Editorials

Should children be evacuated during times of war?

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.g7824 (Published 05 January 2015) Cite this as: BMJ 2015;350:g7824
  1. Derrick Silove, professor
  1. 1School of Psychiatry, University of New South Wales, at Liverpool Hospital, NSW 2170, Australia
  1. d.silove{at}unsw.edu.au

Maintaining the integrity of families should be a cornerstone of policies to protect children in war zones

Debate has long surrounded the question of whether children who experience major separations from parents are at increased risk of future mental disorder.1 2 More than 30 years ago, Michael Rutter concluded that most children show remarkable resilience in the face of separations.3 However, he acknowledged that separations occurring under severe adversity can pose a major threat to future mental health.3

War represents a special case, in which separations in families occur under extreme duress.4 Nevertheless, distinguishing the long term psychiatric effects of parent-child separations from other war related traumas and stresses remains a difficult methodological challenge.4 In a linked paper (doi:10.1136/bmj.g7753) Santavirta and colleagues examine psychiatric outcomes in adulthood among a sample of 1425 Finnish children evacuated to Swedish foster families during the second world war.5 The evacuated children did not differ in their rates of hospital admissions for psychiatric disorders in adulthood from age matched siblings who remained at home or from a larger national cohort of children who remained in the war zone.

The strengths of the study are that the authors drew on a nationally representative sample using objective records to index childhood evacuation status and later psychiatric admissions. …

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