oa Relationship of Violence Exposure and Mental Health of Youth in Iraq

Introduction

Violence is an important public health problem that may be seen in every part of the life and has been increasing in the world. World Health Organization (WHO) defines violence as: “The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation”. Violence exposure can lead to: Mental disorders such as anxiety, depression and posttraumatic stress disorder (PTSD).Behavior, Cognitive and social problems such as social withdrawal, alienation, poor academic functioning. ∅ Physical effects such as cardiovascular strain, fatigue, reduced immune response. Age limit of Youth “Time in a person's life between childhood and adulthood. The term “youth” in general refers to those who are between the ages of 15 to 25.” - World Bank Youth… those persons between the ages of 15 and 24 years.” - United Nations General Assembly. Objective of the research paper: ∅ To estimate the prevalence of symptoms of psycho-social disorders and problems among youths due to exposure to violence in Iraq. Iraqi youth and violence For more than three decades, the Iraqi nation as a whole has been suffering from wars, sanctions and violence. The Iraqi children and youth have been so greatly affected by these dire conditions especially after 2003 and mostly deteriorated since 2006. Research documented that the violence is the main cause of death in men between the age of 15 and 59 years during three years after 2003 invasion. Pre-invasion mortality rates were 5.5 per 1000 people per year compared with 13.3 per 1000 people in the 40 months post-invasion (after 2003 war). A household survey of Iraq that conducted in 2006 has found that approximately 600,000 people have been killed in the violence of the war that began with the U.S. invasion in March 2003 and gunfire remains the most common reason for death, though deaths from car bombing. The 2006 bombing of the Askirya shrine in Samarra, and the widespread sectarian violence that followed, displaced 1.6 million persons within Iraq. In a survey which was conducted by the International Organization for Migration and the Iraqi Ministry of Displacement and Migration (2008) found that there are more than 177000 internally displaced families and the reasons most commonly given by internally displaced persons (IDPs) for displacement were direct threats to life (61%), presence of generalized violence (47%), and fear (40%). An estimated 1 million of Iraq's displaced persons were without adequate access to shelter and food, and an estimated 300000 are without access to clean water. The UNHCR estimated that Iraq has 1.13 million internally displaced persons in 2013, and a total population of concern of 2.2 million. Refugees International put the number at 2.8 million. The condition is much deteriorated after 10 June 2014, Mental disorders among Iraqi youth - Posttraumatic stress disorder (PTSD): Posttraumatic stress disorder (PTSD) is a syndrome that develops after a person sees, involved in, or hears of an extreme traumatic stressor. The person acts to this experience with fear and helplessness, persistently relives the event, and tries to avoid being reminded of it. To make diagnosis, the symptoms must last for more than a month after the event and must significantly affect important areas of life such as family and work. The life time prevalence of PTSD is estimated to be about 8 percent of the general population. The more vulnerable categories for post-traumatic stress disorder (PTSD) attacks are children and young people, females (widows and divorcees). Prevalence of PTSD among Iraqi youth: According to certain academic studies which were conducted in different regions of Iraq (that have experienced high levels of violence and military operations), about 25% of youth have symptoms of PTSD. The table (1) shows prevalence of PTSD among Iraqi youth Region PTSD % Year of study Baghdad 26.43% (males: 17–19 years) 2012 Baghdad 22.9% (18–24 years) 2010 Erbil* 26.5% *(Among youth of displaced families) 2008 Mosul 22.13% 2007 Diyala 27.4% (12–18 years) 2006 - Depression which is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. The percentage of depressive symptoms among university student in Baghdad (2010) was more than 35%; the violence was the leading cause for symptoms of depression. A recent study which was conducted during 2013–2014, showing that percentage of youth (18–25 years) in Baghdad with depression feeling was 41%, among of them 16% had thoughts that would be better off dead, or of hurting in some way. Social problems: Exposure of violence and academic performance. Through a study which was conducted in 2010 on a sample of students from the University of Baghdad (for ages between 18–24 years) found that 30% of them had history of academic failure during their studies earlier, and there was a strong association between violence exposure and history of academic failure – among of these trauma exposure: threat of assault, kidnapping and displacement. Substance abuse Research documented that alcohol and drug abuse may have increased in Iraq since 2006–2007. This apparent increase may be due to increased availability of substances and more traumas experienced by the population. A study was conducted in 2009, showing that the prevalence of alcohol and drug abuse among youth (18–23 years) in Baghdad was 10.7% and 4.9 % respectively.

Conclusion

Iraqi youth are facing very real dangers of diseases, starvation, psychosocial - physical disorders and death due to military operations and terrorism. The real problem What has been mentioned of the figures is an alarm (snapshot) attempting to shed light on the current psychological and social problems which faced by the people especially the youth in Iraq. The important fact is the psychological effects may continue to next generations. The real problem is lack of wide national studies and statistics to document the effects of direct and indirect exposure to wars, military operations and violence against civilians, and thus lack of scientific programs for community development and therapeutic strategies at the official, local or international organizations levels. With ongoing violence, the health system is heavily focused on curative and trauma care, leaving public health programs less supported. Iraqis have witnessed a depletion of social capital, which led to social deprivation in most sectors of the society. Recommendation Urgent need for further wide scale national researches to explore the long term effect of violence exposure on Iraqi population. Establish programs for building resilience among most vulnerable groups (children, youth, and women) via cooperation of national and international organizations that concerned with such subject…Establish mental and social health support centers, especially in the governorates that exposed to high level of violence and military operations…Need the efforts of activists in the field of human rights -individuals and organizations - to claim for compensation about physical and psychological disorders that resulting from the US occupation of Iraq.