<b>Assessment of stress levels, environmental conditions and associated factors in Pakistan's conflict-affected region: A cross-sectional study in Leepa valley, Azad Jammu and Ka</b><b>shmir.</b>

Background: The border area of Leepa Valley bears witness to the persistent echoes of gunfire. The delivery of mental health services in such areas presents enormous challenges, including limited access to trained mental health professionals, stigma surrounding mental illness, and inadequate healthcare infrastructure. This study highlights the mental health status and resilience of residents of Leepa Valley. Objectives: To assess mental health status along with the socio-economic and environmental conditions in the Conflict-Affected Region of Leepa Valley, Azad Jammu and Kashmir, Pakistan. Methodology: A cross-sectional study was executed by circulating a self-structured questionnaire among the patients at a Medical Camp in Leepa. Sample size was calculated by Raosoft. A total of 152 participants were included in the study. Results: An overwhelming majority of 84.1% reported high perceived stress based on the Perceived Stress Scale. 78.3% of individuals reported that their daily life activities were affected by border-related activities. Moreover, 76.3% reported decreased employment opportunities in Leepa Valley due to the ongoing border conflicts. Conclusion: The findings of this study underscore the profound psychological toll of prolonged conflict on individuals and communities, shedding light on the urgent need for targeted interventions to address the complex interplay of mental health challenges and socio-environmental stressors.