Mental health and psychosocial support for the reintegration of people (formerly) associated with violent extremist groups
From surviving to thriving
December 17, 2022
The repatriation and reintegration of men, women and children returnees with perceived or actual (former) affiliation with violent extremist groups (VEGs) pose a great challenge for societies. For those returning to their countries of origin, the distress and hardship endured during violent conflict are often compounded by pervasive stigma faced upon return and, in the case of ex-combatants, the traumatic experience of detention. Processes of reintegration are also shaped by expectations related to gender, age, culture, and traditions. If not adequately addressed, psychosocial distress can jeopardize the rehabilitation process, contribute to mental health disorders, and inadvertently contribute to continued cycles of violence and increased interest in extremist ideology.
The series “Settled Minds, Settled Lives: Building resilience through #InnerPeacebuilding” aims to unpack the principles outlined in UNDP’s Guidance Note on Integrating MHPSS into Peacebuilding under different thematic issues. In this episode, we explore how in the Central Asian region, UNDP works closely with partners such as Beyond Conflict to integrate mental health and psychosocial support (MHPSS) into peacebuilding, including in the reintegration of women and children associated with violent extremist groups.
We speak with colleagues Dana Oraz, Project Manager at UNDP Kazakhstan, Mukash Kaldarov, Senior Adviser on Social Cohesion, and Nurzhan Alymkanova, Communications Specialist at UNDP Kyrgyzstan, as well as Noah Tucker, Associate at George Washington University’s Elliot School of International Affairs Central Asia Programme, and Gulnaz Razdykova, Director of the Centre for Analysis and Development of Interfaith Relations of Pavlodar, Kazakhstan.
Why is working on the returnees’ psychosocial wellbeing important for the reintegration process? In your experience, what kind of support do returnees need, in order for their reintegration into society to be considered safe and sustainable over time?
Dana, Mukash and Nurzhan: Mental distress, socioeconomic exclusion, low levels of education and grievances are typically recognized as primary drivers of radicalization, as suggested by in-depth interviews that UNDP Kyrgyzstan carried out with clients of probation. Consequently, providing MHPSS to returnees is fundamental for preventive efforts, and coupled with professional orientation and employment support, it can offer concrete life alternatives to radicalization and recruitment. Since 2019, a new Institute for Probation has been rolled out under the “Justice Sector Reform” in Kyrgyzstan, aimed at providing support for clients of probation, including legal aid, social programmes, employment and documentation, as well as MHPSS.
UNDP’s approach to reintegration focuses on particular needs of women and children returnees who may be deemed associated with ISIL and affiliated VEGs, as well as on the receiving community. It is vital to counsel returnees and help them deepen their often faint relationships with family members left behind. Strengthening an individual’s social connections is key for their mental health, well-being, and resilience. Having strong ties with family, peers, friends, and the local community allows returnees to develop a sense of belonging, that is linked to lower depression rates of and greater empathy. This is why UNDP Kazakhstan offered grants to small businesses, which allowed generating employment and building the resilience of 100+ at-risk youth (“NEET”), and supported 26 local CSOs to implement social infrastructure projects, including the creation of sport facilities, youth work centres, and recreative spaces, that represent free spaces for engagement, socialization, and access to information and knowledge.
Context and gender-sensitive MHPSS is a critical component of efforts to rehabilitate individuals formerly affiliated with violent extremist groups, to ensure that no one is left behind. Women and men possess different needs, desires, and individual abilities. UNDP Kazakhstan supported the Government in providing women with professional training such as sewing, cooking and hairdressing; some women successfully completed a training in STEM and started their career as IT specialists. As a result of this funding, some returnee women managed to start their own business and even employed other women, generating a positive cycle of empowerment and resilience to violent extremism. MHPSS is integrated in all such activities through continuous counselling and mentorship sessions.
Noah: In the past two years, I have worked across Kazakhstan, southern Kyrgyzstan and Uzbekistan carrying out preliminary assessments of the needs children and families have on their return from conflict zones in Syria and Iraq. While a lot of the public attention is typically focused on the idea that children associated with VEGs could have been radicalized or trained as child soldiers – which was the case in only a small handful of instances – there is little understanding on the danger and trauma caused by exposure to violence and conflict, that continue to interfere with the children’s ability to have a normal childhood, to feel happy and safe and do the things that their peers enjoy. For adults, there is a general understanding that many of them need psychosocial support in the same way survivors of any other war might. But in a lot of ways, this wasn’t just any other war. So many refugees and returnees I’ve spoken with talk about experiencing constant bombardment, extreme hunger and fears of starvation, and are wracked with complex guilt and grief over the loss of children they brought or gave birth to during the war. Getting back to a place where they can live everyday life and perform daily tasks – including taking care of their other children and expanding their family, as many wish to – is a first step, but dealing with the longer-term effects of traumatic stress and complex grief can take a very long time and be almost impossible to do without MHPSS. Moreover, many of the adult women who left for, or were taken to the war have experienced significant trauma, including rape and sexual violence, and therefore face additional stigma from their communities and have specific psychological, social and health needs.
Gulnaz: Taking into account the physical and mental state of the returnees is necessary for their successful reintegration. Psychological rehabilitation includes carrying out the diagnostics, drawing up an individual rehabilitation and psychological assistance plan for both returnees and the host/receiving communities. Not only do returnees need psychological assistance immediately upon repatriation, but also constant counselling and mental health monitoring in the long run. For returnees to be able to re-join civilian life, they also need support in finding employment and in developing the necessary knowledge and skills to enter the labour market. MHPSS interventions, therefore, need to be part of a broader package of measures for rehabilitation and tailored to the social and cultural context, as well as to the gender of each individual. As UNDP’s Guidance Note on Integrating MHPSS into Peacebuilding states, there is no one-size-fits-all, step-by-step approach to the integration of MHPSS into peacebuilding - in this case, rehabilitation activities.
How can you justify providing suspected extremists with mental health care and psychosocial support when such services are often not available for the average citizen?
Dana, Mukash and Nurzhan: Providing MHPSS to suspected extremists is a part of a preventive approach to their possible re-radicalization and is especially important for returnee individuals who are in prison. MHPSS helps prisoners cope with post-traumatic stress, anxiety, uncertainty about the future, and is beneficial for improving relationships with family members. It is also crucial to strengthen the resilience of both cellmates and prisons’ staff, who are also at risk of being radicalized by former violent extremists. MHPSS is vital for “redirecting” suspected former extremists, and therefore it is paramount to raise awareness on this through platforms and occasions where community members can openly discuss issues and challenges of the social reintegration of returnees and their family members.
In Kyrgyzstan, despite the existence of mental health-related clinical and service provision realities, there is still widespread cultural stigma on mental health issues and their treatment. Fortunately, in recent years, communities have started to embrace professional help, and it has become more common for the average citizen to use such services. In the case of suspected extremists, UNDP Kyrgyzstan found that the lack of basic civic competencies to solve life problems appropriately generates a significant psychological burden, creating a vacuum that extremist ideologies could fill. These deep-rooted beliefs and grievances of former combatants require MHPSS to de-construct and “heal” a person’s emotions, thoughts, and violent attitudes. In any event, mental health is still health, and as such, a basic human right – even for convicted extremists.
Noah: It is important to remember that the overwhelming majority of returnees are children. The public broadly agrees that a five-year-old who has suffered severe malnutrition in war and in the camps, and who has experienced serious developmental delays, is not a suspected extremist. One of the things I love about Central Asia that keeps me returning is the strong sense of community and collective responsibility for the well-being of others, especially children. Children who may have been exposed to ideology or conditioning had no role in their parents’ decision to join an extremist group and are rightly seen as victims rather than a danger. The vast majority of adult returnees are women, most of whom (in Kazakhstan, for example) are legally classified as “victims of terrorism” rather than perpetrators. For those who face legal responsibility for participating in or supporting violence, I think we face the same questions and challenges that arise when trying to determine how best to punish and prevent any other type of crime. Incarceration should always aim to rehabilitate, and it's in everyone’s best interest to engage in rehabilitation in addition to punishment. In violent extremism, psychological trauma is sometimes part of the root causes and almost always part of the experience of engaging in violent extremist actions. Socialization within a VEG can sometimes provide a coping mechanism against psychosocial distress and mental health disorders, and leaving it for good requires learning other, healthier ways to cope.
Gulnaz: Usually, in Kazakhstan, MHPSS is provided to convicts and integrated in rehabilitation programmes for individuals perceived as being formerly associated with violent extremist groups (e.g., women and children). MHPSS is needed first and foremost to facilitate individuals’ reintegration into the society by accompanying them to cope with the frustrations, resentment, and guilt they might feel. I have observed that if unaddressed, negative coping mechanisms to mental health issues and trauma can increase life instability and risks of anti-social behaviours, including the risk of involvement in violence and extremism. Providing MHPSS to suspected extremists is, therefore, a matter of prevention and recovery, crucial for society as a whole to thrive.
How do we address the stigma that communities have towards these individuals?
Dana, Mukash and Nurzhan: Individuals returning from conflict zones to their countries of origin often face layers of stigma - from their communities, relatives, and even from themselves. Addressing stigma in all its forms is a whole-of-society effort that is critical for peacebuilding, as highlighted in UNDP’s Guidance note on Integrating MHPSS in Peacebuilding. UNDP fosters constructive dialogue and pragmatic cooperation between state actors at both the national and local levels, while engaging youth- and women-led CSOs and community leaders to encourage an attitude of tolerance towards people formerly associated with VEGs. Under the Joint UN-EU “STRIVE” programme, UNDP develops training packages and materials to raise awareness, equipping communities with skills to identify, prevent, and intervene against early signs of violent extremism, while sensitizing the public to the mental health challenges that returnees face.
Ultimately, as stigma is conjured by the public, disseminating the right information and normalizing MHPSS through communication is key. Working with the media, creating manuals and communication materials can humanize the process of return and reintegration, thereby reducing stigma. Since most returnees and their family members in Kyrgyzstan are highly religious, engaging religious leaders has proven effective to de-construct extremist ideologies, and to re-direct individuals to qualified professionals that can enhance their mental health.
Noah: Stigma remains among the biggest challenges across Central Asia, and it can complicate psychosocial health and treatment. As such, programmes in the region usually keep returnees anonymous. Kazakhstan went so far as to issue local birth certificates for children born in conflict zones abroad from parents supposedly associated with VEGs – a thoughtful and proactive step towards reintegration. Another way to address stigma is profiling successful reintegration and giving those stories a human face, an approach that, however, requires waving anonymity. Lastly, targeted advocacy campaigns can enhance public awareness and communities should be given a chance to voice their concerns.
Gulnaz: Measures to overcome stigma will depend on how the stigmatization manifests itself: it can come from the larger community, the family, or even be self-stigmatization. In the case of Kazakh returnees from Syria and Iraq, the stigmatization mainly originates from the individual’s social networks. In my opinion, the most effective way to overcome stigma is through good media strategies and awareness raising campaigns implemented at the national level.
Can MHPSS contribute to preventing the re-radicalization of individuals?
Dana, Mukash and Nurzhan: Different factors may lead to re-radicalization of returnee individuals. Identity crisis, isolation, social rejection, and domestic violence are social factors that, if taking place upon return, exacerbate situations of economic hardship, financial instability, and unemployment, luring individuals back to violent extremism engagement. Improving an individual’s mental health means increasing their resilience towards recruitment tactics, while helping to mitigate the risk of exposure to violent extremist messages and propaganda. In Kazakhstan, individuals facing societal discrimination, abuse, and marginalization, especially coupled with existing mental health disorders (linked to trauma or not) are the most vulnerable. MHPSS helps individuals heal the invisible, inner wounds left by exposure to violence and conflict. In short, MHPSS can mitigate factors that lead to radicalization.
In order for these processes to be effective, the prevention of re-radicalization requires the willingness, commitment and consistency of returnee individuals. This is why reintegration programmes provided by the Government of Kyrgyzstan require a minimum duration of 6 months, to allow for consistent monitoring of the probation client. It is important to clarify that neither mental illness nor emotional distress cause extremism, but services to reduce the burden of mental health challenges that contribute to reducing long term risks of recidivism and other potentially negative outcomes for people returning from conflict zones.
Noah: Practitioners are still learning about how trauma can result in a wide range of unhealthy and anti-social outcomes, from drug addiction to gang involvement to terrorism. Often we see that people who turn to violent extremism have suffered personal or collective trauma that they are trying to make sense of. But being part of a VEG can create new trauma and loss, producing “sunk costs” that can make it difficult for members to walk away: a mother who has lost a child for a cause she believed in faces a much steeper psychological path to admitting that cause was a mistake, than a casual violent extremist sympathizer. MHPSS can play a critical role in preventing recidivism, and so can address community-level factors that created the initial vulnerability to recruitment.
Gulnaz: There are a number of studies that have shown that those who join VEGs tend to have a lower frequency of diagnosed mental health problems than the average rate in the overall population. In reality, there are usually several aggregated factors contributing to radicalization. Some individuals get recruited in violent extremist groups following an ideology, some for prospective economic gains, others because of marginalization, and a general disappointment with life. In some cases, the desire to belong to a social group plays a role in the recruitment. Until we eradicate or minimize these factors, the risks of re-radicalization will persist. This is why there is the need to work on comprehensive special rehabilitation programmes tackling both push and pull factors of radicalization, taking into account the psychosocial dimension of extremism, including trauma and adversity faced, and their effects on individual psychology and decision-making.
For information on UNDP’s work on MHPSS in peacebuilding, please contact Nika Saeedi, UNDP global focal point on MHPSS and Team Leader for Prevention of Violent Extremism, at firstname.lastname@example.org.
Learn more about UNDP Kyrgyzstan’s support in providing expertise and trainings for the new probation body, and dedicated trainings in partnership with Beyond Conflict that provide guidance to public sector employees on how to apply trauma-informed practices in counselling and mentoring support for individuals at risk of radicalization.
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