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Submitted by Bishnu B. Thapa on


Thank you for this interesting blog piece (which is very pertinent and timely). For me, some of the takeaways from this piece are: (i) mental health in fragile situations is an important issue and deserves attention (in part because such situations are (unfortunately) becoming more prevalent than not), (ii) mental health can be best addressed through an integrated approach (that goes beyond just a ‘health systems approach’ and involves various actors / sectors), (iii) solutions to deal with mental-health related illnesses need to be context-specific, and (iv) mental-health related investments are cost effective. As I thought through this, I had few thoughts in my mind. First, I think it would be quite important to distinguish between mental illnesses that result directly from the effect of conflict (e.g., PTSD?) and the mental illnesses that result from the conditions created by the conflict (e.g., the lack of shelter, food, water and sanitation, etc.). Second, there is no doubt that the role of community and family would be critical (as is the case even in non-fragile situations) but it would be especially interesting to understand how “stigma” plays out in such situations. Could we expect it to be more or less pronounced?