The challenging environments where many contemporary United Nations peace operations are deployed can take a toll on the mental health of both uniformed and civilian personnel. There is increasing evidence that rates of post-traumatic stress disorder (PTSD) and other mental health issues are higher among people who have deployed to UN peace operations than in the general population. This has serious consequences for the performance, reputation, and finances of the UN and, more importantly, for the health and wellbeing of UN field personnel.
A recent policy paper published by the International Peace Institute analyzes the causes, prevalence, and impact of mental health issues on UN field personnel. Its analysis describes the three main stressors that contribute to high rates of mental health issues. First, the environment where peacekeepers operate can be a source of stress, both in terms of the security risks they face and in terms of their living conditions. Second, the nature of peacekeepers’ work is stressful, including their difficult mandates, restrictions on what they can do and accomplish, and their challenging, multidimensional working arrangements. Third, the UN’s bureaucracy, including its rules and regulations, managerial culture, and human resources system, is one of the most acute stress factors.
The UN system cannot change the fact that the environments where peace operations deploy are stressful and emotionally straining or that witnessing the effects of war and atrocities can impact the mental health of any individual. Nonetheless, the UN can work to improve the mental health of its personnel and has taken important steps in this direction. UN Secretary-General Antonio Guterres has been vocal in promoting mental health, and the UN Mental Health and Well-Being Strategy, launched in October 2018, has elevated the issue to a strategic priority for all UN entities.
The UN has established guidelines to inform UN staff about mental health challenges, developed action plans to reduce stigma related to mental health and change the organizational culture to create more supportive and caring environments. During the COVID-19 pandemic, the UN Secretariat has sought to strengthen sensitization and access to mental health care and counseling. The Department of Operational Support, which anticipates receiving more compensation claims for mental health issues induced by UN service in the years to come, is also conducting a study on PTSD to inform future planning.
Despite the prevalence of mental health issues, and the efforts made up to now notwithstanding, most UN staff have not received mental health support. There are several reasons for this. Mental health remains a sensitive topic, with persistent stigmas, cultural approaches that vary from country to country, and an institutional culture that has made “fitness for hardship” a core requirement for the job. The division of responsibilities for mental health support between the UN Secretariat, troop- and police-contributing countries, and individual staff members also remains subject to debate. Moreover, while the UN put in place a Mental Health and Well-Being Strategy in 2018, this strategy has been challenging to implement.
Until recently, the UN Secretariat had not collected comprehensive data on the mental health of UN staff. This changed when the UN, in cooperation with academic researchers, conducted a historic survey on staff well-being and mental health in 2015 and 2016 and issued a public report with comprehensive statistics in 2017. The survey had 17,363 respondents from eleven UN entities, as well as several UN peace operations, representing 17.7 percent of all UN personnel.
The results of the study are stunning. Approximately half of respondents reported symptoms consistent with a mental health condition, a figure significantly higher than for the general population. Forty-nine percent of respondents screened positive for at least one mental health issue, and 22 percent screened positive for two or more. Around 18 percent of respondents were flagged for generalized anxiety disorder, 23 percent for major depressive disorder, 20 percent for post-traumatic stress disorder (PTSD), and 23 percent for hazardous drinking. There was a strong association between poor mental health and the number of years working for the UN, low job satisfaction, and perceived incivility and conflict in the workplace. The prevalence of mental health issues was reported to be higher for women and younger staff.
While the UN Secretariat and member states contributing to peace operations have established processes and structures to address mental health before, during, and after deployment at different levels, major gaps remain. Pre-deployment selection and training processes include only cursory elements to prevent and raise awareness of mental health issues and to help personnel manage stress. The architecture for psychosocial support in the field is inconsistent and fragmented, with three Secretariat departments all working on mental health and two separate counseling services. Post-deployment, when PTSD and other long-term mental health issues can manifest themselves, the UN provides few mental health resources to former personnel.
To address these gaps, the UN system and member states urgently need to prioritize their duty of care to the troops, police officers, and civilians ready to live in dangerous, isolated duty stations with limited resources. To do so, a few steps can be taken.
The first is to raise the profile of mental health in UN peace operations. The UN Secretariat and member states should shed light on the difficult conditions facing peacekeeping personnel, better assess the prevalence of mental health issues among staff, and fight the stigma associated with mental health. They should also come to a clear understanding of their roles and responsibilities in supporting mental health needs.
The second is to provide more pre-deployment support for peacekeepers and staff. There is a need to train and sensitize personnel on how to recognize mental health issues, symptoms, and coping mechanisms. Preparedness and pre-deployment training on PTSD, trauma, and mental health should be based on minimum standards so that all contingents are equally prepared and equipped.
Third, those deployed should be provided stronger support. Both the UN Secretariat and member states should uphold their duty of care for personnel in missions, including by fostering a culture of care, offering adequate, continuous psychosocial support, and improving human resources arrangements.
And, lastly, ensuring that support is provided post-deployment is essential. The UN and member states should recognize that their duty of care does not end when field personnel return from deployment. They should continue following up with former personnel to ensure they are receiving the psychosocial support they need through dedicated structures and resources.
By their nature, peace operations are stressful work environments, and war, atrocities, and hardship can take a toll on any individual. Nonetheless, the UN system has to fulfill its duty of care to the troops, police officers, and civilians ready to live in dangerous, isolated duty stations with limited resources. It should approach mental health with the same sense of urgency that the 2017 report of Lieutenant-General Carlos Alberto dos Santos Cruz brought to the safety and security of peacekeepers—an operational stress injury should be treated with the same level of seriousness and credibility as a physical injury.