Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073, Ulm, Germany.
Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland.
Eur Child Adolesc Psychiatry. 2022 Jun;31(6):845-853. doi: 10.1007/s00787-022-01974-z.
The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family's safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. Mental health and psychosocial interventions for war-affected children should be multileveled, specifically targeted towards the child's needs, trauma-informed, and strength- and resilience-oriented. Immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security. Screening and assessment of the child's mental health burden and resources are indicated to inform targeted interventions. A growing body of research demonstrates the efficacy and effectiveness of evidence-based interventions, from lower-threshold and short-term group-based interventions to individualized evidence-based psychotherapy. Obviously, supporting children also entails enabling and supporting parents in the care for their children, as well as providing post-migration infrastructures and social environments that foster mental health. Health systems in Europe should undertake a concerted effort to meet the increased mental health needs of refugee children directly exposed and traumatized by the recent war in Ukraine as well as to those indirectly affected by these events. The current crisis necessitates political action and collective engagement, together with guidelines by mental health professionals on how to reduce harm in children either directly or indirectly exposed to war and its consequences.
对儿童施加战争和军事侵略必须被视为侵犯其基本人权的行为，会对其身心健康和幸福感产生持久影响，并对其发展产生长期后果。鉴于乌克兰最近发生的数百万人逃离的事件，本政策范围界定社论旨在通过概述战争对儿童心理健康的直接和间接负担，帮助指导对战争中年轻受害者的心理健康支持。我们强调多层次、以需求为导向、以创伤为中心的方法，以在经历战争创伤后重新获得和维持外在和内在安全。战争对儿童的影响是巨大而普遍的，具有多种影响，包括即时应激反应、特定精神障碍风险增加、被迫与父母分离的痛苦以及对个人和家庭安全的恐惧。因此，儿童在战争期间和之后所经历的一切，都与他们的发展需求以及在身体和情感上安全和可预测的环境中成长的权利形成鲜明对比。受战争影响的儿童的心理健康和社会心理干预应该是多层次的，具体针对儿童的需求，以创伤为中心，以力量和弹性为导向。即时支持性干预应侧重于为儿童提供基本的身体和情感资源和关怀，帮助他们重新获得外在安全和内在安全。需要对儿童的心理健康负担和资源进行筛查和评估，以提供有针对性的干预措施。越来越多的研究表明，从低门槛、短期的基于小组的干预到个体化的循证心理治疗，基于证据的干预措施是有效的。显然，支持儿童还需要使父母能够在照顾孩子方面得到支持和支持，以及提供促进心理健康的移民后基础设施和社会环境。欧洲的卫生系统应共同努力，直接满足因最近乌克兰战争而直接受到创伤的难民儿童以及间接受到这些事件影响的儿童日益增长的心理健康需求。当前的危机需要采取政治行动和集体参与，同时还需要心理健康专业人员提供指导，说明如何减少直接或间接暴露于战争及其后果的儿童的伤害。
