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Humanitarian aid workers at risk for mental health problems

International humanitarian aid workers are at significant risk for numerous mental health problems including depression, anxiety and burnout, according to study results.

“International humanitarian aid workers are increasingly at high risk for experiencing violence and being exposed to terrorism and direct attacks (e.g., Iraq and Afghanistan),” the researchers wrote. “Such extreme distress may result in negative mental health consequences, which in turn may affect the functioning and productivity of the aid organizations.”

Barbara Lopes Cardozo, MD, MPH, a CDC psychiatrist and one of the founding members of Doctors Without Borders, and colleagues surveyed 212 international humanitarian aid workers from 19 nongovernmental organizations (NGOs). The researchers measured stressors and traumatic experiences such as participants’ living conditions, workload, threatening checkpoints, being forced into unwanted sexual contact, kidnapping, murder of a colleague or family member, and threats of being physically harmed.

Participants were assessed for depression, anxiety, burnout and life and job satisfaction before deploying to disasters, shortly after returning from deployment and 3 to 6 months postdeployment.

Before deploying to host countries, 3.8% of participants reported anxiety symptoms vs. 11.8% at post-deployment (P=.0027), and 10.4% reported depression symptoms before deploying compared with 19.5% at post-deployment (P=.0117) and 20.1% at follow up (P=.00083). Extraordinary stress contributed to an increased risk for burnout/depersonalization (AOR=1.5; 95% CI, 1.17-1.83).

However, the provision of social support was associated with lower depression (AOR=0.9; 95% CI, 0.84-0.95), psychological distress (AOR=0.9; 95% CI, 0.85-0.97), burnout/lack of personal accomplishment (AOR=0.95; 95% CI, 0.91-0.98), and greater life satisfaction (P=.0213).

According to study researcher Alastair Ager, PhD, of the Mailman School of Public Health at Columbia University, the study results have important implications for NGOs in providing for their staffs’ mental health needs.

“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,” Ager said in a press release. “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.”

Disclosure: The researchers report no relevant financial disclosures.