There is a 'dire need' to address the unique mental health challenges faced by victims of 'enforced disappearances', according to academics.
Writing in the journal Medicine, Science and the Law, researchers from Cardiff University and Aston Medical School outline the challenges faced by victims and families of 'enforced disappearances' – the arrest, detention, abduction, or any other form of deprivation of liberty by state agents, or those acting with state approval.
Professor Andrew Forrester of Cardiff University's School of Medicine, and Dr Anis Ahmed from Aston Medical School say that the psychological trauma of victims of enforced disappearances and their families is under-researched and there is no clear guidance for mental health professionals treating them.
The researchers address a 'dire need' to develop evidence-based treatments and the 'therapeutic void' that is vital to address.
Professor Forrester said: "Enforced disappearances are a serious violation of human rights, impacting thousands of people in many parts of the world, including Latin America, South Asia, the Middle East, and parts of Africa. In Syria today, tens of thousands remain missing due to state repression and ongoing conflict. This is not a problem limited to war zones - disappearances also happen in many other situations, often targeting political opponents, journalists, or members of marginalised communities."
These disappearances cause deep mental and emotional strain for both the missing individuals and their loved ones. Unlike ordinary bereavement, families live in a constant state of uncertainty, unable to grieve fully or move on. Yet, despite the seriousness of this emotional toll, there is very little research on how best to support these families, leaving both them and mental health professionals without clear guidance.
The researchers say that the families of those who have disappeared live in a state of 'ambiguous loss' with a prolonged state of uncertainty in which they are unable to grieve or move forward, often suffering chronic depression and anxiety and post-traumatic stress disorder (PTSD).
Victims who return also face unique challenges. In addition to the psychological aftermath of prolonged captivity and torture, they struggle with trust, hypervigilance and shame. Reappearance can attract unwanted attention, suspicion and social stigma.
The researchers highlight significant challenges in conducting research and developing the appropriate mental health guidelines – including fear, which can acts as a powerful barrier, not only for victims, who may remain silent due to threats of reprisal or renewed targeting, but also for mental health professionals, who may hesitate to engage fully out of concern for their own safety.
They say that the first step towards developing the necessary guidance is a study to map the prevalence and psychological impact across different regions, followed by developing and testing targeted treatments.
Enforced disappearances remain a deeply neglected area in academic and clinical discourse, especially concerning mental health impacts. I'm currently working to establish an international, multidisciplinary research collaboration to address this gap - bringing together voices from psychiatry, anthropology, sociology, human rights, and legal studies. This is a complex issue that requires cross-sector engagement.
The paper, 'Mental health challenges of enforced disappearances: A call for research and action' , was published in Medicine, Science and the Law.
