Do no harm: Toward contextually appropriate psychosocial support in international emergencies.

Abstract

In the aftermath of international emergencies caused by natural disasters or armed conflicts, strong needs exist for psychosocial support on a large scale. Psychologists have developed and applied frameworks and tools that have helped to alleviate suffering and promote well-being in emergency settings. Unfortunately, psychological tools and approaches are sometimes used in ways that cause unintended harm. In a spirit of prevention and wanting to support critical self-reflection, the author outlines key issues and widespread violations of the do no harm imperative in emergency contexts. Prominent issues include contextual insensitivity to issues such as security, humanitarian coordination, and the inappropriate use of various methods; the use of an individualistic orientation that does not fit the context and culture; an excessive focus on deficits and victimhood that can undermine empowerment and resilience; the use of unsustainable, short-term approaches that breed dependency, create poorly trained psychosocial workers, and lack appropriate emphasis on prevention; and the imposition of outsider approaches. These and related problems can be avoided by the use of critical self-reflection, greater specificity in ethical guidance, a stronger evidence base for intervention, and improved methods of preparing international humanitarian psychologists.

Psychosocial support among refugees of conflict in developing countries

“…One example is the case of child soldiers in Liberia who received far more aid and money than their communities, who then reacted negatively toward them considering what the child soldiers received as blood money (Wessells, 2009). …”

“…Individual-focused western psychology is not equipped for response to emergencies where the damage to the social structure of communities and support networks exceed personal losses (Wessells, 2009). Another problem is the lack of cultural sensitivity, which could lead to unintended harm.…”

Haiti Disaster Tourism—A Medical Shame

“…These include government teams, non-governmental organizations (NGOs), and even individuals pitching up on their own to assist those in need.These volunteers are nobly motivated to help, but all emergency interventions have unintended consequences. 4 Professional humanitarian workers have mixed feelings about the influx of "foreign disaster relief experts". Sometimes, the responders are poorly suited to help, with little or no experience in international relief, poor understanding of the local culture, and usually have no relationship with either local agencies or the affected population.…”

The Impact of Mental Health and Psychosocial Support Interventions on People Affected by Humanitarian Emergencies: A systematic review

“…156,157 The synthesized process evidence further reiterates this need. Findings highlight the importance of ensuring that programmes remain appealing and accessible to local populations by increasing opportunities for meaningful engagement via peer group support and the inclusion of programme components that are socially and culturally relevant.…”