NGOs left with responsibility for supporting the mental health needs of torture survivors
Across the globe, every day thousands of survivors of torture receive support to meet their mental health needs by members of the International Rehabilitation Council for Torture Victims (IRCT). The vast majority of these services are provided by NGOs. From Sarajevo to Santiago and Paris to Phnom Penh, 150 rehabilitation centres across more than 70 countries provide care ranging from individual counseling to group therapy.
The nature of torture leaves an indelible and lifelong mark on its victims. Many suffer from symptoms, such as flashbacks, severe anxiety, insomnia, nightmares, depression and memory lapses. Rehabilitation, including meeting the mental health needs of survivors and their families, can help survivors gradually regain control of their lives. As one torture survivor who benefitted from support from an IRCT member said,
“My life has changed and become normal again, little by little, as the social counseling sessions advanced. My mental problems, which disturbed me so much have become fewer and fewer. Even the nightmares are disappearing.”
In many cases these rehabilitation centres are working in challenging environments, where there are little or no resources for mental health services and they face constant threats and harassment. Others may have stable resources but at a time when the international community is facing the highest number of refugees since the Second World War, they have long waiting lists and a significant increase in refugees who may also be torture victims, seeking treatment at their clinics.
Yet without these centres survivors have nowhere else to turn for mental health services. For example, in Cambodia it is estimated that about 40% of the population suffer from mental health and psychological problems, yet there are only 35 trained psychiatrists and 45 psychiatric nurses in the entire country. IRCT member centre the Transcultural Psychosocial Organization (TPO) is one of the few organisations providing support to survivors of torture in the country.
Torture is more prevalent than most of us can imagine and is not limited to developing countries or nations affected by civil war or armed conflict. According to Amnesty International, torture and ill-treatment happens in over 140 countries, many of which have ratified the United Nations Convention against Torture. In some countries torture is seen as “normal” and acceptable and the public believe that people who have been tortured deserve it.
This can make it even more difficult for survivors to receive mental health care, as they are shunned by society and their needs ignored. This lack of understanding, combined with a lack of funding means huge numbers of survivors fall through the cracks and never receive rehabilitation. The dependency of the torture rehabilitation community on voluntary sector funding, means there is a constant struggle to survive; the needs of survivors are not met, there are gaps in services and caregivers work in unsustainable conditions.
States need to acknowledge their obligation - as set out in the United Nations Convention against Torture and further developed in General Comment 3 of the Committee against Torture - to support victims of torture and to provide them with rehabilitation services. This of course includes mental health services. Rebuilding the life of someone who has been tortured takes time. This means long-term material, medical, psychological and social support is needed.
Without the support of states it will be impossible for many IRCT members to survive and, as a knock on effect, without mental health care torture victims will never be able to rebuild their lives. On a daily basis IRCT member centres integrate mental health into their approaches. As an organisation the IRCT also has a focus on how to incorporate mental health in the services that might already exist in their communities.