Post-War Community Mental Health Monitoring Results Announced

More than 3 months after the first war-related psychological trauma assessment was conducted, its results were published. The figures show very few participants in the assessment, a high number of people suffering from war-related psychological trauma, and very few people who support receiving specialized psychological interventions.

This project, with the approach of identifying the psychological crisis of war and emphasizing on post-traumatic stress disorder (PTSD) was carried out from June 1 to July 15 this year by the country's welfare organization and for the entire population over 18 years old in 31 provinces of the country by sending SMS and online questionnaires. While the country's population over 18 years old is about 60 million people, and mobile phone operators had sent SMS messages to participate in the online questionnaire to about 60 million users, but according to the report of the country's welfare organization, from the results of this measurement, only a little more than one million SMS recipients (1 million four thousand 395 people) visited the national mental health assessment system, and less than 44 percent of the visitors (435 thousand 159 people) of the process They completed the mental health assessment completely, and among the respondents, more than 70 thousand people (70 thousand and 723 people) and equal to 16.3 respondents were identified at the high risk level. The worrying part of these results is that only about 52% of the population who had reached the high-risk stage of post-traumatic stress disorder and post-war psychological trauma were willing to receive specialized counseling and psychological services. Another worrying result of this assessment is the 20% prevalence of war psychological trauma in participants from Tehran province, but less than 20% of people who had high-risk symptoms of war mental disorders agreed for specialized psychological interventions.

Why was the first measurement of psychological trauma of war done?

The assessment of mental trauma of war is the first monitoring of mental disorders affected by war in the last 4 decades, which was conducted on June 1 of this year and less than 45 days after the ceasefire of the 40-day war, for one month by the social health deputy of the country's welfare organization and by sending a questionnaire in the online system. In the introduction to the publication of the results of this monitoring, the country's welfare organization has stated: "Crises, especially wars, do not destroy only physical infrastructure. They also create deep layers of anxiety, psychological insecurity and disruption of social relations in the society. Global experiences in the field of mental health show that the psychological consequences of crises are sometimes more lasting than their material consequences. Acute stress disorder, pervasive anxiety, depression and post-traumatic stress disorder are among the consequences that can continue for months and even years after the end of the crisis in individual and collective life. »

This assessment is the first monitoring of war disorders for the country's population over 18 years of age, which was carried out in the "golden window of intervention", and the welfare organization's argument is that the short distance between conducting this survey and the air strikes and destruction and financial and life losses and martyrdoms and injuries caused by the 40-day war for our countrymen can provide clearer and more explicit results, and also, early intervention and the possibility of preventing the initial stress from turning into Provides chronic disorders. After the 40-day war and before the implementation of this assessment, the country's welfare organization had conducted two surveys for the covered population and the elderly, which had important and alarming findings about the psychological trauma of the war. The results of a survey conducted by the Welfare Organization after the 40-day war on the mental health of 2,500 elderly people in the country showed that the most important consequences of the war for this group are increased stress, anxiety, fear, worry, apprehension and depression to the extent that these mental problems for this age group are twice as important compared to economic issues. According to the results of this nationwide survey, 70% of the elderly said that their anxiety increased due to the war, 48% experienced a decrease in sleep quality, and 78% reported a decrease in the sense of security in their living environment. The research also showed that the intensity of anxiety is higher in economic deciles 3 to 7 of the elderly, while the decrease in the sense of security and sleep quality was more observed in the economic deciles 1 to 3, and also elderly women experienced the highest level of vulnerability from the psychological crisis of war.

The second national survey conducted by the country's welfare organization after the 40-day war and before the implementation of the first national assessment of psychological trauma of the war was related to the population covered by this organization and included people with disabilities, female heads of households, children under protection and people involved in addiction. The results of this survey also showed that about 70% of these groups were facing increased anxiety and the highest level of anxiety was observed among female heads of the household, in addition to the fact that about 50% of the surveyed people from the same population said that they felt less secure.

What were the findings of the first national assessment of mental health after the war?

According to the announcement of the country's welfare organization, the purpose of this assessment was to identify people with acute stress symptoms and related disorders, rapid and specialized mental health screening in the general population, risk level classification, providing short-term primary psychological interventions, targeted referral to specialized services according to the risk level, and reducing the incidence of chronic disorders after the accident. SMS was supposed to be sent to all people over 18 years of age in the country to enter the online evaluation system, and then the assessment was done in three stages. The first stage was an initial assessment with 9 questions for psychological response to the crisis, and in this way, people in the middle or high risk range were identified. The people identified in a more specialized evaluation answered questions to check the severity of psychological trauma symptoms and the possibility of suffering from post-traumatic stress disorder, and in the third stage, people were referred to psychological services based on the risk level.

According to the report published by the country's welfare organization on the results of this assessment, during the implementation of the project and out of a total of more than 435 thousand people who completed the mental health assessment process, more than 70 thousand people and the equivalent of 16.3 respondents were identified as high-risk. Among this population who had reached the high-risk stage of post-traumatic stress disorder and post-war psychological trauma, more than 36 thousand people declared their readiness to receive specialized services, more than 23 thousand of them were introduced to counseling and psychological centers to receive specialized services, and more than 11 thousand people received counseling services.

Status of participants by gender

According to this report, out of a total of more than 435 thousand participants in the assessment plan (about 44 percent of the visitors to the mental health assessment system), more than 241 thousand people (55.4 percent) were men and more than 193 thousand people (44.5 percent) were women.

Status of participants by occupation

The highest participation was observed among self-employed people with more than 106 thousand people (24 percent), followed by housewives with more than 103 thousand people (23.6 percent) and employees with more than 87 thousand people (20 percent). More than 76 thousand unemployed people (17.5 percent), more than 35 thousand working people (8.2 percent) and more than 26 thousand retired people (6 percent) were the rest of the participants in the plan.

Status of participants based on education

The most participants with more than 126 thousand people (29%) had a diploma, followed by people with a bachelor's degree with more than 102 thousand people (23.4%), people with a bachelor's degree with more than 92 thousand people (21.2%), a master's degree with more than 44 thousand people (10.2%), a post-graduate degree with more than 34 thousand people (10%), a doctorate degree with more than a thousand people (2.3%), and a seminary education with more than 2800 people (0.6 percent) were in the next rows.

Status of participants by age group

The highest frequency of participants in the first assessment of war psychological trauma was in the age group of 18 to 25 years with more than 76 thousand people (17.4 percent), and the age group of 36 to 40 years with more than 68 thousand people (15.8 percent), the age group of 41 to 45 years with more than 68 thousand people (15.6 percent), 31 to 35 years with more than 52 thousand people (12 percent), 26 Up to 30 years with more than 48 thousand people (11 percent) were in the next rows and the lowest number of participants was in the age group over 76 years with more than 2800 people (0.6 percent).

Status of participants based on marriage

The largest number of participants in this survey were married people with more than 273 thousand people (63 percent), followed by single people with more than 130 thousand people (30 percent) and divorced people with more than 31 thousand people (7 percent).

Status of participants based on provincial participation status

According to the report of the Social Health Deputy of the National Welfare Organization, the provinces of Golestan with more than 48 thousand people, Mazandaran with more than 44 thousand people and Tehran with more than 36 thousand people had the largest number of participants in this assessment. The number of participants in the provinces of Razavi Khorasan, Khuzestan, Fars and Gilan was between 22 thousand and 31 thousand people, in each of the provinces of East Azerbaijan, Sistan and Baluchistan, Hamadan, Isfahan, South Khorasan, West Azerbaijan, Lorestan, Ilam and Yazd, more than 10 thousand to 19 thousand people participated in this assessment, and the number of participants in the rest of the provinces was less than 10 thousand people, in addition to the lowest participation in the province Ardabil was registered with a population of 2054 people.

The status of high-risk people identified in each province

The most important part of this assessment, which can actually be the agenda of the country's welfare organization and the Ministry of Health as the custodians of monitoring various mental disorders and specialized and therapeutic measures, is the part of providing information on high-risk individuals identified in each province. The report of the country's welfare organization shows that based on the number of participants, the highest rate of psychological trauma of war was in Tehran province with a prevalence of more than 20% and the lowest rate was in North Khorasan province with a prevalence of 0.91%. The findings of this assessment show that Khorasan-Razavi province with a prevalence of 8.84% (6250 people), Isfahan with a prevalence of 6.65% (4706 people) and Fars with a prevalence of 5.82% (4114 people) from the total number of high-risk people among the population that fully participated in the war trauma assessment were in the ranks after Tehran province. The welfare organization's report also shows that only Semnan province with a prevalence of 0.93% and North Khorasan province with a prevalence of 0.91% of the number of high-risk people among all the participants in this assessment, had a prevalence of less than 1% of war psychological trauma, and 13 provinces with a prevalence between 1% and 2%, 7 provinces with a prevalence between 2% and 3%, and 5 provinces with a prevalence between 4% and 5%. The important point in these findings is that the prevalence of war psychological trauma in Tehran province is very far from other provinces, as in Tehran province and among the participants in this assessment, more than 14 thousand people with a prevalence of 20.15% have been identified as high-risk people, and Tehran province is in the first row of war psychological trauma, while

The second message of these alarming numbers is that despite the significant number of high-risk people with war psychological trauma symptoms, a very small number of people, about 52%, have accepted and agreed to receive specialized services, and about 48% of people with high-risk war psychological trauma symptoms are abandoned in society. The optimistic assumption should be that these people, after learning about such symptoms, would personally and by paying a fee, refer to receive specialized services.