Syrian Children Face Growing Mental Health Crisis, New Report Reveals

New research by Save the Children finds widespread evidence of ‘toxic stress’ and mental health issues among children inside Syria, as experts warn the psychological damage could be irreversible

A new report by Save the Children has revealed a mental health crisis among children trapped in Syria, as the war approaches the six year mark.

The children’s rights organization and its Syrian partners interviewed more than 450 children, adolescents and adults across seven governorates in Syria for Invisible Wounds, the largest study of its kind conducted during the course of the conflict. The report finds that many children are living in an almost constant state of fear, terrified by shelling, airstrikes and ongoing violence, with devastating psychological consequences.

Save the Children’s new report shows that the constant psychological strain on children has manifested itself in bed wetting, involuntarily urination in public, speech impediments and children losing the ability to speak altogether, increased aggression and substance abuse.  Communities and professionals also report a rise in self harm and suicide attempts among children as young as 12.

 Findings show 84% of adults and almost all children believe ongoing bombing and shelling is the number one cause of psychological stress in children’s daily lives.

• 50% of children say they never or rarely feel safe at school and 40% say they don’t feel safe to play outside, even right outside their own home.
• 71% said that children increasingly suffer from frequent bed-wetting and involuntary urination.
• Experts say children are now suffering from “toxic stress” as a result of the extreme violence inside Syria, risking life-long impact on children’s mental health

Patricia Erb, President and CEO of Save the Children, said, “What this research shows is that we are witnessing a mental health crisis among children brought about by six years of war in Syria. Children are soiling themselves when they hear a loud noise, terrified to play outside, afraid to go to school but worried that their futures are being ruined without an education.

“It is a tragedy that can’t be allowed to continue – we can end the toxic stress many children are suffering by stopping the bombardment of civilian areas like schools and hospitals, and reaching everyone with life-saving aid and psychological support.”

“Canada’s multi-year assistance to Syria is very welcome, and must include funding for children’s mental health. Without this support, we risk condemning a generation of children to a lifetime of mental and physical health problems – we need to ensure that children who have already lost six years of their lives to war don’t have to lose their whole future as well.”

Mental health experts consulted for this report said findings show children are suffering from a condition called ‘toxic stress’, which can occur when children experience strong, frequent or prolonged adversity¸ such as the extreme violence occurring in the Syria conflict. [1] Continuous toxic stress response can have a life-long impact on children’s mental and physical health.

The report also highlighted children’s fear in continuing their education in the context of continued violence, limiting children’s ability to get to and from their schools and safely learn once inside. Almost half of children interviewed said they did not feel safe at school or playing outside.

Zeinab, aged 12, at a displaced persons camp in Hassakeh NE Syria, “When the war came, all the Syrian children forgot everything they learned and now know nothing else except war. I feel like I’ve seen so many terrible things. I lost out on two years of school, and my brother has grown up and has hardly studied at all. What if I get old and I continue on this same path and I lose out on my entire future?”

In addition to losing out on education, the ongoing violence inside Syria – particularly airstrikes and shelling on civilian infrastructure like schools – have a profound impact on children’s mental wellbeing, and came out strongly in the report as the primary cause of child mental health issues.

Save the Children is very pleased the Government of Canada recently endorsed the Safe Schools Declaration, which aims to reduce the use of schools by armed groups and forces in a conflict and to minimize the negative impact of war on children’s education. The children’s rights organization, which has long called for Canada to endorse the Declaration, welcomed Minister for International Development and La Francophonie Marie-Claude Bibeau’s statement that children belong in schools and must be protected.

As the Syria conflict approaches the six year mark, Save the Children is calling for an immediate ceasefire and a negotiated end to the violence, and for:

• All parties to stop using explosive weapons in populated areas and attacking civilian infrastructure like schools and hospitals, as this clearly came through as the main cause of children’s distress and fear.
• An immediate end to siege tactics and unrestricted humanitarian access to all areas, so that agencies like Save the Children and our partners can reach the most vulnerable.
• The Government of Canada and other donors to make a new global commitment to support children’s mental health and wellbeing in emergencies, including sufficient funding for mental health and psychosocial programming inside Syria.
• Read the report on Save the Children’s website here.

ENDS

New multimedia content on child mental health available at these links, including photos and case studies from inside Syria, b-roll and interviews from inside Syria and b-roll, case studies and photos with refugee families in Jordan.

NOTES TO EDITORS:

• For this report, Save the Children staff and partners spoke to 458 children, adolescents and adults inside seven of Syria’s 14 governorates – the largest and most comprehensive study undertaken into children’s mental health and well-being inside Syria during the conflict.

The research took place between December 2016 and February 2017 and consisted of:

• 313 individual questionnaires,[i] including 154 adolescents aged 13–17 (59 girls, 95 boys) and 159 parents and adult caregivers (61 women, 98 men).
• 17 focus groups with 125 children (56 girls, 69 boys) split into four age groups: 5-7, 8-11, 12-14 and 15-17 years. The older ages were divided into groups of girls and boys.
• In-depth interviews with 20 psychosocial workers, children, aid workers, teachers, parents and psychologists.

The research was carried out with trained practitioners who also offered psychosocial first aid to children involved. It took place in multiple locations in Aleppo, Damascus, Dara’a, al-Hasakah, Homs, Idlib, and Rif Damascus, with additional interviews with experts based in countries neighbouring Syria.

• Save the Children provides mental health and psychosocial support (MHPSS) and education activities for children across 10 governorates of Syria, as well as in countries hosting Syrian refugees. In addition, Save the Children supports seven primary healthcare facilities and a maternity hospital, conducts vaccination campaigns and distributes household items, hygiene kits and winter kits, among other activities in Syria. To date our programs have reached more than 2.4 million people inside Syria, including over 1.5 million children.
• In February 2017, the Government of Canada announced $239.5 million over three years to address humanitarian needs in Syria, Iraq, Jordan and Lebanon, as well as a $17.5 million CAD over five years to address urgent needs of youth in conflict-affected areas.

[1] Center on the Developing Child, Harvard University, http://developingchild.harvard.edu/science/key-concepts/toxic-stress/ Shonkoff,  J P and Gardner, A S (2012) The Lifelong Effects of Early Childhood Adversity and Toxic Stress, American Academy of Pediatrics,