A 2018 cross-sectional survey of children in Afghanistan found that 71% of children had experienced physical violence in the past year, with the home being the most likely location for violence. There have been decades of economic and security disruption in the country, and the mental health of Afghan children is in jeopardy as a result.
The most recent military escalations in the country have further exacerbated this psychosocial crisis, and the children of Afghanistan are experiencing acute food insecurity, malnutrition, displacement, loss of family members and poverty as they face an uncertain future.
Constant exposure to combat, directly and indirectly, means that many children will have known people who have been killed or injured. The cycle of trauma continues and children themselves become perpetrators of violence. In a study of school-age children, 111 (32%) of 350 male students and 74 (18%) of 420 female students reported having perpetrated more than one instance of cruelty in the previous month.
The type and number of events that resulted in trauma are key factors influencing how mental health problems develop in children.
Multilevel psychosocial care is required, with multisectoral collaboration. We propose providing psychological first aid through a toll-free hotline, training non-medical professionals to provide simple and cost-effective psychological interventions, providing online counseling through dataless connections, and telepsychiatry services so that first-class health workers contact get expert opinion. A committee made up of local and foreign mental health experts with experience in conflict situations could guide the early childhood and adolescent mental health response. Mental health promotion using print, electronic and social media platforms is needed and could be adapted from material used in neighboring countries. Long-term planning must be done by validating psychometric instruments, conducting feasibility studies of psychotherapeutic interventions, and obtaining funds to keep mental health services running.
In this context, to prevent a mental health catastrophe in children, we call for collaborative support from global establishments. A multinational alliance between current rulers, neighboring governments and non-governmental organizations is imperative to avoid vicious cycles of trauma and violence. There are understandable reasons why high-income countries and multilateral organizations are reluctant to work with Afghanistan’s new regime: its legality is questionable and its hierarchical administrative structure controversial. However, the children of Afghanistan are deeply vulnerable in this conflict and need immediate support.
We do not declare conflicting interests.
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Published: February 18, 2022
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