of Syrians, from grandparents to young children, are trying to cope with post-traumatic stress disorder and acute depression under the most horrible conditions imaginable.
A report last year by the International Medical Corps (IMC), which provides mental health services to Syrian refugees in Jordan, Lebanon, Syria and Turkey, found that 54 percent of the displaced Syrians had “severe emotional disorders,” while nearly 27 percent of children “faced intellectual and developmental challenges.”
That was followed by problems of epilepsy and psychotic disorders. Among children, epilepsy, intellectual and developmental disorders and severe emotional disorders are most common.
Omer Karasapan, a Middle East and North Africa specialist at the World Bank who authored the Brookings analysis, wrote that children and women in particular confront difficult vulnerabilities.
Women and girls in Syria and host countries often feel threatened by “gender-based violence,” sexual abuse, isolation and forced early marriages. Life in exile for these women has often meant becoming the main breadwinner, and for many the burden is overwhelming.
Meanwhile, children, who make up about half the total refugee population, are not only victims in their own right, but the biggest source of stress for many adults worrying about the fate of their young family members. At the same time, “Children also suffer the stress of constantly worrying about their parents and siblings,” according to the Brookings analysis.
What’s more, children have reported being actively recruited to take part in the fighting by parties to the conflict who have offered gifts and salaries' of up to $400 a month, according to a recent report by Reuters.
Here are several other findings in Karasapan’s report:
- Roughly half the Syrian refugees in Germany have mental health issues. Seventy percent say they witnessed violence and half said they were the victims of violence, according to a 2015 study by the German Federal Chamber of Psychotherapists.
- Turkish authorities reported that 55 percent of Syrian refugees there needed psychological services.
- The United Nations High Commissioner for Refugees (UNHCR) stated that “the most prevalent and most significant clinical problems among Syrians are emotional disorders, such as: depression, prolonged grief disorder, PTSD and various forms of anxiety disorders.” Their problems only get worse without treatment, but medical care is out of reach for most.
Despite the widespread mental health problems in Syria, the country currently has only one partially operating mental health hospital. More than half of the doctors and medical professionals there have fled the country.