Humanitarian aid workers are at significant risk for mental health problems, both in the field and after returning home, according to a new study.
Researchers at the U.S. Centers for Disease Control and Prevention (CDC) and collaborators, including Columbia University’s Mailman School of Public Health, surveyed 212 international humanitarian workers at 19 NGOs (non-governmental organizations). Prior to being deployed, 3.8 percent reported symptoms of anxiety and 10.4 percent symptoms of depression, which is in line with the prevalence of these disorders in the general population, according to the researchers. Post-deployment, these rates jumped to 11.8 percent and 19.5 percent, the researchers noted.
Three to six months later, while there was some improvement in rates of anxiety — falling to 7.8 percent — rates of depression were even higher at 20.1 percent.
The researchers also noted that adjusting to home life is often difficult for these humanitarian workers.
“It is quite common for people returning from deployment to be overwhelmed by the comforts and choices available, but unable to discuss their feelings with friends and family,” said Alastair Ager, Ph,D,, study co-author and professor of Clinical Population & Family Health at the Mailman School.
And, as unlikely as it sounds, many of the workers missed the excitement of working in the field.
“I remember one highly capable humanitarian worker struggling because the time she spent with her children simply didn’t give the same ‘buzz’ as leading emergency operations in the field,” said Ager. “She felt guilty in this, but her nervous system had become ‘wired’ for emergency settings.”
It is that continual exposure to a challenging work environment that increases the risk for depression, not the experience of particular dangerous or threatening situations, the researcher said. Weak social support and a history of mental illness also raised risks. On the plus side, aid workers who felt highly motivated and autonomous reported less burnout and higher levels of life satisfaction.
The researchers outline several recommendations for organizations, including screening candidates for a history of mental illness, alerting them to the risks associated with humanitarian work, and providing psychological support during and after deployment. Organizations also should provide a supportive work environment, manageable workload, and recognition, and encourage social support and peer networks, the researchers advised.
The well-being of humanitarian workers can be overshadowed by the needs of the people they serve, the researchers noted.
“It has been challenging to get mental health care for workers onto the agendas of agencies employing them — and even onto the radar of workers themselves,” said Ager. “Depression, anxiety and burnout are too often taken as an appropriate response to the experience of widespread global injustice. We want them to know that the work they are doing is valuable and necessary and the situations difficult, but this doesn’t mean they need to suffer.”
The study was published online in the journal PLOS ONE.