The recent International Committee of the Red Cross report, Civilians without Protection, makes it clear that the conflict in Iraq is inflicting immense suffering on the civilian population.[1] Mental health as an aspect of suffering in war has been receiving increasing attention, with particular concerns centring on children because of their vulnerability and the growing awareness of the potential long-term harm to society through disruption of human attachments, and the development of aggressive patterns of behaviour, which have the potential to aid recruitment to terrorist networks. [2,3] There is debate about models of treatment, resources for reconstruction and protection of the innocent.

Iraqi children and adolescents form more than 55% of the Iraqi population (29 million people). Over the last two decades they have experienced high levels of psychological trauma, such as loss of parents due to imprisonment or death, dislocation of families, exposure to violence and conflict, and the witnessing of scenes of carnage; many have suffered religious and political persecution, detention and torture.

Since 2003, rates of direct physical harm and abuse have been high. There is no hard data on child deaths, though Burnham et al. record 26 of the 300 violent deaths in their survey as being children under the age of 14;[4] it is therefore likely that many tens of thousands of children have been killed and injured in this conflict. There is concern about an increase in physical violence against children within families. There are also a significant and growing number of orphans for whom no organized services are available.

Many reports indicate that insurgent groups and militias are involving minors, including orphans and children of insurgents, in the fight against the Multi-National Force (MNF) and Iraqi Security Forces (IFS).[5]

Children have been arrested and detained by the MNF and by the IFS. There are reports that children are held in the same cells as adult detainees and subjected to the same treatment, including torture. Human Rights Watch recorded the case of a juvenile who was beaten with cables and underwent falaqa (beating on the sole of the foot) while being held in the custody of the criminal intelligence service.[6]

An estimated four million Iraqis