Basic facts
- Almost all people affected by emergencies will experience psychological distress, and most will improve over time.
- Among people who have experienced war or other conflict within the past 10 years, one in five (22%) will develop depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia.
- People with severe mental disorders are particularly vulnerable during emergencies and need to have access to mental health care and their other basic needs met.
- International guidelines recommend provision of services at a number of levels – from basic services to clinical care – and point to the need for immediate access to mental health care for specific and urgent mental health problems in a health response.
- Despite the tragic nature of emergencies and their negative effects on mental health, they have been shown to provide opportunities to build sustainable mental health systems for all those in need.
Types of problems
There are many types of social and mental health problems in any major emergency.
Social problems:
- Pre-existing problems: such as poverty and discrimination against marginalized groups;
- Problems resulting from emergencies: such as family separation, lack of security, loss of livelihood, disruption of social networks, and a decrease in trust and resources;
- Problems arising from humanitarian response: such as overcrowding, loss of privacy, and undermining community or traditional support.
Mental health problems:
- Pre-existing problems: such as mental disorders such as depression, schizophrenia, or harmful alcohol use;
- Problems resulting from emergencies: such as grief and distress, acute stress reactions, harmful use of alcohol and drugs, depression and anxiety, including post-traumatic stress disorder;
- Problems arising from the humanitarian response: such as anxiety resulting from the lack of information about food distribution or how to access basic services.
Spread rate
Most people affected by emergencies will experience distress (such as feelings of anxiety and sadness, hopelessness, restlessness, stress, irritability or anger and/or aches and pains).
This is normal and will improve over time for most people. However, the prevalence of common mental disorders such as depression and anxiety is expected to more than double in humanitarian crises.
The burden of mental disorders among conflict-affected populations is very high: a WHO review of 129 studies in 39 countries showed that among people who had experienced war or other conflict in the past 10 years, one in five (22%) would be affected. Depression, anxiety, post-traumatic stress disorder, bipolar disorder, or schizophrenia (1).
According to the WHO review, the prevalence of mental disorders in conflict-affected populations at any given point in time (specific prevalence) is estimated at about 13% for mild forms of depression, anxiety and post-traumatic stress disorder, and about 4% for moderate forms of these disorders. The specific prevalence of severe disorders (ie schizophrenia, bipolar disorder, major depression, major anxiety, and severe post-traumatic stress disorder) is estimated at about 5%. It is estimated that one in 11 people (9%) living in places exposed to conflict in the past 10 years will develop a moderate or severe psychological disorder.
Rates of depression and anxiety increase with age in conflict-affected settings. Depression is more common in women than men.
During and after emergencies, people with severe mental disorders may be particularly vulnerable and need access to essential services and clinical care. A 2014 review of the health information system for 90 refugee camps in 15 low- and middle-income countries concluded that 41% of health care visits for mental, neurological and addictive disorders were for seizures, 23% for psychotic disorders, and 13% for moderate and severe forms. Depression, anxiety, or post-traumatic stress disorder.