Opening speech at the International Conference on MHPSS in Crisis Situations by Minister for Foreign Trade and Development Cooperation Sigrid Kaag

Your Excellencies,

Peter Mauer, President of the ICRC,

Ladies and gentlemen,

But above all, experienced experts,

Friends and colleagues,

This is a very important day. To all of us, personally and professionally. This is the day on which we change. When we translate talk into action, commitment. To really serve all those whom we may never know. They are as important as anyone who is close to us, and dear to us. But who are as important as anyone else.

In the West we have the privilege of knowing that mental health is important, but as Tim Kendall has rightly said, this topic has been fairly ignored. The pain you can’t see, can’t touch, that is the most difficult to heal. For family, friends, and above all, the persons affected. 
The people is crisis situations are seemingly the most difficult to reach, but everybody is affected. This is why I have decided that if my ministerial role is to be worth something, this theme is what I will have to deliver on. 

If I die today, this is the one I will leave with pride.

I would like to refer to the words of the war poet Wilfred Owen.

‘Who are these? Why sit they here in twilight?’
He asked this question in 1917, at the height of the First World War when he was being treated in Craiglockhart Military Hospital near Edinburgh. This facility housed officers suffering from severe post-traumatic stress disorder – referred to at the time as shell shock. 

Who were they? 
In Owen’s words: 
‘These are men whose minds the Dead have ravished.
[…] murders they once witnessed. […]
Treading blood from lungs that had loved laughter.
Always they must see these things and hear them,
Batter of guns and shatter of flying muscles, 
Carnage incomparable, and human squander.’

Today we may use different words to describe people affected by trauma, but we mean the same thing. We are failing them now as then. We are failing to provide help to those whose minds the Dead have ravished, whose lungs once loved laughter, whose souls have been tarnished by carnage incomparable. 

That’s why we are all here today. We have convened this conference for those who are sitting in twilight. The children, women and men branded by war and conflict. Our efforts today and tomorrow are for them.

That’s why I’m truly honoured to welcome you to Amsterdam, for the opening of the world’s first ministerial conference on mental health and psychosocial support in crisis situations. 

This conference is urgent. And many of you come from countries and conflict settings where you know this and live this. Day in and day out. It is necessary. And it is needed. Sadly, it is also late. Countless conferences have already been held about emergency aid, humanitarian access, medical assistance in crisis situations and development cooperation. All necessary. But none, none on the issue that’s on our agenda today. 

This, I think, makes us pioneers of sorts. But this is an uncomfortable truth. It is a role that none of us would have sought. It’s distressing and reassuring in equal measure.

Distressing, because despite all the resolutions that have previously been drafted and adopted, all the aid agencies that have been set up, and all the relief efforts that have been undertaken, this issue has never been given the status and priority that it deserves.

Reassuring, because you are all here today, it means that the tide is turning. When I look around this hall, I feel a sense of hared of duty and commitment, and a duty to deliver towards our shared humanity. Your presence here today is a tribute to those who have long suffered in silence. Their voices have to be heard, so that we might find words for what has previously gone unspoken.

What has gone unspoken, has not gone unnoticed. At least one in five people in a conflict situation develops a mental health condition. Close to forty per cent of children in conflict zones have severe emotional issues. 

Twelve per cent of the world’s population lives in active conflict situations. Vital healthcare, mental as well as physical, is scarce in areas ravaged by conflict, in and out of camps or settings of internal displacement. At best, mental health support or access is a secondary concern. But usually, it’s unacknowledged. Unaddressed.

But this doesn’t resolve any particular situation. Broken souls remain broken, even after the damaged bodies that house them have healed. A terrible reminder of this is the fact that suicide rates amongst veterans of conflict situations are significantly higher than among other groups, even when assistance has been provided. War’s trauma endures long after the last bullet has been fired. And all too often, the very last step taken or bullet fired is a desperate act of self-harm.

At a time when the number of conflicts around the world is increasing, when the numbers of internally displaced persons and refugees are growing, adequate mental healthcare and psychosocial support are needed The quality of mental health care and psychosocial services in crisis response is, of course, still significantly lower than the quality of physical health care services. And even then we are not talking about the triple-A package, we’re talking about modest, inadequate, and insufficient services. And the amount of development assistance dedicated to mental health remains pitifully small. What we don’t plan for, we don’t ask for. Our collective failure to respond to this global health crisis results in a monumental loss of human capital. But above all I believe it is a significant dent in our human dignity, and our shared humanity. We often say, at conferences like these, that we believe in investing in human capital, but we seem to forget about the most important adjective: human.

What makes us human. 

No longer.

So no longer  will we focus our efforts exclusively on rebuilding bombed-out bridges and providing first aid. We need to acknowledge the soul; that which makes us human. We need to acknowledge that access to mental healthcare and psychosocial support is vital, a human right, and from today we will coalesce and leverage our collective efforts to ensure that we reach new heights. We scale up, we invest, we make it happen. 

We need to break the silence that still oppresses so many. 
The silence that lies heavily on societies torn apart by conflict.
The silence of shame; of unacknowledged, unnoticed suffering.

So I am touched that so many of you are here today. It is my sincere hope and personal commitment that this conference will be the first step of many we will make, in order to achieve what we set out to do. a long road to improved access to mental healthcare and psychosocial support in crisis situations.

First steps are usually small, but they are significant. What we do here today and tomorrow means something. To some, it may mean everything. Let’s not forget that.

And as we can read in the Talmud. Every person matters. Whoever saves a life, saves the world. 

Let’s go make that happen.

Thank you.