Mental Health and Psychosocial Support in Emergencies - Ashley Leichner

1. ©2013 International Medical Corps
Mental Health and Psychosocial Support
in Emergencies
October 2016
From Relief to Self-Reliance
Technical Unit Ashley Leichner
aleichner@internationalmedicalcorps.org
All content in this document is the property of International Medical Corps and should not be reproduced without prior written consent. This material is protected
by copyright. ©2013 International Medical Corps. Materials may not be reproduced without International Medical Corps’ prior written consent.

2. ©2012 International Medical Corps
Introduction to MHPSS
What is it?
• Any type of local or outside support that aims to:
– protect or promote psychosocial well-being and/or
– prevent or treat mental disorder
IASC MHPSS Guidelines 2007

3. ©2012 International Medical Corps
MHPSS Needs in Emergencies
• Basic Needs & Safety (Water, food,
Shelter, sanitation)
• Resources (Income, livelihood)
• Physical Health
• Child-specific needs (School, safety,
separation from caregivers)
• Mental health needs (existing mental
health disorders, distress, grief, loss,
death of loved ones, social support,
separation from family, substance abuse)
• Humanitarian response (access to
information, resources, capacity to move
to safer areas)

4. ©2012 International Medical Corps
MHPSS Intervention Pyramid
What is it?
• Any type of local or outside support that aims
to:
– protect or promote psychosocial well-being
and/or
– prevent or treat mental disorder
IASC MHPSS Guidelines 2007

5. ©2012 International Medical Corps
Our Mental Health and Psychosocial
Support Programs
• Advocacy and Policy Development
• MHPSS Needs & Systems Assessments
• MHPSS Coordination and Mapping
• Emergency Approaches - Psychological First Aid
• Integrating mental health into general health care
– MH training for health care providers and supportive staff
– Community based MH Case management
• Early Childhood Development & youth psychosocial
programs (life skills approaches)
• Peer Support
• Psychiatric Hospitals and Rehabilitation

6. ©2012 International Medical Corps
MHPSS Needs Assessments and
Mapping
• Country level analyses (e.g. health
systems and policies, available
resources)
• Community level analyses (e.g. Priority
MHPSS problems, Attitudes toward
mental disorder, Help-seeking for
mental health, Current ways of coping
and community support)
• Health facilities assessments (PHC
Integration Checklist)
• Mapping of existing programming,
services and gaps (e.g. 4Ws)
Guidance: WHO-UNHCR Toolkit and IASC

7. ©2012 International Medical Corps
MHPSS Tools and Guidelines
• Basic IASC (2007) MHPSS Guidelines
– Supplementary guides (health,
protection, camp management,
assessment)
• UNHCR (2013) Operational Guidance
and Global Review
• IASC/UNICEF (2011) Advocacy: MHPSS
Basics for lay people
• WHO/UNHCR (2012) MHPSS
Assessment Toolkit
• WHO (2011) Mental health GAP
Intervention Guide
• WHO (2010) Psychological First Aid
and adapted Ebola PFA Guide

8. Mental Health & Psychosocial Support
(MHPSS) in Emergencies
October 13, 2016
Dennis Cherian
Senior Director, Health
WorldVision US
Mental Health and Humanitarian response

9. Mental Health & Psychosocial
Support (MHPSS) in
Emergencies
 Framework = IASC Guidelines on MHPSS in Emergency
Settings (2007)
• First wave interventions:
 Briefing other sectors about the action sheets relevant to
their sectors & training those in contact with crisis
affected populations in Psychological First Aid (PFA). If
possible, provision of information (e.g., with NFI kits) and
basic referral mapping. MHPSS included in rapid
assessments.
• Second wave interventions:
 psychosocial support to build family and communities
(e.g., in Child Friendly Spaces, Education, Women and
Young Child Friendly Spaces, Infant Stimulation with
nutrition). WV is presently developing a Channels of
Hope program for faith communities.

10. Mental Health & Psychosocial
Support (MHPSS) in
Emergencies
• Third wave (recovery) interventions:
 More detailed assessments, training lay counsellors in
Interpersonal Psychotherapy for Groups (IPTG) and/or
mhGAP for integration with primary health facilities.
 Problem Management Plus (PM+) has just been released
and will likely form part of World Vision’s future responses,
particularly for SGBV.
 Linking with child protection is also common, particularly
training case support workers/home visitors for
psychosocial support and referral processes.
 World Vision does not provide psychiatric care. We
commonly work with local psychiatric services for referral
and supervision of lay counsellors

11. mhGAP in Kitgum, Northern Uganda
• World Vision Uganda partnered with Uganda MoH to pilot mhGAP in 3 Uganda
districts, including in northern Uganda’s post-conflict district of Kitgum, Gulu
• IPTG was effectively integrated as part of the mhGAP intervention, and proved
effective for 14-21 year olds
• 91% of people recognized symptoms of mental illness
• 67% of people with mental health concerns (individuals or family members) sought
treatment at their primary health facility
• 98% of service users (who benefited from either mhGAP and/or IPTG) reported
increased life satisfaction
• mhGAP health workers trained regularly used the intervention guide in patient care

12. Problem Management Plus (PM+)
in Peri-Urban Kenya
World Vision Kenya completed a Randomized Control Trial (RCT) in the Dagoretti district
of Nairobi City County, demonstrating effectiveness of PM+ compared with an enhanced
treatment as usual group
Of those screening
positive for
psychological distress
and impaired
functioning, 75% had
experienced GBV,
indicating
this will likely be a
positive
intervention for future
emergency contexts.

13. Psycho Social Wellbeing and Healing Trauma
April 2016
1
3

14. 14
Psycho Social
Support

15. Myth:
• “All victims of armed conflict or disasters need counseling to get back on
track again.”
Reality:
• ”Psychosocial service is not about individual therapy, it’s the work we do
when we assist affected communities in their collective recovery.”
Community Based
Psychosocial Approach

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Child’s Individual
Capacity
-Inner sense of
security/strength
-Basic needs
-Physical & mental health
-Knowledge & skills
-Social, emotional,
spiritual wellbeing
Family & Community
Functioning
Societal Culture & Values
Policies &
LawsReligion
Social
Cohesion
Customs
Traditions
Family/
Caregiver
DALY’s
&Social Role
Friends/
Peers
People of
Support &
Trust
Basic
services
Psychosocial Wellbeing Framework: Child in Environment
Safety &
Security
Beliefs
Play& Learn
Institutions

17. 17
Core Humanitarian Standards

18. 18
Protection Mainstreaming Framework
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• Safety
• Access
• Dignity
• Sex
• Age
• Diversity

19. Intended Outcomes of PSS
Social Connection
Safety & Inner Peace
Resilience & Inner Strength
Well-being
Meaning & Purpose
Healing Grief & Trauma
Acceptance & Inclusion
19
Joy Fun
Laughter Play Learning
Growth Friendships
Support Love Peace

20. PSS Role of Animators
Strengthen Protective Factors & Reduce RiskFactors
• Provide comfort and support
• Restore hope
• Create structure
• Listen
• Facilitate activities
• Create social connections
• Encourage learning & growth
• Positive communication/interaction with communities
• Promote psychosocial wellbeing thru PFA: Look, Listen Link
• Advocate for the rights and needs of the children, families and
community served by the CRS
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21. Integrating PSS
Critical link between the provision of basic needs & PSS
Sierra Leone Ebola Virus Disease: Social Mobilization &
Livelihoods; WASH; Education
Iraq emergency context: Shelter & Settlements; WASH;
Education
Nepal: Relief, Shelter & Settlements, WASH, Livelihoods
Jordan, Egypt, Lebanon, Turkey: CFS; Education
Ecuador: Relief; Shelter & Settlements; WASH
Greece: Shelter & Settlements; Protection
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Questions??