Mental Well-Being in Settings of ‘Complex Emergency’: An Overview

Abstract

The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology (Last, 2000).This volume brings together a wide range of disciplines in the human sciences to address some of the key questions that bear upon the mental health and well-being of populations affected by war and displacement, with contributions from applied biosocial and medical anthropology (Almedom; Lewando-Hundt et al.); applied psychology/public health and social psychiatry (Carballo et al.; Snider et al.; Fullilove et al.); social work (Ahearn & Noble); and political sciences (Pupavac). The four themes that run through this set of papers (outlined below) remain topical areas of contention in contemporary humanitarianism. Scholars and practitioners in the biosocial sciences may wish to engage in the empirical study of human (if not humanitarian) responses to disaster focusing on questions as yet unanswered. Background context and the dynamics of humanitarian action

A life in waiting: Refugees' mental health and narratives of social suffering after European Union border closures in March 2016

“…Between a third and three quarters of respondents declined referral to psychological services (depending on sites), a decision further explained by the findings of the qualitative study, where the refugees reported a preference for practical assistance over mental health consultations. The appropriateness of introducing interventions that deal exclusively with mental health in situations where social, economic, and political needs have not been met, has been questioned (Almendon and Summerfield, 2004;Summerfield, 1999). Furthermore, some clinical guidelines now advocate for a phased approach to intervention that emphasizes the provision of direct practical assistance and the reinforcement of social networks as a first stage of mental health care (Inter-Agency Standing Committee (IASC), 2007; Rosen and Frueh, 2010;Rousseau et al, 2011;UNHCR, 2013).…”

Individual and Collective Dimensions of Resilience Within Political Violence

“…Among populations suffering from political violence, recovery must happen not only within individuals within larger social and political contexts (Almedom & Summerfield, 2004).…”

Recommendations for Canadian Mental Health Practitioners Working With War-Exposed Immigrants and Refugees

“…Refugee survivors of trauma and torture largely originate from non-western cultures (Johnson & Thompson, 2008); however, there are limited empirical studies undertaken by those from these cultures (Crumlish & O'Rourke, 2010), thus the research is limited by local understanding of psychological distress among traumatized immigrant and refugee populations. Lack of standardized measures and well-designed studies has further impeded research in this field (Campbell, 2007), and when distress is noted, the tendency is to misplace emphasis on post-traumatic stress disorder (PTSD; Almedom & Summerfield, 2004;Mollica, 2004;Pain, Kanagaratnam, & Payne, 2014). As a consequence of the now recognized differences in manifestations of distress and the lack of culturally valid assessment and treatment approaches to address these issues, refugees are considered to be the most clinically challenging group to engage in a psychotherapeutic context (Regel & Berliner, 2007).…”

“…An ongoing major controversy in the assessment and treatment of people exposed to war trauma is universal versus cultural applicability of a PTSD diagnosis and its framework in capturing mental distress within the refugee population (Kienzler, 2008). Critics argue that the PTSD framework was primarily derived from American Vietnam veterans and heedlessly extended to clinical practice with refugees (Almedom & Summerfield, 2004;Bracken, 2001;Summerfield, 1999). An antithetical argument suggests that criticism of PTSD and the assertion that it results in medicalization of the refugee experience has no valid grounds (Basoglu, 2006).…”