A worryingly high proportion of aid workers have experienced mental health issues, exclusive findings from the Guardian can reveal.

79% of the 754 respondents to the mental health and wellbeing survey on the Global Development Professional Network stated that they had experienced mental health issues. The overwhelming majority, 93%, believe these to have been related to their work in the aid industry.

Over three quarters of those that took the survey were female and the majority of participants identified as international staff working at an international NGO.

The findings raise fresh concerns over the wellbeing of staff in the profession, and lends further weight to the arguments of a small but growing number of figures questioning the quality of support and protection provided by humanitarian organisations. “This is a huge, hidden and important issue,” said one anonymous contributor to the survey.

Over half of contributors said they had experienced or been diagnosed with anxiety, and 44% with depression. Panic attacks and post traumatic stress disorder (PTSD) were also cited among over a fifth. While there was little gender differentiation for these results, men were almost twice as likely to cite alcoholism than women.

While the conclusions of the survey must be weighted against the fact they are drawn from a relatively small sample size and participants who had experienced mental health issues may have been more likely to complete the survey, they suggest the problem may be more prevalent than previous studies have indicated. Research by the Antares Foundation found that 30% of field workers report symptoms of PTSD after field assignments. Around a quarter of the UK population will experience some kind of mental health problem within the course of a year, according to the Mental Health Foundation.

“These results are higher than those consistently reported by others,” said Jim Guy, from the Headington Institute, an organisation providing psychological support to aid workers. “Nonetheless, we know that the culture of an organisation – whether employees feel supported by supervisors and colleagues – can have a huge impact on whether stress becomes tolerable or toxic.”

The survey paints a stark picture of both suffering and resilience among aid workers. 63% of those that say they have experienced mental health problems believe them to have impacted on their ability to do their job, and 79% say they have led to them considering leaving the industry. Despite this, a large majority, 84%, say they have continued working with untreated mental health issues that they felt affected their work.

What’s behind the issue?

Stress and danger in the field

Exposure to security threats and witnessing human tragedy came up frequently in the section of the survey where contributors were given the opportunity to share more detail on their experiences.

60% of respondents cited specific incidents witnessed at work as having an impact on their mental health, and half said that they were permanently deployed to a country affected by disasters or conflict.

“Aid workers are likely to witness events that would classify as a traumatic events and therefore we know that a proportion of them will be vulnerable to a chronic traumatic reaction,” said Richard Stott, clinical psychologist and specialist in anxiety disorders and trauma. Last year was one of the most dangerous recorded for aid workers, with 155 killed, 171 seriously wounded and 134 kidnapped.

Lack of support

While there were individual reports of praise for the support received from employers, participants overall cited a lack of support (66%) at work as the principal factor impacting on their mental health, followed by specific incidents witnessed at work, heavy workloads and isolation.

“Humanitarians often face similar traumatic experiences to those working in the military, and yet there are established mental health support services to those in the military, whilst there are none to aid workers,” said Idit Albert, clinical psychologist at the Maudsley Centre in London. A recent study of armed forces in the UK found 4% reported probable PTSD, and 19.7% other common mental health problems.

One aid worker, commenting anonymously in the survey, stated that where support was available it wasn’t sufficient:

During a traumatic experience for my colleagues and I last year (several colleagues had been abducted and executed), I felt a massive lack of mental health support. What can be best defined as tokenistic support was made available to staff. But it was brief, late and hugely insufficient.

The findings suggest a distinction between what is available in theory and in practice. 68% of respondents said it was not clear who was responsible for their wellbeing and mental health while on the job, and the majority do not agree that their organisation is supportive of staff experiencing mental health problems.

Culture of silence

The survey also hinted at a culture of silence surrounding, and potentially perpetuating, mental health issues in the industry.

Anonymous contributors to the survey stated:

There is a culture where asking for conditions that benefit your own personal well-being (and mental health!) means you are not a “true” humanitarian.

There is such a culture of martyrdom amongst aid workers. This culture both allows for abuse and gives no room to complain or seek help. I ultimately had to leave the sector before I felt it too late. I am so glad I did. I have been away for almost four years and only now feeling I can re-enter in a healthier place.

These attitudes may account for why so many appear to have continued working despite untreated problems, and why the most popular change that people wanted to see on staff welfare in the industry was “a more open culture of talking about mental health”. The great majority of those that did seek support chose private therapy over that provided by their organisation.

What more needs to be done?

Improved counselling services, and a clearer sense of who is responsible for staff wellbeing were also highlighted as key changes organisations could make to better support staff with mental health problems.

“The question of mental health and well-being of humanitarian staff is so far under-addressed,” said Marine Menier, security manager at humanitarian training organisation RedR. National staff, that face similar or greater challenges than their international colleagues, are particularly overlooked, she added.

“We need more consistency and commitment across organisations,” said Emmanuelle Lacroix, people capacity and development manager at CHS Alliance. “It should not be left to luck for aid workers to have a manager who take staff care seriously or an agency that somehow has worked out a way to allocate and integrate relevant support provisions to both mitigate and manage the mental health risks associated with aid work.”

We will be continuing to explore the issue of mental health and well being in the aid sector this week on Global Development Professionals Network. You can follow the coverage here. Get in touch on globaldevpros@theguardian.com if you would like to comment on the topic.

• If you have been affected by the stories in this article, the Samaritans can be contacted on 116 123 in the UK. If you live outside the UK, a list of organisations providing support internationally can be found here.
  

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