There are a range of ways to take a holistic approach to mental health, examples of which are given here.
- Case management and MHPSS: many NGOs use a case management approach to mental health, where a case manager makes an initial assessment of the needs of the young person and their family. This might include mental health or psychosocial support services but also aims to address the family’s wider needs. This could include MHPSS services for the parents or other family members, medical services, housing support, legal advice, cash assistance, etc. This approach recognises that mental health in conflict and post-conflict settings is affected at least as much by daily stressors as it is by conflict exposure, and that children’s mental health is affected by their parents’ mental health.
- MARCH Lebanon: This project approaches peacebuilding through theatre, culture, mental health, and economic development. Through bringing together young male former fighters to create theatre and carry out work to improve their neighbourhoods, this project recognises that informal activities that build trust and give people a sense of purpose are more effective than formal activities like workshops or the passive process of receiving services. Ultimately, it recognises that young people need to have hope that things can be better and the agency to drive change.
When it comes to addressing the risk of young people perpetrating violence, there are limits to punitive approaches that do not take into account underlying trauma and mental health problems. Such approaches were criticised for neglecting the nuances of individual experiences and failing to provide necessary support for long-term recovery and resilience. Importantly, many children and young people affected by conflict are not ‘radicalised’ or at risk of committing violence and the language of “ticking timebombs” risks stigmatising them and making it less likely that they receive the care they need. Viewing children through this risk lens may make it hard to see their potential in driving positive change. Case studies of repatriated European children from IDP camps in Syria demonstrated largely positive outcomes from reintegration into their communities.
Finally, it was noted that a major barrier to the reintegration of youth who have been associated with armed groups is stigma, including the attitudes of host communities, who view these young people as threats. There can be risk of retaliation if they or their families return, undermining reintegration attempts. However, hostility is often driven by victims not having justice or the same access to resources as returnees. There is also a question around how the need for justice and clear moral norms can be squared with the need for reconciliation and reintegration. There is inherent tension between the societal need for red lines on behaviour, and the resulting shame and its impact on the psyche of children and youth who have been associated with armed groups.
This tension can vary depending on the age of the children when they were involved in violence. Based on the UNSC Children and Armed Conflict mandate, if a child is associated with an armed group, they have been recruited and used; such recruitment and use is a war crime if the child is/was under 15. Juvenile justice standards are clear that children formerly associated with armed forces/groups should be treated primarily as victims and should receive community-based reintegration support; however, this view not always understood or endorsed in practice.