Civil society and regional governments, looking back at the end of the civil wars that devastated Central America in the 1980s, have noted a collective failure to discuss and treat trauma at the time. Some see direct links to the violence that overwhelms their communities today. Although homicide rates have started to fall in recent years, in part thanks to improved policing and controversial negotiations with gangs, progress on delivering mental health services has lagged. 

Today, local and international organizations are increasingly trying to incorporate mental health care into their work. Teachers, police officers, lawyers, and medical professionals – all considered “first responders” who often come into contact with victims of violence – are starting to ask tough questions. What impact have years of violence left on society? What would it take for people to actually feel safe in Central America? How can I be part of this solution?

“We’re not [used to] addressing trauma and mental health as a root cause of violence and understanding it as a key strategy to preventing the perpetuation of violence,” says Celina de Sola, from the organization Salvadoran Glasswing, which runs mental health first-aid trainings.

Investing in mental health is an “opportunity to … really prevent these patterns of violence.”

Lizeth, an emergency room nurse at a major public hospital here, doesn’t flinch when she attends victims of violence. But her medical training did not include how to confront patient tears or silence or fear.

“Don’t worry, it will all be over soon,” she says she used to tell patients dismissively, thinking it helped them get through a tough moment. But after undergoing a mental health training for professionals steeped in violence and trauma, organized by a nongovernmental organization here, she’s changed her approach. Now she offers breathing exercises, tries to create a safe environment, and builds trust through listening.

Lizeth, who asked to use only her first name for security reasons, is joining a growing number of professionals reshaping mental health in a country still reeling from civil-war era trauma and dealing with more than a decade of widespread gang warfare.

Homicides have decreased across Central America in recent years, in part thanks to improved policing and justice systems and controversial negotiations with gangs. But progress in mental health services has lagged – and without it, many say, these security gains could be short lived, given the link between trauma and violence.

Local and international organizations are increasingly incorporating mental health care and trauma response into their work. Teachers, police officers, lawyers, and medical professionals like Lizeth are asking tough questions about trauma in their day-to-day work. What impact have years of violence left on society? What would it take for people to actually feel safe in Central America? How can I be part of this solution?