Reinventing the Rules
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Interview with Lisa Laplante on Fusing Psychosocial Care into Justice Reform in Post-Conflict Peru
This month I had the pleasure of interviewing Lisa Laplante, an Associate Professor of Law and Director of the Center for International Law and Policy at New England law school. Lisa spent six years providing legal counsel to victims bringing complaints to the Inter-American Human Rights System and researching the Peruvian Truth and Reconciliation Commission. She has also directed a trial monitoring project for the trial of former Peruvian president Alberto Fujimori. In the interview, Lisa provides fascinating insight on how Peru incorporated the mental health needs of their conflict-affected population into their transitional justice process. She also explains why ‘rule of law reform is an empty concept’ if programs don’t consider the psychosocial needs of a population in post-conflict countries.
Can you talk a little about the conflict in Peru and your work on transitional justice and rule of law?
In the Peruvian context, the internal armed conflict began in the early 1980s. It was a conflict between the government and internal opposition groups, the most well known being Shining Path. The conflict continued until 2000 when then President Fujimori fled the country because of corruption scandals. Peru’s internal conflict is a little bit unique because it occurred during three different democratically elected governments. But during the 90s, Fujimori became a repressive leader and enacted all these draconian anti-terrorism laws. When Fujimori fled the country to Japan in 2000 because of a corruption scandal, the interim government set up a committee that studied ways they could apply a transitional justice model and one of the things they chose was to create a truth commission. They created it and it worked for about 2 years.
In Peru, the government got a quick start and enacted a reparations law after the truth commission ended its work, and set up a special council to administer the reparations and they have begun to implement some reparations, but there’s a lot of problems with the process.
A lot of the work I did was observing, studying, and evaluating this process through a grant provided by the US Institute of Peace. I was also working with a victims’ group that was trying to lobby the government for reparations. I was helping them with advocacy strategies and with bringing their case to the Inter-American Human Rights System. A lot of my work recognized one of the missing components, which was while you can do a lot of institutional reform to address the rule of law, you can build courthouses, and train judges and lawyers, but if the population isn’t prepared to use those mechanisms, then really the rule of law is an empty concept.
How did the mental health concerns of the war-affected population impact the rule of law and transitional justice work that you did? How did it impact their ability to get access to justice?
One of the things I observed is that you’re often beginning the recovery process with a very disempowered population. Often there are socioeconomic inequalities and if you put on top of that the kind of trauma that is experienced in conflict and political violence you’ve got major challenges to create a culture that empowers people to access their rights and justice. One of the things that’s important to keep in mind is that the psychosocial impact of war isn’t a traditional mental health model.
In peace, we tend to think of mental health as people that may have chemical imbalances or they’re born with mental health challenges, but in post-conflict contexts it’s really different. Citizens experience a normal mental response when loved ones are randomly killed or disappeared or bomb shells are going off. The approach to treating this kind of mental health issue is very different. That said, there will be cases of more traditional mental health needs but one of the arguments I make is that it actually requires working with communities in ways that may not look like traditional Freudian-lying-on-a-couch type of therapy.
Communitarian Mental Health Projects
One of the things that was really interesting in Peru was that they had communitarian mental health projects. The Minister of Health actually worked with their local mental health professionals to work with communities to do a needs assessment. In some of these communities, they build parks for their children or they create portable water systems, or they build a school. That doesn’t really fit into our idea of mental health recovery, but it was the Minister of Health doing it as a mental health recovery project. The process of involving the community in assessing what they felt needed to be done to improve their community and providing the funds was in itself a process of recuperating mental health because it’s a sense of empowerment, of control over your environment, and seeing a concrete result.
One of the aspects of mental health in these post-conflict situations is a profound lack of trust because it was essentially the government that did all of these horrible things to these people. Thus these government-led community projects help to reestablish a relationship of trust with the government which goes towards addressing some of the mental distress of these affected populations.
Why do you think little attention is paid to mental health concerns in post-conflict countries?
I first wrote about mental health in post conflict settings in 2004 and I am surprised that there still has not been much written on the topic. But overall, the topic of mental health in post conflict settings hasn’t gone mainstream so there’s still need for more research and writing. The material that has been generated is from a public health perspective, whereas I look at it from a human rights perspective.
We’re talking about a decade and this issue still hasn’t become an important global topic, such as at the level of the United Nations. Now that said, that doesn’t mean at the local level there’s not a lot of innovative work being done. In Latin America, there’s some amazing psychologists who have really been leaders in this, for example Elizabeth Jelin in Argentina. There’s a lot of rich material, but it’s in other languages. One source in English would be Brandon Hamber who is also doing excellent work in Northern Ireland. Local practitioners are doing their own unique work and some of it is memory work, some of it is narratives, some of it is oral history. It might not look like what we think as traditional mental health work.
Focus on Mental Health Depends on Local Expertise
In Peru what was really unique is that the Peruvian Truth Commission established an office on psychosocial care and they hired a very innovative progressive psychologist: Viviana Valdez. In a lot of ways, the focus on mental health depends on the local expertise to make sure the perspective is a part of a transitional justice experience. Viviana and her colleagues did a lot of work during the Truth Commission to make sure that mental health was considered, such as assuring psychologists were available to work with victims who gave public testimony. She also assured that the TRC’s final recommendations also took mental health into account. Then she and other like-minded psychologists continued to do work to lobby the government, especially the Minster of Health, to consider implementing a national law on this issue.
How should the law and justice sector incorporate mental health needs for war-affected populations in programs that work with the informal/customary justice sector?
One of the things I looked at was the way that local victims groups were lobbying the government for mental health responses. The paradox is you need mental health to lobby for mental health. One of the things that struck me the most was the actual process of empowering the victims, or “los affectados” as they are called in Peru. The process involves building the capacity and skills to engage with the government. I argue that this process is itself a form of recuperating mental health because it’s in essence addressing the disempowerment they experienced when the government violated their rights.
Imagine there’s Individual A who was dragged out of his house, put in prison, tortured for 10 years, and wasn’t given access to a fair trial. This treatment was done by the government and then he’s released and he’s supposed to engage with the government to get reparations. That’s a high demand to ask of these people. But if supported, it can also be a very powerful experience for them to sit across from a government official and actually get respect, to get their needs met, to get a response. They begin to own their rights.
However in these local situations, there’s a lot of things that are in the way of this process from happening. One is funding. Two is capacity. A lot of these people may never have engaged with the government, may not have a formal education, may not know how to advocate and write proposals. Also, sometimes the human rights organizations may be led by non-victims so there’s some issues that come up in the relationship between the bigger well-funded organizations and the victims group that can sometimes replicate power dynamics. That’s something to be conscious of.
You’ve also written that in places that had mental health facilities available, people’s distrust dissuaded them from using it. Why is that and what lessons should rule of law practitioners keep in mind as they implement programs for other war-affected populations?
I did a study with funding from the Ford Foundation and presented the findings to the Minister of Health on attitudes of local populations towards public mental health workers and facilities. These were primarily rural populations, and often indigenous, or less educated, or farmers. The preexisting relationship with mental health practitioners even before the internal armed conflict revealed a lot of issues so you can’t just suddenly set up mental health programming post-conflict and expect it to work. Those issues continue through the recovery period. A lot of it had to do with two things.
- A power inequality: A lot of times these populations didn’t feel that they had the right to demand a certain level of health or to request a doctor or take control over their health. The idea of health was never framed as a right. In some of these communities, they felt lucky if a doctor showed up at all because it was a two-day walk to reach them. Or they had experiences that were negative and they didn’t feel they had the right to complain.
- Stigma: The idea of mental health itself and the stigma of saying you need something for your mental health. Saying something about your mental health was basically like saying that you were crazy, and there was a stigma attached to it. Part of the challenge was to find a way to work with communities to shift that paradigm to help educate them that the results of conflict are normal and that’s to be expected.
When I did talk to individuals in local communities, they all talked about how they couldn’t sleep or the memories that wouldn’t go away– they have different ways of talking about it, but it’s clear that mental health is a big issue that gets in the way of leading a normal life. If you hear the stories that these people went through – you know that they have to have suffered some kind of trauma. The need is there, but they often don’t seek therapy of any sort.
What did local victims groups do in Peru to address mental health concerns?
I work with the Asociación Reflexión de Inocentes Liberados. They’re a group of people who were unjustly imprisoned for terrorism in Peru. They found this space in downtown Lima and with very modest funding they created a community center. Affiliated members from all over the country would travel to participate in their meetings and workshops. For example, ARIL would collaborate with the Minister of Health to educate victims about mental health benefits through the government’s reparations programs. They also provided guidance to youth who were seeking scholarships through the same reparation program. They had a radio show that kept the whole country informed. For example, we learned that small villages in the jungles or in the mountains used this radio program as the only source of information about reparations. ARIL also printed newsletters and did mental health empowerment sessions with children.
They were one of the strongest groups in the country for a while and managed to push the government to finally pass title of land that was supposed to be reparations but they had to invest a lot of their own money to make it livable. Imagine, this very arid plot still has a military factory and an explosive factory on it. It was the worst land you can imagine and this was their reparation. But they made it their community and now when you visit them you will find they built a park, community center and even a memory lane that symbolizes their struggle. They are very inspiring people. Despite all they went through they only want peace for their country and that no other person has to suffer all the horrible things they went through.
Reinventing the Rules 