Evidence-based mental health and psychosocial support in humanitarian settings: gaps and opportunities

Tol, Wietse A.; Ommeren, Mark van

doi:10.1136/ebmental-2012-100644

Cited by 41 publications

(44 citation statements)

References 22 publications

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“…The papers were limited in scope and we did not identify research that has been published focused on refugees displaced in the current armed conflict. The psychiatric epidemiological research on populations displaced from South Sudan in previous conflicts suggested high prevalence of common mental disorders (depression, PTSD, anxiety), although the use of non-validated cut-off scores for the population may mean that psychological distress and mental disorders are conflated in these studies [24]. Exact expected rates of mental disorders are challenging to estimate from existing studies.…”

Section: Resultsmentioning

confidence: 99%

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

Adaku¹,

Okello²,

Lowry³

et al. 2016

Confl Health

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BackgroundSince December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions.MethodsWe conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45).ResultsData from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included “overthinking”, ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were very limited MHPSS services available in Rhino Camp.ConclusionsThe types of MHPSS problems among South Sudanese refugees in northern Uganda are diverse and the burden appears to be considerable, yet there are currently few available services. The assessment indicates the need for a range of services addressing social concerns as well as varied types of mental conditions. The idiom of “overthinking” may form a useful starting point for intervention development and mental health communication.

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Section: Resultsmentioning

confidence: 99%

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

Adaku¹,

Okello²,

Lowry³

et al. 2016

Confl Health

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show abstract

“…The most common effects include distress and grief, and, less frequently, but nonetheless commonly, anxiety disorders and depression [2]. People's attempts at self-medication for the stress, often with alcohol, may lead them into harm and substance use disorders, which may also mask mood and anxiety disorders and postpone their recognition.…”

Section: Introductionmentioning

confidence: 99%

“…Tol and van Ommeren say [2] “ … mental health and psychosocial support programmes … are increasingly a standard component of humanitarian response. ” Thus, this topic is of global concern.…”

Section: Introductionmentioning

confidence: 99%

Mental Health Services Required after Disasters: Learning from the Lasting Effects of Disasters

McFarlane

Williams

2012

Depression Research and Treatment

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Disasters test civil administrations’ and health services’ capacity to act in a flexible but well-coordinated manner because each disaster is unique and poses unusual challenges. The health services required differ markedly according to the nature of the disaster and the geographical spread of those affected. Epidemiology has shown that services need to be equipped to deal with major depressive disorder and grief, not just posttraumatic stress disorder, and not only for victims of the disaster itself but also the emergency service workers. The challenge is for specialist advisers to respect and understand the existing health care and support networks of those affected while also recognizing their limitations. In the initial aftermath of these events, a great deal of effort goes into the development of early support systems but the longer term needs of these populations are often underestimated. These services need to be structured, taking into account the pre-existing psychiatric morbidity within the community. Disasters are an opportunity for improving services for patients with posttraumatic psychopathology in general but can later be utilized for improving services for victims of more common traumas in modern society, such as accidents and interpersonal violence.

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“…[15][16][17][18][19] This practice alone proves insufficient to alleviate the concerns natural disaster victims, who are commonly found to experience distress and grief, 21 anxiety disorders, 19,20 PTSD, 20,21 and major depressive disorder 20 among others. Thanks to a growing body of literature supporting the link between disaster and mental health, patterns of humanitarian aid have shifted in response.…”

Section: Application To Hurricane Matthewmentioning

confidence: 99%

Mental health promotion in the wake of natural disaster

Robinson¹,

Su²

2017

UWOMJ

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Significant psychological trauma to victims is an unavoidable by-product of severe natural disasters, and Hurricane Matthew is no exception. Making landfall on the 4th of October 2016, it swept across Haiti and eastern Cuba before reaching coastal regions of Florida, Georgia, and South Carolina. Despite Matthew's far-reaching impact, it was in Haiti where the Category Four hurricane made its greatest mark. Infrastructure damage led to water contamination and cholera outbreaks, sparking major concern amongst the World Health Organization and Haitian Ministry of Health. Consequently, physical health impact related to cholera control through clean water access was prioritized over psychological repercussions. In this article, we aim to provide recommendations for local organizations to deliver effectively psychological intervention to Haitian victims of Matthew. We focused on Global Trauma Research, one of few humanitarian agencies with an established framework for implementing psychological trauma relief efforts, and wish to use it as the basis of our suggestions. In order to do so, we chose to review mental health promotion in the context of a relevant historical precedent, Hurricane Katrina. We uncovered a two-pronged approach taken by Hurricane Katrina responders: identification of at-risk groups followed by provision of targeted-relief efforts, and widespread delivery of care to all affected populations, with an emphasis on community reintegration. Based on these general principles, we recommend that Global Trauma Research identify groups at risk of long-term emotional disturbance, provide relief in a targeted fashion on the basis of relative need, and place emphasis on Haitian citizen support through relocation and community integration.

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Evidence-based mental health and psychosocial support in humanitarian settings: gaps and opportunities

Cited by 41 publications

References 22 publications

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

Mental Health Services Required after Disasters: Learning from the Lasting Effects of Disasters

Mental health promotion in the wake of natural disaster

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