Almost all people affected by emergencies will experience psychological distress, which for most people will improve over time. The burden of mental disorders among populations is extremely high: WHO’s review of 129 studies in 39 countries showed that among people who have experienced emergencies in the previous 10 years, one in five people (22%) will have depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia. In emergencies settings, depression and anxiety increase with age. Depression is more common in women than in men.
One of the priorities in emergencies is to protect and improve people’s mental health and psychosocial well-being. In the early phase of an emergency, social supports are essential to protect and support mental health and psychosocial well-being.
The Inter-Agency Standing Committee (IASC)* has developed 6 Core Principles of Mental Health and Psychosocial Support in Emergencies:
1. Human rights and equity.
Humanitarian actors should promote the human rights of all affected persons and protect individuals and groups who are at heightened risk of human rights violations. Humanitarian actors should also promote equity and non-discrimination.
2. Participation.
Humanitarian action should maximise the participation of local affected populations in the humanitarian response. In most emergency situations, significant numbers of people exhibit sufficient resilience to participate in relief and reconstruction efforts.
3. Do no harm
Work on mental health and psychosocial support has the potential to cause harm because it deals with highly sensitive issues. Humanitarian actors may reduce the risk of harm in various ways, such as:
– Participating in coordination groups to learn from others and to minimise duplication and gaps in response;
– Designing interventions on the basis of sufficient information Committing to evaluation, openness to scrutiny and external review;
– Developing cultural sensitivity and competence in the areas in which they intervene/work; and
– Developing an understanding of, and consistently reflecting on, universal human rights, power relations between outsiders and emergency-affected people, and the value of participatory approaches.
4. Building on available resources and capacities
All affected groups have assets or resources that support mental health and psychosocial well-being. A key principle, even in the early stages of an emergency, is building local capacities, supporting self-help and strengthening the resources already present. Externally driven and implemented programmes often lead to inappropriate mental health and psychosocial support and frequently have limited sustainability. Where possible, it is important to build both government and civil society capacities.
5. Integrated support systems
Activities and programming should be integrated as far as possible. The proliferation of stand-alone services only with people with a specific diagnosis, can create a highly fragmented care system.
6. Multi-layered supports
In emergencies, people are affected in different ways and require different kinds of supports. A key to organising mental health and psychosocial support is to develop a layered system of complementary supports that meets the needs of different groups.
Despite their tragic nature and adverse effects on mental health, emergencies have shown to be opportunities to build sustainable mental health systems for all people in need.
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*The Inter-Agency Standing Committee (IASC)* was established in 1992 in response to General Assembly Resolution 46/182, which called for strengthened coordination of humanitarian assistance. The resolution set up the IASC as the primary mechanism for facilitating inter-agency decision-making in response to complex emergencies and natural disasters.
Resources:
https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies
Checklist for field use IASC MHPSS