THE four-day Pakistan-India conflict in May has had favourable outcomes for Pakistan. On the international stage, Pakistan has re-established itself as a serious force to be reckoned with. On the diplomatic side of things, the country`s reputation seems to have been reinvigorated as relationships with important countries, including the US and those in the Middle East, have been greatly enhanced. One cannot help but assume that our performance against a much more powerful foe is at least partly responsible for these developments. Domestically, there is a patriotic fervour the country has not seen in many years, creating opportunities and political capital to tackle issues that may not have been possible earlier.

Pakistan gallantly defied Indian aggression, with Pakistani content creators in overdrive, taking social media by storm with their humour and memes. X was also unblocked to unleash Pakistan`s social media warriors. But, at the other end, there was fear, especially among people living in areas that had experienced the conflict first-hand. At least two generations of mainstream Pakistanis had never heard threatening soundsin theirairspace.

While these experiences and emotions across mainstream Pakistan are still fresh in the nation`s memory, we must highlight an issue that has for far too long been unaddressed. The recent standoff lasted a mere four days. Now imagine the state of mind of a population exposed regularly to the buzzing sounds of drones, the thumping noise of artillery rounds, the whirring of gunship helicopters and the roar of jets bombarding nearby targets all while living in conditions of restricted movement and varying degrees of brutal militant control for the past two decades. This has been the reality for many living in KP`s Malakand Division, or Swat, and the merged areas of Pakistan, which many know as simply `former Fata`.

On selected platforms, there has been some discussion about the human loss and infrastructure destruction in these areas. Sadly, there has been very little recognition of or conversation about the psychological trauma that continues to dog large parts of this populace. While the donor community, recognising the trauma, has carried out limited interventions, there has been hardlyany significant project by the government that comes to mind.

One donor-run project delivering health services at the BHU level in a district in the merged areas also provided psychologist services on a pilot basis soon after the merger. They were able to reach 1,170 patients suffering from mental health problems in the few months that these services were provided. Of these patients, about 70 per cent were found to be suffering from issues related to militancy, including post-traumatic stress disorder, depression and anxiety. The patients straddled gender and age. These cases can be attributed to conflict and the loss of loved ones, and the ensuing economic stress militancy-related income disruptions is a topic that Ihave written about earlier on these pages.

Meanwhile, a large number of cases go unreported on account of cultural and societal taboos that discourage people from talking about their mental health struggles. Even in some liberal societies of the West, in spite of concerted public awareness campaigns, people can be reluctant to discuss their mental health problems due to fear of stigma. In a conservative society like the merged areas, on top of the stigma factor, there are issues such as `purdah` and of not being able to take women to male health practitioners.

Unresolved, mental health problems can have larger societal repercussions. Research shows that while the relationship between mental illness and violence is a complex one, under certain circumstances, patients can be prone to violent actions. There is also a strong link between mental health and substance abuse, often seen in violent tendencies.Infact, a spikein drug addictionand narcotics use has been noted in the merged areas, which were not that prevalent even at the time of the Afghan war, when some places in the region were centres of narcotics production.

Similarly, instances of potentially fatal violence, especially in domestic settings, by young male members of the family have also become more frequent. While locals are justifiably asking for more to be done by the government to control narcotics sale, especially illegal methamphetamine (commonly known as `ice`), even they fail to link the root cause with mental healthrelated issues.

Mental health disorders can be debilitating and make individuals far less productive. This is even more concerning in a region where multidimensional poverty is among the worst anywhere in the country. Those suffering from mental health disorders end up becoming a burden on their families and communities rather than contributing in a productive manner.

Itisunfortunatethatduetoatendencytooverlook the existence of mental health illness in the area, and consequently doing little to address it, we do not exactly know the extent of the problem in the former Fata areas and Malakand Division, which have been battered by years of militancy and conflict. However, judging from whatever limited work that has been done there and from what one learns about conflict-affected populations globally, a large part of the population is likely to be suffering from mental health conditions to varying degrees.

The government needs to launch large-scale awareness programmes in the area and focus on making the services of mental health professionals available to all. At the same time, it needs to concentrate on employment-generation opportunities, especially for families that have lost loved ones and livelihoods to militancy and the state`s counter measures to curb it. While short-term medical camps might work for physical injuries incurred in times of conflict, a more sustained support structure and programme needs to be in place to tackle psychological repercussions. • The wnter is a development practitioner and a former parliamentarian.

X: @GhaziGJ