The crucible of Iraq--causes and consequences.

War can be seen as a crucible in which global geopolitical forces act on a population in a transformative manner. The psychological impact of war can be described in many ways, from the diagnostic to the narrative, from the intrapersonal to the relational. This paper explores whether the forces driving the conflict relate to the consequent psychological processes of those caught up in it. Geopolitical drivers, underlying global issues and the consequences on mental well-being are described. The models we use to define the consequences of war determine the degree to which the causes are seen as relevant to restorative, transformational or therapeutic processes; however a simple model reducing the consequences to traumatic events and symptoms, whilst having some validity, is not a sufficient description of the human experience. Understanding the causes and consequences of war is a multidisciplinary venture.

Mass violence and mental health--training implications.

Mass violence carries with it an enormous impact on health; the psychological impact is well recognized but poorly understood. There is a need for health professionals around the world to learn basic issues about the psychological impact of violence and to have available more specialized training to equip them with skills necessary to work directly with victims of mass violence. Organizing mental health services in conflict and in post-conflict situations requires many skills and complex work across sectors. Understanding mass violence from a public mental health perspective provides a framework for a curriculum that covers treatment for individuals and interventions for populations as well as exploring the mental states and social relationships which promote peace. Training implications are broad and should take account of individual and population needs, but also of a deeper human need to understand and contain that violent side of our nature that threatens us with extinction.