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conflict. Finally, there could be forward-looking impacts, in that conflict exposure can change
people’s mindset regarding trust in the government, willingnessto cooperate with others, or
expectations about a better future. Such changes in mindset can result in worse mental health selfreports.
The empirical evidence onmental health in the aftermath of natural disasters and
economic crises suggests that the backward-looking view is the most likely mechanism. De Mel,
Woodruffand Mackenzie (2008) find that mental health recovery after the 2004 tsunami depends
mostly on the time elapsed since the disaster, and not on the recovery of anindividual’s
livelihood. Friedman and Thomas (2008) also find that in the aftermath of the 1997-98 East Asian
crisis, mental health did not recover, even whenincome recovered to its pre-crisis level. These
results are consistent with a backward looking view of emotional distress; the loss of a household
member due toexcess mortality due to the crisis may also be at the root of the observed
persistence of emotional distress.
The mechanisms that underlie the impact of exposure toconflict on mental health status
deserve further investigation, as they determine appropriate policies for post-war reconstruction.
However, evaluating impact ofexisting aid policies on recovery faces empirical challenges.
Reconstruction and reconciliation efforts are more likely to be targeted to areas or populationsthat have suffered more from war. This “endogeneity” of aid programs makes it difficult to
disentangle the effect of aid itself from other factors – e.g. conflict v
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