title: Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.
abstract: Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews were conducted with 258 former child soldiers who participated in a communist (Maoist) revolution. Eighty percent of child soldiers joined 'voluntarily'. Girls were 2.07 times as likely to join voluntarily (95% CI, 1.03-4.16,p=0.04). Among girls, 51% reported joining voluntarily because of personal connections to people who were members of the armed group, compared to 22% of boys. Other reasons included escaping difficult life situations (36%), inability to achieve other goals in life (28%), and an appealing philosophy of the armed group (32%). Poor economic conditions were more frequently endorsed among boys (22%) than girls (10%). Voluntary conscription was associated with decreased risk for PTSD among boys but not for girls. Interventions to prevent voluntary association with armed groups could benefit from attending to difficulties in daily life, identifying non-violent paths to achieve life goals, and challenging the political philosophy of armed groups. Among boys, addressing economic risk factors may prevent recruitment, and prevention efforts for girls will need to address personal connections to armed groups, as it has important implications for preventing recruitment through new methods, such as social media.
authors.affiliation: Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, USA.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Kohrt
authors.affiliation: Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Minyoung
authors.initials: M
authors.lastname: Yang
authors.affiliation: Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, USA.
authors.forename: Sauharda
authors.initials: S
authors.lastname: Rai
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, USA.
authors.forename: Anvita
authors.initials: A
authors.lastname: Bhardwaj
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
authors.forename: Wietse A
authors.initials: WA
authors.lastname: Tol
authors.affiliation: Centre for Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.
authors.forename: Mark J D
authors.initials: MJ
authors.lastname: Jordans
keywords: children and adolescents; mental health; recruitment; terrorism; war