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2. Violence and Mental health Pathways to prevention Muthoni Mathai ( University of Nairobi) Symposium: Columbia University. Preventing brain disorders improving Global Mental Health Date: 2.05.2014

3. Introduction We live in a violent world- Each year, nearly 1.4 million people worldwide lose their lives to violence. 80 % of these as a result of Homicide and suicide and 6 % as a result of war some est. 250,000 deaths a year mostly in civil wars 90% of the deaths due to violence occur in LMIC (WHO) Group conflicts are a particular global problem  Ethnic conflicts, genocide (Ruanda Bosnia), rape and violence against women and children and enslavement (Syria, Afghanistan, DRC, Chad, Niger, Mali, Somalia Uganda, Kenya, CAR, Dafur, Sudan)  Terrorists attacks (non state attacks) – this (est) year 1 every day in some country- Africa, Middle East, Asia  Since Oct 2011 Kenya has experienced 45 terrorist atatcks with 159 dead and 621 injured

4. Conflicts

5. A global wave of violence that leaves men women and children, families and nations in devastation Displaces millions of people around the globe (45.2 million. 2012. UNHCR Facts and figures) In 4 months conflict South Sudan has produced > 700,000 displaced persons

7. Impact of Trauma to health  In addition to physical injuries, Traumatic experiences are now clearly associated with various mental disorders  ASD and PTSD  Depression and suicide  Various Anxiety disorders  Substance use disorders etc.  Somatoform disorders Increased risk- unwanted pregnancy, HIV and STI

8. Aggression Violence and resources  Aggression and Violence is as old as human history.  In the process of human evolution aggression has been seen to have played an adaptive role, securing vital resources for the survivor of the individual and group.  Resources- extend the survival beyond physical to survival as a coherent group then resources are not just water and food but include emotional and social

9. Adaptive or maladaptive ? Aggression bleeds more aggression and even small gains are overshadowed by the losses  What is the adaptive function of group Violence in modern times ?  While human conflicts are unavoidable- is violence the venue for resolution ?  Why has Human socialisation and development not rendered group violence obsolete ? 

10. Technology economic greed and Violence  Technological developments have made it possible for humans to inflict massive damage to other human beings  Acting individually or in groups  Individually for a group.  Or even at the press of a button from a distance

11. Remote villages and urban centres Modern Arms ICT for distant planning Intervention and rescue operation

13. Psychosocial theories  Human aggression and violence is such a complex phenomenon that no single sociological or psychological theory can adequately explain what we are experiencing  Anderson’s socio-cognitive theory and the General Aggression Model probably comes closest

14. Anderson’s general aggression model episodic processes

15. Sustaining group violence Miler 2004 came up with strategies that are use to sustain and support violence in groups  Belief that target group represents a threat to resources  Sustain the impression that violence works  Desensitizing group to images of horror (live/media)  Sustaining a belief system that dehumanises target group, justifies on moral grounds the need to attack them,  Minimise negative consequences to self/group  Maximising positive consequences in the near future or after life  Hard and extreme Training to carry out violent attacks against target  De-individualisation

16. Pathways to prevention  Violence is a significant public health, human rights and human development problem  General understanding that we should halt violence  The complexity of human conflicts- approach must take into consideration context

17. When Violence breaks out Steps to stop violence  Stop cycle of violence  Ensure basic needs are met  Address symbolic needs (religion etc)  Plan Long term conflict resolutions Actors Prevent Violence Governments International organizations & Multinationals Local organizations and communities Civil society

18. Long term strategies WHO recommends strategies that address underlying causes  low levels of education,  harsh and inconsistent parenting  concentrated poverty,  unemployment  social norms supportive of violence.

19. Prevent violence: WHO strategies Schools & communities Life skills training and social development complete schooling and pursue courses of higher education and vocational training. Address gender norms and attitudes, improving school settings, including, school policies and security. Families Training for parents on child development and positive parenting Parental involvement through home-school partnerships; Attachments between high risk youth and caring adults Societies Reducing alcohol availability Controling access to lethal means promoting gender equality and economic empowerment of women

20. The role of Mental Health workers Untreated MH disorders are risk factors to perpetuation of violence  A lot of distress to individual family and intergenerational - negative child outcomes  Reduce human functioning and productivity- inc poverty  Risk factors for communicable and non-communicable diseases  Increases vulnerability to re-victimization  Risk factor to becoming Perpetrators

21. Terror and Hope

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