Mental health in humanitarian settings

Author(s):  
Vanessa Cavallera ◽  
Lynne Jones ◽  
Inka Weissbecker ◽  
Peter Ventevogel

This chapter provides the basic knowledge about mental health and psychosocial support that all health workers in humanitarian emergencies should have and includes descriptions of the presenting symptoms and management of common clinical conditions encountered. In addition to detailed approaches to specific conditions, including recognition and management, this chapter also emphasizes an understanding of the humanitarian context in which these conditions occur, including social and cultural considerations, and the necessity of collaboration with non-health actors to address the psychosocial needs of patients.

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Wietse A. Tol ◽  
Alastair Ager ◽  
Cecile Bizouerne ◽  
Richard Bryant ◽  
Rabih El Chammay ◽  
...  

Abstract Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC’s research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).


2019 ◽  
Vol 4 (5) ◽  
pp. e001484 ◽  
Author(s):  
Mukdarut Bangpan ◽  
Lambert Felix ◽  
Kelly Dickson

BackgroundHumanitarian emergencies are a major global health challenge with the potential to have a profound impact on people’s mental and psychological health. Effective interventions in humanitarian settings are needed to support the mental health and psychosocial needs of affected populations. To fill this gap, this systematic review synthesises evidence on the effectiveness of a wide range of mental health and psychosocial support (MHPSS) programmes delivered to adults affected by humanitarian emergencies in low and middle-income countries (LMICs).MethodsA comprehensive search of 12 electronic databases, key websites and citation checking was undertaken in 2015 and updated in May 2018. We included controlled trials published in English from 1980. We extracted data and assessed risk of bias prior to performing a meta-analysis using random effects models. When meta-analysis was not used, we narratively described individual trial effect sizes using forest plots.ResultsThirty-five studies were included. Overall, MHPSS programmes show benefits in improved functioning and reducing post-traumatic stress disorder. There are also indications from a limited pool of evidence that cognitive–behavioural therapy and narrative exposure therapy may improve mental health conditions. Other psychotherapy modalities also showed a positive trend in favour of MHPSS programmes for improving several mental health outcomes.ConclusionIn addition to MHPSS programme for improving mental health outcomes in adults affected by humanitarian emergencies in LMICs, there is also a need to generate robust evidence to identify potential impact on broader social dimensions. Doing so could aid the future development of MHPSS programmes and ensure their effective implementation across different humanitarian contexts in LMICs. Future research on MHPSS programmes which focus on basic services and security, community and family programmes, their cost-effectiveness and mechanisms of impact could also strengthen the MHPSS evidence base to better inform policy and practice decision-making in humanitarian settings.Protocol registration numberCRD42016033578.


PLoS Medicine ◽  
2011 ◽  
Vol 8 (9) ◽  
pp. e1001096 ◽  
Author(s):  
Wietse A. Tol ◽  
Vikram Patel ◽  
Mark Tomlinson ◽  
Florence Baingana ◽  
Ananda Galappatti ◽  
...  

2003 ◽  
Vol 11 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Monica Gilbert ◽  
Kathryn Miller ◽  
Lesley Berk ◽  
Velma Ho ◽  
David Castle

Objectives: The psychosocial needs of people with psychotic disorders are not being addressed adequately. The present paper outlines a proposed framework that will help to meet some of this deficit and deliver psychosocial treatments for these individuals, as part of routine clinical practice. Conclusions: The recent Australian study on low prevalence (psychotic) disorders found that, although most Australians (91%) with a psychotic illness were taking medication, few were receiving adequate psychosocial support from mental health services; fully 47% of these saw the need for a particular type of service that was not able to be accessed by them, either because of it simply not being available or not being affordable. The programme described herein will develop, evaluate and disseminate comprehensive modular treatment packages addressing the psychosocial needs of people with psychotic disorders. It is novel in terms of the comprehensiveness of the approach, the rigour of the evaluation (using a controlled experimental design), and the extent of intersectoral and multidisciplinary involvement in mapping needs, developing the interventions, and dissemination. The potential impact for mental health consumers with psychosis is enormous because currently there is no coherent and consistent approach to addressing their psychosocial needs. The impact for the scientific community will be great because there is currently very little by way of controlled trial data in this important area of activity.


Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel

‘Global psychiatry’ discusses the global mental health movement. Across the globe, and especially in low- and middle-income settings, there is a high prevalence of untreated psychiatric illness. In lower resourced settings there is often the need to address the added influence of poverty. The chapter discusses the question of how to scale up services and models, including using lay mental health workers and also integration of mental health care into primary health care settings to better meet the needs of those suffering from psychiatric illnesses across the globe. Four areas are discussed in more detail—the HIV/AIDS pandemic, perinatal mental illness, child and adolescent mental health, and humanitarian emergencies.


Author(s):  
Inka Weissbecker ◽  
Peter Ventevogel ◽  
Fahmy Hanna ◽  
Soumitra Pathare

1974 ◽  
Vol 5 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Dwight Harshbarger

Disasters and community life are intimately related. This paper focuses upon the relatively neglected problems of “picking up the pieces” after a disaster has struck. The aftermath includes problems associated with the provision of temporary shelter and survival needs, through the short-range rehabilitation of the community, and on to meeting the psychosocial needs of the survivors which may persist for months or years. Mental health workers should re-evaluate the type of resources they have available to offer disaster victims and the most effective means of utilizing their energies and skills. This paper also serves as the introduction to a symposium on the topic of disaster intervention and human ecology.


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