Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-19T13:07:40.368Z Has data issue: false hasContentIssue false
  • English
  • Français

Transitioning Mental Health & Psychosocial Support: From Short-Term Emergency to Sustainable Post-Disaster Development. Humanitarian Action Summit 2011

Published online by Cambridge University Press:  19 March 2012

P.P. Patel ,
J. Russell ,
K. Allden ,
T.S. Betancourt ,
P. Bolton ,
A. Galappatti ,
Z. Hijazi ,
K. Johnson ,
L. Jones  and
L. Kadis
...Show all authors
P.P. Patel
Affiliation:
Health & Disability Advocates, Chicago, Illinois USA
J. Russell
Affiliation:
Department of Psychiatry, McGill University, Montreal, Quebec, Canada
K. Allden*
Affiliation:
Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire USA
T.S. Betancourt
Affiliation:
Harvard School of Public Health, FXB Center for Health and Human Rights, Boston, Massachusetts USA
P. Bolton
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
A. Galappatti
Affiliation:
The Good Practice Group, Colombo, Sri Lanka; Social Policy and Research Centre, University of Colombo, Sri Lanka
Z. Hijazi
Affiliation:
International Medical Corps, Middle East Programs, Beirut, Lebanon
K. Johnson
Affiliation:
Faculty of Medicine, McGill University, Montreal, Quebec, Canada
L. Jones
Affiliation:
Radcliffe Institute for Advanced Study, Harvard University, Boston, Massachusetts USADevelopmental Psychiatry Section, Cambridge University, UK
L. Kadis
Affiliation:
Carmel Institute for Family Business, Carmel, California USA
K. Leary
Affiliation:
Cambridge Health Alliance, Cambridge, Massachusetts USA
I. Weissbecker
Affiliation:
International Medical Corps, Washington DC USA
J. Nakku
Affiliation:
Department of Psychiatry, Makerere University College of Health Sciences; Butabika Referral & Teaching Hospital, Kampala, Uganda
*
Corresponding Author: Kathleen Allden, MD Health Care and Rehabilitation Services 49 School Street Hartford, VT 05049 USA E-mail: kathleen.allden@dartmouth.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples.

Objectives: The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development.

Methods: The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States).

Results: The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance.

Conclusions: The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

Keywords

mental healthpsychosocialrefugeeIDPhumanitarianconflictcross-culturalemergencydevelopmentsustainable
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 26 , Issue 6 , December 2011 , pp. 470 - 481
Copyright
Copyright Patel © World Association for Disaster and Emergency Medicine 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Allden, K, Jones, L, Weissbecker, I, et al. . Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group. Prehosp Disaster Med. Jul-Aug 2009;24 Suppl 2:s217–227.Google Scholar
2.Inter-Agency Standing Committee. IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva 2007.Google Scholar
3.Jones, L, Asare, JB, El Masri, M, Mohanraj, A, Sherief, H, van Ommeren, M. Severe mental disorders in complex emergencies. Lancet. Aug 22 2009;374(9690):654–661.CrossRefGoogle ScholarPubMed
4.OCHA Orientation Handbook on Complex Emergencies: UN Office for the Coordination of Humanitarian Affairs; 1999.Google Scholar
5.Ceric, I, Loga, S, Sinanovic, O, et al. . [Reconstruction of mental health services in Bosnia and Herzegovina]. Med Arh. 2001;55(1 Suppl 1):5–23.Google ScholarPubMed
6.Budosan, B, Jones, L, Wickramasinghe, WAL, et al. . After the wave: a pilot project to develop mental health services in Ampara district, Sri Lanka post-tsunami. Journal of Humanitarian Assistance. 2007. http://sites.tufts.edu/jha/archives/53.Google Scholar
7.Jones, LM, Ghani, HA, Mohanraj, A, et al. . Crisis into opportunity: setting up community mental health services in post-tsunami Aceh. Asia Pac J Public Health. 2007;19 Spec No:60–68.CrossRefGoogle ScholarPubMed
8.Asare, J, Jones, L. Tackling mental health in Sierra Leone. BMJ. Oct 1 2005; 331(7519):720.Google Scholar
9.Jones, L, Rrustemi, A, Shahini, M, Uka, A. Mental health services for war-affected children: report of a survey in Kosovo. Br J Psychiatry. Dec 2003;183:540–546.Google ScholarPubMed
10.Moss, WJ, Ramakrishnan, M, Storms, D, et al. . Child health in complex emergencies. Bulletin of the World Health Organization. 2006;84:58–64.CrossRefGoogle ScholarPubMed
11.De Jong, K, Kleber, RJ. Emergency conflict-related psychosocial interventions in Sierra Leone and Uganda: lessons from Medecins Sans Frontieres. J Health Psychol. May 2007;12(3):485–497.Google Scholar
12.Baingana, F, Ventevogel, P. Mental health and psychosocial interventions and their role in poverty alleviation. Proceedings of a conference. Intervention. 2008;6(2):167–173110.1097/WTF.1090b1013e328307c328911.Google Scholar
13.Sekimpi, DK. Report on study of community health workers in Uganda (with focus on Village Health Teams strategy - VHT). 2007. http://www.unacoh.org/admin/publications/SUBMISSION%20REPORT%20ON%20VHT%20SURVEY%20-%20UGANDA%202007.pdf.Google Scholar
14.Baingana, F, Bannon, I, Thomas, R. Mental health and conflict: Conceptual framework and approaches Washington, DC: World Bank; 2005. http://www.jhsph.edu/bin/q/b/Baingana_MH_and_Conflicts.pdf.Google Scholar
15.Medeiros, E. Integrating mental health into post-conflict rehabilitation: the case of Sierra Leonean and Liberian ‘child soldiers’. J Health Psychol. May 2007;12(3):498–504.CrossRefGoogle ScholarPubMed
16.Hasanovic, M, Sinanovic, O, Pajevic, I, Avdibegovic, E, Sutovic, A. Post-war mental health promotion in Bosnia-Herzegovina. Psychiatr Danub. Jun 2006; 18(1–2):74–78.Google Scholar
17.Silove, D. The challenges facing mental health programs for post-conflict and refugee communities. Prehosp Disaster Med. Jan-Mar 2004;19(1):90–96.CrossRefGoogle ScholarPubMed
18.Wessells, M. Supporting the mental health and psychosocial well-being of former child soldiers. J Am Acad Child Adolesc Psychiatry. Jun 2009;48(6):587–590.Google Scholar
19.Fullerton, CS, Reissman, DB, Gray, C, Flynn, BW, Ursano, RJ. Earthquake response and psychosocial health outcomes: applying lessons from integrating systems of care and recovery to Haiti. Disaster Med Public Health Prep. Mar 2010;4(1):15–17.Google Scholar
20.Stark, L. Cleansing the wounds of war: an examination of traditional healing, psychosocial health and reintegration in Sierra Leone. Intervention. 2006;4(3): 206–218210.1097/WTF.1090b1013e328011a328017d328012.CrossRefGoogle Scholar
21.Mohanraj, A. The “Quiet House” in Lok Nga. 2006; http://www.imcworldwide.org/page.aspx?pid=1473. Accessed July 15, 2011.Google Scholar
22.Gupta, L, Zimmer, C. Psychosocial intervention for war-affected children in Sierra Leone. Br J Psychiatry. Mar 2008;192(3):212–216.Google Scholar
23.Kline, PM, Mone, E. Coping with War: Three Strategies Employed by Adolescent Citizens of Sierra Leone. Child and Adolescent Social Work Journal. 2003;20(5):321–333.Google Scholar
24.Betancourt, TS, Borisova de la Soudiere, M II, Williamson, J. Sierra Leone's Child Soldiers: War Exposures and Mental Health Problems by Gender. J Adolesc Health. Jul 2011;49(1):21–28.Google Scholar
25.Lekskes, J, van Hooren, S, de Beus, J. Appraisal of psychosocial interventions in Liberia. Intervention. 2007;5(1):18–2610.1097/WTF.1090b1013e3280be1095b1047.Google Scholar
26.Kigozi, F, Ssebunnya, J, Kizza, D, Cooper, S, Ndyanabangi, S. An overview of Uganda's mental health care system: results from an assessment using the world health organization's assessment instrument for mental health systems (WHO-AIMS). Int J Ment Health Syst. 2010;4(1):1.Google Scholar
27.Baker, B, Liebling-Kalifani, H. Justice and health provision for survivors of sexual violence in Kitgum, northern Uganda. 2010. http://wwwm.coventry.ac.uk/researchnet/AfricanStudies/Documents/Justice%20and%20heath%20provision%20for%20survivors%20of%20sexual%20violence%20in%20uganda%20-%20Execu%20Summary.pdf.Google Scholar
28.Dybdahl, R. Children and mothers in war: an outcome study of a psychosocial intervention program. Child Dev. Jul-Aug 2001;72(4):1214–1230.Google Scholar
29.Patel, V, Araya, R, Chatterjee, S, et al. . Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. Sep 15 2007;370(9591): 991–1005.Google Scholar
30.Sumathipala, A, Siribaddana, S. Research and clinical ethics after the tsunami: Sri Lanka. Lancet. Oct 22-28 2005;366(9495):1418–1420.Google Scholar
31.Bolton, P. Cross-cultural validity and reliability testing of a standard psychiatric assessment instrument without a gold standard. J Nerv Ment Dis. Apr 2001;189(4): 238–242.CrossRefGoogle ScholarPubMed
32.Guha-Sapir, D, van Panhuis, W, Lagoutte, J. Aid after disasters: evidence for psychosocial services needs strengthening. BMJ. Jul 2 2005;331(7507):50.CrossRefGoogle ScholarPubMed
33.Layne, CM, Saltzman, WR, Poppleton, L, et al. . Effectiveness of a school-based group psychotherapy program for war-exposed adolescents: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. Sep 2008;47(9):1048–1062.Google Scholar
34.Jordans, MJ, Komproe, IH, Tol, WA, et al. . Evaluation of a classroom-based psychosocial intervention in conflict-affected Nepal: a cluster randomized controlled trial. J Child Psychol Psychiatry. Jul 2010;51(7):818–826.Google Scholar
35.Tol, WA, Komproe, IH, Jordans, MJ, Thapa, SB, Sharma, B, De Jong, JT. Brief multi-disciplinary treatment for torture survivors in Nepal: a naturalistic comparative study. Int J Soc Psychiatry. Jan 2009;55(1):39–56.CrossRefGoogle Scholar
36.Rolfsnes, ES, Idsoe, T. School-based intervention programs for PTSD symptoms: a review and meta-analysis. J Trauma Stress. Apr 2011;24(2):155–165.Google Scholar
37.Karam, EG, Fayyad, J, Nasser Karam, A, et al. . Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon. World Psychiatry. 2008;7(2):103–109.Google Scholar
38.Weine, SM, Pavkovic, I, Agani, F, Jukic, V, Ceric, I. Mental health reform and assisting psychiatric leaders in post-war countries. In: Reyes, G, Jacobs, G, eds. Handbook of International Disaster Psychology: Refugee mental health>. Westport, CT: Praeger Publishers; 2006.Google Scholar