The Peruvian Truth Commission's Mental Health Reparations: Empowering Survivors of Political Violence to Impact Public Health Policy

Abstract

The Peruvian Truth and Reconciliation Commission (TRC), formed in 2001, turned national attention toward the serious mental health consequences of the country's 20-year internal armed conflict. The TRC prioritized reparations in mental health, using a legal justification that provided victims-survivors of the war with a rights-based framework for demanding that the public sector attend to their mental health needs. Since the majority of victims-survivors come from historically poor, rural, and marginalized populations and have tended to not exercise their right to health for a variety of social, economic, and cultural reasons, framing mental health in terms of rights helps to empower these people to impact the development of appropriate policies in mental health. The authors suggest that this process contributes directly to improving the mental health of this population.

Women as political participants: Psychosocial postconflict recovery in Peru.

“…In this way, PIR goes beyond simply offering economic compensation, and instead considers the entire reparation package as promoting psychosocial healing and as a means for national reconciliation. In the process, it adds to an evolving school of thought on best practices for attending to postconflict mental health that entails something more than individualized therapy (Laplante & Rivera, 2006). Indeed, its recommendations include a more comprehensive approach to psychosocial healing that moves beyond traditional medical models and includes empowerment.…”

Political violence, collective functioning and health: A review of the literature

“…Equally important is the ability of individuals to aid in the rebuilding of social and political arenas of their societies after political violence through active participation, which necessitates trust and the ability to work collectively (Hernández, 2002). Understanding, then, how political violence affects both individuals and the social and political systems on which their health and well-being depend will help us to identify potential targets for multilevel policy and practice interventions (for examples of this, see Robben, 2005, Laplante and Holguin, 2006, Hoffman and Kruczek, 2011). …”

“…Resilience- the successful recovery from or adaptation to hardship (Agaibi, 2005; Masten, et al ., 1990) – is not an anomaly, but rather, is a predictable reaction to stress for both individuals and collectives (Bonanno, 2004; Norris, Stevens, Pfefferbaum, Wyche, & Pfefferbaum, 2008). While some individual traits may build resilience in the face of political violence (for reviews of these, see Betancourt and Khan, 2008; Masten, et al ., 2012; Sousa, et al ., 2013), resilience ultimately depends on the relationship between people and their social and political environments (Masten, et al ., 2008; Shinn and Toohey, 2003; Ungar, 2011b). Individuals’ involvement in collectives, cohesive community networks, and democratic, responsive governmental systems are each central to health and well-being (Garbarino, 2011; Hobfoll et al ., 2007; Katz, 2001; Nowell and Boyd, 2010; Pfeiffer et al ., 2008; Ungar, 2011a; World Health Organization, 2008).…”

The association between post-traumatic stress-related symptoms, resilience, current stress and past exposure to violence: a cross sectional study of the survival of Quechua women in the aftermath of the Peruvian armed conflict

“…An important contribution of the CVR was indeed the identification of high levels of historical discrimination against the Indigenous population as the major underlying cause of the violence [18]. As Laplante and Rivero [26] stated, “before becoming victims of war, they had been victims of historical, social, and economic conditions that deprived them of basic social services such as health.” However, the distress and suffering produced by violence cannot be effectively addressed without further understanding of the simultaneous resilience process [27]. This study expands this understanding by examining the resilience as well as the post-traumatic responses of Quechua women in post-conflict Ayacucho.…”