Health and explosive violence

Explosive weapon harm: mental health and psychological impacts

The use of explosive weapons in populated areas causes death and destruction, devastating families and communities. Improvised explosive devices, artillery, mortars and other explosive weapons destroy families, homes, workplaces and public spaces.

In addition to causing serious physical harm, their use can also result in significant psychological distress. That is true for those directly involved in the incident, such as individuals who sustain injuries and the families of those killed, and also for the broader community who may witness the aftermath of an attack, or live in fear of future attacks. However, while the impact of conflict on mental health within the military has been widely recognised and discussed, the same is not true for civilians exposed to explosive violence. Relatively little attention has been paid to the mental health impacts of the use of explosive weapons in civilian communities, and the assistance requirements needed to support those affected psychologically.

A blast is often unexpected and can cause major devastation. Being present at the moment of an explosion is a highly stressful event for those who survive or witness the blast. As well as suffering from acute stress, there are also long-term mental health risks for anyone involved, including for the family members and loved ones of those killed or injured. This is the case whether the attack is an isolated incident or part of a longer-term pattern of explosive weapon use. A report by Article 36 recognises that “both isolated explosive events, such as an improvised explosive device (IED) attack, and the repeated use of explosive weapons through shelling or bombardment, put affected people at grave risk of suffering psychological trauma.” They have an impact on people’s daily lives and create many sources of stress. Living with constant reminders of an incident causes high rates of psychological distress for survivors.

The conflict which is currently raging in Syria is causing major mental health crisis. The fighting has destroyed homes, separated families, and led millions to flee. “Many have physical problems from injuries in the war. Even more have internal, emotional damage,” says Lauren Wolfe, the Director of Women under Siege. Access to mental health support is extremely scarce. Humanitarian agencies dealing with the emergency are seriously lacking trained professionals: “I have met with many psychologists who similarly say they are the only ones for miles around (…) all of these professionals have said the number of people experiencing symptoms of depression or anxiety is staggering.”

The injuries caused by explosive weapons can have a psychological impact on survivors. Typical injuries, such as extremity injuries, auditory, respiratory and brain injuries, will often require long-term medical attention, and can sometimes result in life-changing procedures, such as a limb amputation. These are traumatic consequences survivors will have to deal with for the rest of their lives, likely to put a lot of pressure on their mental health for a long time after the incident.

Surviving a blast without a physical injury doesn’t mean avoiding the risk of psychological trauma, as severe mental health impacts can also be caused by narrowly escaping an event, by the fear of future attacks (…).”There is a risk of mental health problems developing for witnesses, even in the absence of a physical injury.

Some of those most at risk are children, who will experience the effects long after an incident. Experiencing psychological trauma has a significant impact on their cognitive, emotional and social development. A recent survey on the mental health impact of the 2013 Boston Marathon bombings on children revealed that about 11% of those who attended the event, where three individuals were killed and 64 were physically injured, showed symptoms of Post-Traumatic Stress Disorder (PTSD) six months after the event. Only 0.4% experience the same symptoms in a normal population. Those who had more than three hours of media exposure of the bombings and the subsequent manhunt also showed similar symptoms. These types of events “have a considerable effect on children’s psychological functioning,” according to Jennifer Greif Green and Melissa Holt, Boston University School of Education professors. “After mass crises, we see increases in depression, anxiety, post-traumatic stress disorder, and behavioural problems in children.”

The wider community is also at great risk of psychological harm as a result of the use of explosive weapons in a populated area. This is true especially in conflict zones, where there is heightened sense of insecurity. According to a World Bank report on mental health and conflict, “in every population, 1-3% have a psychiatric disorder. Where conflict is present, the number may increase due to PTSD, alcoholism/drug abuse and depression arising from conflict-related stress. (…) following a traumatic event a large part of the population may suffer nightmares, anxiety, and other symptoms of stress.” Widespread psychosomatic disorders and a generalised sense of numbness develop from extreme violence and loss. A study on mental health conducted in Gaza demonstrated that people living in such unstable conditions are more likely to engage in violent actions themselves.

The effect of explosive violence on civilians’ mental health reflects the wide reaching impacts of the use of explosive weapons. Explosive weapons do not only cause serious physical and structural devastation, but also long-term psychological harm. Their use in populated areas is unacceptable. Immediate attention needs to be brought to the catastrophic effect explosive weapons can have on a population as a whole, and on the support requirement of those who suffer psychological harm as a result.