• By Dartington SRU
  • Posted on Wednesday 23rd September, 2009

Afghan children have worse to worry about than war

A national school-based survey of the mental health of young people in Afghanistan has found that elevated mental health problems are associated with multiple traumatic experiences. For those who have suffered more than five such episodes, the odds that they will suffer from a psychiatric disorder are approximately two and a half times greater.Such findings may sound all too predictable given the conditions in such a war-ravaged country. But rather on the contrary, most trauma related less than to the conflict than to the quality of children’s ordinary lives. Accidents, painful medical treatments and beatings by close relatives and neighbors greatly outnumbered traumas arising from combat or land mines. “In Afghan children’s lives, everyday violence matters just as much as militarized violence in the recollection of traumatic experiences,” write the joint research team from the University of Durham, in the UK, the University of Peshawar, in Pakistan, and ALTAI Consulting, in Afghanistan. Just published in the UK medical journal, The Lancet, the research also found that the mental health of parents and other caregivers had an impact on children’s mental health.  It was less marked, but nevertheless consistent across all section of the population. Led by Durham Professor of Anthropology, Catherine Panter-Brick, the team point out that in the light of these findings, interventions that target mental health issues in the family and community would be most appropriate.  Policies which strengthen whole family units and improve their access to basic social, health and educational services are a way forward.The survey of 11-16 year olds builds on several previous studies that have revealed high levels of mental health problems among adults in Afghanistan. Research teams collected data over eight months in 2006, visiting 25 schools in the Kabul, Bamyan and Mazar-e-Sharif regions. Information was collected about emotional and behavioral difficulties, depression and traumatic events using questionnaires tested in areas of low-income, conflict and disaster. The ease with which the team were able to carry out their work and the interest shown in it by teachers, parents and children augurs well for the introduction of school-based interventions, the authors say. Teachers involved in the project mentioned that they had not previously considered how a child’s state of mind might affect their performance in school. In contrast to the evidence of mental health issues, the survey also highlighted the strength and ability to cope that young Afghans show in the face of adversity. Their levels of emotional and behavioral difficulty fell just within the expected range.The authors concede one major flaw: they were unable to include the large proportion of children who do not attend school. In the 2004/ school year attendance stood at around 50% for girls and 80% for boys. Children not attending school may be at a higher risk of mental health problems, say the authors, so these may have been underestimated. The research was also confined to three areas that are not necessarily representative of the country as a whole. See: Panter-Brick C, Eggerman M, Gonzalez V and Safdar S (2009), “Violence, suffering and mental health in Afghanistan: a school-based survey”, The Lancet, 374, pp 807-16

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