War often forces people to move to other cities, countries, and continents in search of safety, food, and money. This displacement disturbs the routine life of people, separating them from their homes and families, sources of income, and cultures for decades after the war. Often there are challenges such as lack of food, medical care, safe housing, and stable income. As people navigate these hardships, they often require long-term support to rebuild their lives.
The present study set in the Sri Lankan civil war setting, explores how daily stressors are examined in a post-conflict setting. They authors, led by Fiona C. Thomas, interview people affected by war to understand the long-term challenges they face. Stressors were categorized as systemic or chronic. Systemic stressors affect entire populations through policies and societal structures, while chronic stressors affect individuals daily over many years. By examining these factors, the study highlights the daily challenges faced by war-affected populations and highlights the importance of targeted support for their recovery and overall well-being. Trauma is assumed to be a singular past event but for refugees, trauma does not end with war. The present research explains it long-lasting effects.
The Sri Lankan civil war (1983–2009) was a long conflict displacing around 800,000 people, mainly from the Northern and Eastern Provinces, disrupting their lives, education, and healthcare. The conflict led to death, disappearances, and the destruction of livelihoods, forcing many into unstable daily wage labour, increasing poverty and economic insecurity. Many displaced people ended up in government welfare centres, weakening community and family ties. The resulting economic and social insecurity and vulnerability continues to present day.
Even though this study focuses on one place, it helps us learn more about post-conflict societies in the Eastern part of the world—something that has not been studied much. Most research happens in Western countries or only looks at what happens right after war or disasters. But a lot is missed when the long-term impact is ignored, and people’s mental health are treated without thinking about their long term struggles.
Recent research on Global Mental Health has helped throw light on the social factors of mental health such as long-term psychological consequences of war. Several studies have summarized the growing research on mental health in people affected by conflict and forced migration. Such research aligns with psychological models, like the social ecological framework developed by Miller and Rasco to understand the various stressors affecting the mental health of displaced people, especially refugees. The model explains that human development is shaped by multiple factors—individual, family, community, and society—over time.
Their approach goes beyond the immediate trauma of war and violence, emphasizing that the hardships of daily life after displacement—such as poverty, lack of resources, and social instability—also contribute to distress.
Their work laid the foundation for the daily stressors framework, introduced in global mental health research in 2010. This framework has been widely used in studies on conflict-affected populations to explore how war-related losses, ongoing post-conflict challenges, and everyday hardships increase the risk of mental health issues.
Most studies using this framework have studied children and adolescents and limited their data to soon after the war ended. So, research on adults and long-term effects of conflicts is limited. This study aims to address this gap by examining how war-related losses and chronic post-conflict stressors interact in the lives of adults in Northern Sri Lanka. The researchers use the term chronic stressors to highlight how these hardships are both long-lasting and deeply distressing in the post-war environment.
The study was conducted in Jaffna and Vavuniya, two districts in Northern Sri Lanka that were heavily impacted by the civil war. 53 participants were interviewed in Tamil from primary healthcare clinics (PHCs) in these two districts between January and April 2018 including Divisional Hospitals (DHs) and Primary Medical Care Units (PMCUs).
Participants identified four key chronic stressors: material loss, safety concerns, family changes, and war-related health issues. These occurred within broader systemic stressors, including unresolved grief, weak institutional support, and shifting social values.
Systemic Stressors:
- Unresolved grief-
Family bonds are deeply valued in South Asian societies. The loss, disappearance, or capture of loved ones during the conflict leaves a lasting emotional impact. In these communities, for example, performing last rites is given great importance, and the inability to do so causes deep guilt. With no way to make up for these losses, grief stays for life in the absence of lost loved ones.
A 49 years old participant said,
“I lost my relatives. My younger brother, younger sister…my brother-in law died saving others. My uncles, cousins. Who’s going to bring them all back?…Now I’m all alone. What can I do if this is life?”
- Limited institutional support-
Participants recalled receiving basic supplies like food, shelter, and medical care in refugee camps during the conflict. After the conflict, aid varied—some received financial support to rebuild homes, while others received none. Without structured assistance, many were left to navigate trauma, displacement, and economic instability alone. These ongoing struggles heightened stress, increasing the risk of psychological distress. It is doubtful that medical treatment alone would truly benefit them without a fundamental change in their social or economic circumstances.
- Shifting social values and networks-
When food, shelter, and security become urgent needs, social and cultural values may take a backseat to survival. Limited resources force people to prioritize their own well-being over helping others, potentially shifting traditional value systems. Scarcity can also create tension within communities and between groups, especially between those who received aid and those who did not. This weakens longstanding traditions of cooperation and mutual support. A respondent said,
“Before, this was a generous place. People used to be invited for a meal if they visited a house. Even though there were problems, there was no scarcity for food. But now, it’s difficult for us. Today, poverty is everywhere…”
Chronic Stressors
- Material Loss-
In addition to loss of loved ones, participants reported loss of land, homes, vehicles, farm animals etc.
“Everything was lost…farm animals, vehicles, [even our] education. I only went with the clothes I was wearing. When we were in the boat, my baby was 45 days old. I just took her, without anything else. I was injured, my son was injured. My husband carried my son, I carried the baby. My chest was wounded. Only when we got to the boat, did they give us some towels and clothes [crying]. We didn’t take a single thing from here”
- Personal safety concerns-
Safety was a major concern for participants, especially among women and children. Many feared violence, harassment, and general insecurity, both during and after the conflict. The absence of proper protection, law enforcement, and safe living conditions made them more vulnerable. For women, concerns included the risk of assault, lack of safe spaces, and social restrictions that limited their freedom. Children, too, faced threats such as exploitation and unsafe environments. These fears affected their daily lives, mental well-being, and ability to move freely within their communities.
- Changes to family systems-
Participants shared that family relationships had changed over time. Many had to leave their homes to find jobs, leading to long-term separation from loved ones. Families that once lived together were now spread across different places, making it hard to stay connected. Those left behind, especially the elderly, struggled without support. Over time, this separation made it harder for families to stay connected and support each other.
A 76 years old female reported,
“I financially supported my grandson to go abroad and I still have that loan pending. I used my gold [to send him abroad] but he came back…He barely talks to me now. One other grandson is in prison. It’s very difficult to even think [about the situation]…someone introduced him to selling marijuana. The younger generation doesn’t know how to earn a living. . .there are so few options.”
- Physical Health concerns-
Participants faced serious health challenges due to the lasting effects of conflict. There is limited access to healthcare, those in remote areas travel long distances for even basic medical care. Malnutrition becomes another major concern, with food shortages and poverty leaving many without proper nutrition, particularly among children and pregnant women.
Poor living conditions like overcrowded shelters and limited clean water, make it easier for infections to spread. As a result, diseases became more common. On top of that, the mental health effects of war and being displaced were also very serious. These ongoing health struggles made daily life even more difficult for war-affected communities, adding to their already heavy burden.
In Mainstream Psychology, research on post-conflict areas are limited to PTSD and trauma is seen as an individual problem. The reality is much different. Because almost every professional is fixated on the stress reactions themselves, a symptom-focussed but not a holistic or effective solution is available.
Another problem of the discipline addressed in this article is making the PTSD model as universal. It was a product of research on the Vietnam War. The situation, causes, and effects of each war are different from the others, so making one model as ‘the model for conflicts’ is not a great idea. Psychology research ignores the larger social, economic, geographical factors while studying individuals affected by war and post-conflict societies. Even within a society, the experiences of each individual is unique so psychological help also needs to be able to cater to individual-specific and society-specific needs. It is important that we widen our understanding of trauma, as what is traumatic or not traumatic shifts according to identity and context.
For long enough, Psychology has made the error of applying research from West to the rest of the world. Thus, behavior is studied purely from a Western lens. This approach presents human behaviour as same across the world, which loses its uniqueness and relevance in local contexts. This results in psychological theories that fail to apply to culturally different societies. When one looks at psychological research and theories in such settings, Dr. Sunil Bhatia’s interview with Mad in America explains the problem,
“…who is telling the story of psychology, who has the power to construct and disseminate knowledge about psychology, whose voices are being included in that story?”
This research highlights the lasting impact of war-related stress on communities in Northern Sri Lanka and emphasizes the need for mental health support that goes beyond individual care. Social, cultural, and economic factors all play a role in healing. Local traditions—such as grief rituals—along with financial assistance, can be meaningfully combined with counseling to support overall well-being. To create effective solutions, experts from fields like healthcare and social work must work together. Most importantly, listening to the voices of the community is key to developing support that is both meaningful and sustainable.
Ayushi Jolly
Ayushi Jolly is a PhD Candidate in Social Psychology at Jawaharlal Nehru University, India. Her research aims to foster a more holistic understanding of the human psyche that acknowledges the intricate interconnections between individual lives and the broader societal tapestry. She is dedicated to restoring the 'social' in social psychology.
Outside the academic sphere, she relishes the joy of travel and trekking and finds