Invisible wounds of war: children’s mental health in crisis zones

Date: 28/10/2025
Children in emergencies are at greater risk of exploitation and mental health conditions. However, mental health support for children is grossly underfunded. In this long-read, SOS Children's Villages explains how we're helping and what needs to be done to ensure long-term improvements for children and families.

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“Children without parental care are traumatised because of the violence of the conflict. Some are coming from families where everybody has been killed. They find themselves alone with nobody to take care of them.”

These are the words of Armand Tchoffouo, the National Director of SOS Children’s Villages in the Democratic Republic of Congo (DRC). His words are especially troubling given that children without parental care have unique needs, especially in relation to support for their mental health.

Over 200 million school-aged children and young people worldwide are affected by humanitarian emergencies.

Because of these crises, they’re at severe risk of developing mental health conditions such as depression, anxiety and post-traumatic stress disorder.

Up to 142million children live in conflict zones, with an estimated 24million experiencing high levels of distress and needing mental health support.

Children in emergencies at greater risk of exploitation.

Not only do these children require immediate access to essential services such as healthcare, education, and emotional and mental support, but children separated from parents are at greater risk of abuse, exploitation, and violence, including abduction, forced recruitment and trafficking.

They may also face arrest or detention due to perceived association with armed groups and experience ostracisation or victimisation by authorities.

The impact of conflict on Gaza’s children

The world’s eyes are currently on Gaza, and it’s no surprise that Gaza’s children have been deeply traumatised.

As Zoya Thalgieh, an SOS Children’s Villages psychologist in the West Bank who works with children evacuated from Gaza, says: “In our setting, trauma shows itself most clearly through behaviour. Many children act out with aggression, either verbally or physically. Some harm themselves, while others sink into deep hopelessness or anxiety. For many, anger becomes the only way they know how to hide their fear and grief.”

Her words are echoed by Baker Awad, an SOS Children’s Villages psychologist working in Gaza, who says: “The most serious issues are the psychological effects of worsening hunger and famine, which directly impact the most vulnerable groups: children, women, and the elderly. Among displaced children, the lack of basic necessities inside camps has resulted in both health and psychological problems”.

Yet, despite this, there’s little evidence that any extra or special support is generally granted to children. According to a 2019 report, Mental Health and Psychosocial Support (MHPSS) received only 0.14% of Overseas Development Assistance funding between 2015–2017, indicating limited resources for children’s mental health, even amid in emergencies.

Mental health support for children grossly underfunded

A paper in 2023 suggested that a shortfall of nearly $650million in child protection funding is leaving nearly 18million vulnerable children and caregivers living in the world’s worst humanitarian crises at risk of violence, exploitation and abuse.

The same report suggested that the shortfall would reach $1billion if the trend remains in place.

As Orso Muneghina, SOS Children’s Villages International MHPSS Lead makes clear, “Children in humanitarian crises already face collapsing protection and very fragile mental health systems.

“A billion-dollar funding gap would mean stripping away the very last safety nets, leaving millions exposed to violence, exploitation and trauma.”

Children risk being retraumatised by everyday events
This absence of support has numerous implications…

Firstly, children can be retraumatised by everyday events. For example, huge anxiety can be triggered by loud noises because it reminds children of violence they’ve witnessed.

The loss of stability and repeated displacement causes daily stress and trauma, with children repeatedly asking themselves how long it will continue.

It’s particularly challenging when children have witnessed their parents killed in front of them.

There’s now evidence that this trauma has become intergenerational. According to a recent report by Rwanda’s Ministry of Health, at least one in two Rwandans have experienced trauma, which means that young people are currently living with transgenerational trauma.

And as Jean Bosco Kwizera, national director of SOS Children’s Villages in Rwanda points out, “If you are not mentally well taken care of, it has an impact on your decision making, your education, your concentration on tasks, and how you grow up responsibly.”

“Inside their minds is chaos”

Above all, though, children without parental care need emotional support.

As Gina Nqabakazi South Africa’s SOS Children’s Villages National Director says, “Children may have shelter, food, clothing, but inside their minds there is chaos. They still have a lot of healing to do, and the environment does not provide a platform to lay out their turmoil, confusion, and anxiety.”

These children are crying out for support. Fortunately, SOS Children’s Villages has been at the forefront of the response, often deploying innovative techniques in current and former crisis zones across the world. In fact, we have been one of the few providing sustained mental health and psychosocial services to children in long-term crises.

As Anastasiia Karandashova, psychologist and MHPSS Advisor in SOS Children’s Villages Ukraine says: “It’s very important for such a child to have a “witness” to their experiences. An adult who can notice, listen, acknowledge the pain, offer support, and show that life also has another side.

“That while difficult events affect life, they do not define the person.

“This helps restore a sense of stability and control, that there is still something they can influence, even when war is all around.”

At SOS Children’s Villages, mental health support is one of the key pillars of our humanitarian response.

In just 2024 alone, more than 3,101 children and young people, across 19 countries, were supported through our TeamUp intervention; an initiative aiming to strengthen children’s emotional resilience.

Keeping children at the centre

Models like TeamUp meet the needs of children at risk of, or already separated from, their family. Keeping children at the centre of the care system, our approach focuses also on families, communities and society at large to build an environment that helps increase access to mental health and psychosocial support services.

The challenge, as Orso Muneghina explains, is, “how can we provide mental psychosocial support to children and families in low-resource settings.”

The solution, he says, is the introduction of the ‘step-care model’.

What is the step-care model?

This model involves easy to deliver, low-cost intervention, which allows the limited number of specialists to focus on providing training instead.

In this way, more intensive care is scaled up only when preventative and universal interventions cannot meet the increased needs for treatment.

Working with parents in crisis

In Haiti, SOS Children’s Villages is piloting programmes focused on parents. ‘Problem Management Plus’ trains staff to work with parents in crisis, helping them manage stress so they can support their children.

Schools were identified as spaces to act as protective environments. For parents, school is no longer just a school but a safe place where they know their children can be cared for.

This emphasis on parents is replicated in South Africa. As Gina Nqabakazi points out, “In parenting networks, parents realise, ‘I’m not alone.’ They share experiences and see that their situation is normal. That is empowering and helps them overcome challenges.”

In Gaza, SOS Children’s Villages contributes to community integration of displaced families by providing specialised psychosocial support programmes and activities that help integrate children and adolescents through recreational days, individual and group counselling sessions, awareness activities, and psychological first aid, all of which significantly support their integration into the surrounding community.

What unites all these approaches, however, is that children’s views are central.

“When children had a voice in shaping their space, everything started to change.” said Gina Nqabakazi

And when their voices are heard, their true selves are reawakened.

As Zoya Thalgieh of SOS Children’s Villages Palestine says: “When a child begins to open [up] to someone they trust, forming a new friendship, or expressing themselves through art or school, it reminds me that recovery is always possible.

“I also find hope in the commitment of our staff and the kindness of the community. Everyone works with such heart to give the children the care they deserve. Most of all, it’s the children themselves who inspire me.”

The world cannot forget that urgent mental health support is still required for countless children.

As Bilal Naem in Gaza says, “Mental health support must be integrated consistently into humanitarian responses, with careful consideration of available resources and priorities, so that it’s not treated as a secondary activity but as an essential component of interventions to reduce trauma and strengthen children’s psychosocial resilience.” 

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