2. Mental Health Status of Returned Child Soldiers compared with Community Children in Nepal. A TERM PAPER PRESENTATION BY: SUJEN M. MAHARJAN. 2007 ON

3. Introduction Mental wellbeingLack of a mental disorder Mental health Child soldiers Community children Associated with armed groups/forces No official definition (WHO) PLA SF Spy/informer, messenger, porter, cook, fund collector, logistic supporter, artists in cultural groups Soldiers + In Nepal No epidemiological studies No Mental Health policy <1% Annual Budget Mental Health Status of returned child soldiers compared with community children in Nepal.

4. Literature Review Sri Lanka Northern Uganda Mozambique  Tamil Tigers/ 1983  High PTSD, Depression, Somatisation (Somasundaram, 2002)  Lord’s Liberation Army: 90% army- children (abduction)  Renamo / 30 years of civil war  Cen- evil spirits  Depression + Anxiety (Akello et al.,2006)  Longitudinal study: 1988-2004 19 male former child soldiers  High PTSD/npfuka (Boothby et al., 2004)  Experience of various traumatic events

5. Objective To determine if child soldiers in Nepal have greater mental health problems than community children exposed to political violence who have not associated with armed groups. Mental Health Status of returned child soldiers compared with community children in Nepal.

6. Case Control Assessment of: posttraumatic stress symptoms depression symptoms anxiety symptoms other generalized psychosocial functioning Standard Psychological Instruments adapted for the Nepali context Mental Health Status of returned child soldiers compared with community children in Nepal. Methodology Illam

7. Demographics

8. Mental Health Status of returned child soldiers compared with community children in Nepal. Findings and Results Figure General comparison of community children and returned child soldiers on psychosocial measures.

9. Mental Health Status of returned child soldiers compared with community children in Nepal. ControlCase ControlCase

10. Mental Health Status of returned child soldiers compared with community children in Nepal. Discussion  Both returned child soldiers and community children face different kinds of psychosocial problems like fear, anxiety, confusion, distrust, guilt, shyness, etc. due to the impact of armed conflict.  There is a significant variation from region to region.  Child soldiers display poorer mental health status with higher rates of depression, PTSD, anxiety, aggression, and poor daily functioning than community children.  Being female is a risk factor for depression and anxiety. Girls had significantly greater psychosocial distress than boys.  Children forced to become child soldiers had more psychosocial problems than children who reported to have joined voluntarily.  The exposure and experience of different kind of traumatic events and stressors placed child soldiers at long-term risk of psychological distress which might affect them even after a long period of time.

11. Mental Health Status of returned child soldiers compared with community children in Nepal. Conclusion  The high prevalence of psychological distress among returned child soldiers compared with community children confirms that child soldiers are an at- risk group in need of intensive and focused services.  Although at a regional level, child soldiers may require more mental health services; it should not be assumed that at a national level all child soldiers have psychosocial problems equally.  Providing special mental health services for child soldiers is crucial and emergency in Nepal. However, attention also should be directed to vulnerability based on gender, ethnicity, economic status, and region of the country.  Mental health care can work toward peace-building and prevent further recruitment of children into armed groups.  The research shows that child soldiers have poorer mental health status than community children.

12. Mental Health Status of returned child soldiers compared with community children in Nepal. Acknowledgements THANK : YOU Tri-Chandra College TPO (Transcultural Psychosocial Organization) Nepal Comments : smiling.sujen@gmail.com