Children mental health in Pakistan nowadays

The terrorist attack on the Army Public School in Peshawar has left an indelible mark on the psyche of the Pakistani nation. One cannot even begin to comprehend what the children must have gone through in those harrowing moments when the terrorists burst into the school premises and opened fire, mercilessly killing more than 140 of them.

Neither can one comprehend the anguish and turmoil their families must be going through now. Needless to say, terrorism and violent acts have become a way of life in Pakistan today and no one is suffering from this more than the children of this country.

War or any act of terror is the most challenging and difficult time for children, as they are psychologically immature. This psychological immaturity makes them more vulnerable to the effects of distressing and inescapable stresses. Children are reliant on care, empathy and support provided by their adults. When there is a suicide blast or war, their attachment with their loved ones is disturbed due to loss of parents, emotional unavailability of depressed parents and parents in extreme worrisome conditions.

The care of the child is then shifted to his/her relatives, Edhi centers and orphanage homes. War and blasts also affect the physical and emotional resources that are provided by their parents. On the other hand, children who are the victims of war or suicide bombings, lose the opportunity of acquiring education and are forced to move in camps where they reside for years in miserable conditions,waiting to recommence a normal life.

The United Nations Children's Fund is calling attention to the affect that three years of conflict has had on Syria's young people, saying the crisis is the "most damaging conflict for children in the region's recent history."

According to a new UNICEF report released, 5.5 million Syrian children now need assistance because of the war -- a number that has more than doubled in the past year. Among the hardest hit, it says are one million children living under siege and in hard to reach areas in Syria.

The report says of January, violence has killed more than 10,000 children in Syria, who are often are not accidental victims of war, but rather deliberately targeted. Witnesses say children and infants have been killed by snipers, or become victims of summary executions or torture. Schools have been bombed.

The 2014 Israel-Gaza war took a heavy toll on Gaza’s children: more than 500 were killed, 3,374 were injured – nearly a third of whom suffer permanent disability – and more than 1,500 were orphaned. Hundreds of thousands were left in trauma.

The war devastated infrastructure that was already teetering on the brink of collapse. The education and health sectors were particularly hard hit. During the 51-day conflict, 258 schools and kindergartens were damaged, including 26 schools that are beyond repair. Seven health facilities were destroyed and 67 hospitals and clinics were damaged.

The history of humans is a history of intergroup conflict, whether it be between tribes, city–states, kingdoms, or nations. It is estimated that 2 million children have been killed due to war-related injuries, 4 million have been disabled, 1 million orphaned, and 12 million dislocated from their homes (UNICEF, 1996). The Durant’s (1968) after writing The History of Civilization concluded that “war is one of the constants in history” and that “in the last 3,421 years of recorded history only 268 have seen no war.” Population explosions, the breaking up of the colonial empires, the rise of nationalism, tribalism, and religious fundamentalism have spurred people to define boundaries more exclusively with subsequent conflicts with neighbors. As low intensity regional conflicts replaced the global conflicts between nationalized armies of the world, the victims of war have gradually encompassed a greater proportion of the civilian population.

He became irritable, aggressive and said he wanted to kill someone. He couldn’t sleep, had flashbacks and stopped going to school”. The quality of life of children is impacted by the war and terrorism. Many children lose their limbs and are rendered disabled. So the whole life of these children will be lived under the shadow of war injury and they are less likely to be employed and to marry. Hence, such traumatic events bring negative changes in a child’s life.

War and terrorism not only disturbs physical and social life of children but also has an immense effect on the psychology of children.

Trauma-focused cognitive behavioural therapy (TF-CBT) for children and parents is an evidence based treatment approach for traumatized children. Evaluation of TF-CBT includes several randomized controlled trials, effectiveness studies and ongoing studies for children experiencing sexual abuse, domestic violence, traumatic grief, terrorism, disasters and multiple traumas. The model of TF-CBT described here is a flexible, components-based model that provides children and parents with stress management skills prior to encouraging direct discussion and processing of children’s traumatic experiences.

Pakistan has been going through a perpetual state of low- to medium-intensity war for the last couple of decades. And this state of affairs is unlikely to end anytime soon. Many children and young people have been affected personally by terrorism, either by being at the scene of an attack, by knowing someone injured or killed by militants or watching graphic scenes on their television screens.

Many children suffer acute anxiety when in public places. Others may have symptoms such as difficulty in sleeping, poor concentration, irritability, aggression, loss of appetite etc. Post-traumatic stress disorder is a psychiatric condition that can be triggered after experiencing or witnessing a life-threatening event, from military combat to terrorism, natural disasters and personal assaults.

Government of Pakistan should protect the citizen of Pakistan because it is always the responsibility of the state to protect people’s life.