Equipping the next generation of clinicians for addressing conflict mental health: A role for Geopsychiatry
Joseph El‐Khoury, Audrey McMahon, Fatema Kazem, Mia Atoui, João Maurício Castaldelli-Maia, Joana Corrêa de Magalhães Narvaez, Júlio Torales, Myrna Lashley, Michael Campbell, Michael Liebrenz, Alexander Smith, Yunyu Xiao, Albert Persaud
Abstract
The past two decades have seen a surge in violent conflicts worldwide, leading to 238,000 conflictrelated fatalities in 2022 alone [1].This challenges the perception that conflict is limited to 'unstable' regions, highlighting its global reach.Active wars in Ukraine, Sudan and Palestine have drawn attention onto conflicts even further.Beyond immediate death tolls, the enduring psychosocial impacts are profound, with conditions like Post Traumatic Stress Disorder (PTSD) affecting millions [2,3].During its last World Health Assembly, the World Health Organization approved a crucial resolution to integrate mental health and psychosocial support (MHPSS) across all stages of emergencies, including conflicts, disasters, and humanitarian crises.The distant and recent experience from conflict zones raises doubt on whether local healthcare systems and external interventions have the needed skills and experience to deliver in times of crisis [4]. Current gaps in trainingPsychiatric training often lacks comprehensive education on conflict-related mental health.A US survey revealed only 20% of psychology doctoral programs offer trauma-focused training [5].Similarly, a Canadian study found significant gaps in preparing residents to handle warinduced trauma [6].Despite some programs like George Washington University's global mental health (GMH) initiative, which includes rotations in conflict zones, these are exceptions rather than the norm [7].The lack of training means that many clinicians are ill-prepared to deal with the complex mental health needs of populations affected by conflict.For example, traditional psychiatric training often focuses on PTSD without addressing other common conflict-related conditions such as depression, anxiety, and substance abuse.Furthermore, training programs rarely include components on cultural competence, which is crucial for effectively treating refugees and migrants who may have different expressions of psychological distress.