Yet the United Nations refugee agency is better than most, according to Kaz de Jong, head of staff care for the Netherlands division of Doctors Without Borders. His is one of the rare aid organizations known for doing a good job on this front. “At least they’re doing something,” he says, referring to the 2013 report. “Many do nothing at all.”

He’s right. A 2009 survey of 20 aid organizations found that many staff-care programs fail to adhere to basic standards. Little has improved since. What progress has been made often remains at the headquarter level, far from the shelling and violent stories that aid workers regularly face on the front lines.

At the same time, the work itself has become increasingly dangerous, with aid workers more stretched than ever. For the first time since World War II, more than 50 million people are displaced worldwide. Attacks on aid workers more than tripled in the last decade.

Of course, the traumas of aid workers pale in comparison to those they serve. But many do face near-death experiences — 45 percent of those surveyed in the 2013 report had believed their lives were in danger or that they would be seriously injured at least once during their careers. They hear firsthand accounts of rape and murder on a near daily basis. They are usually an ocean away from their families. All while they are expected to fulfill the impossible task of helping to feed, house and protect the world’s growing number of displaced in a world of shrinking humanitarian resources.

De Jong, a psychologist who has been in the humanitarian business for decades, thinks the aid world is failing its staff for two reasons: first, lack of funding. But he admits that many interventions — providing online support and identifying staff willing to speak frankly about their struggles, for example — cost little. More fundamentally, De Jong says, the issue is old-school attitudes about mental health. He says that most humanitarian managers tend to equate psychological support with weakness.

One United Nations employee who was violently assaulted a few years ago while working in a war zone and who continues to suffer from post-traumatic stress as a result, thinks it’s also because so few people know there’s a problem.

“The U.N. and other humanitarian organizations are the ones developing policies on gender sensitivity, human rights, labor law and so on,” she told me. “So people just assume that these organizations are applying the same standards to their staff. But it doesn’t work that way.”