IASC Task Force on Mental Health and Psychosocial Support in Emergencies1

Inter-Agency Standing Committee (IASC)

Guidance on Mental Health and

Psychosocial Support in Emergency

Settings

Inter-Agency Standing Committee (IASC)

Guidance on Mental Health and

Psychosocial Support in Emergency

Settings

Pau Pérez-Sales pauperez@arrakis.es

Psychosocial and Mental Health Advisor. Médicos del Mundo España. IASC Task Force member on behalf of MdM-E / IAVC

IASC Task Force on Mental Health and Psychosocial Support in Emergencies2

Why inter-agency guidance?

• Enough consensus on good practices to develop interagency guidance

• Transcend ideological debates• Facilitate addressing of a range of issues (from

protecting and improving social well-being to severe mental disorder)

• Multiple needs in multiple sectors: no humanitarian actor can address needs alone

• Reduce inappropriate practices• Less chaos: facilitate coordinated response on

priority issues

IASC Task Force on Mental Health and Psychosocial Support in Emergencies3

Inter-Agency Standing Committee (IASC) Committee of heads of

large humanitarian agencies responsible for global humanitarian policy

(see UN General Assembly Resolution 48/57)

• 10 UN agencies (e.g. UNFPA, UNHCR, UNICEF, UNHCR, WFP, UNICEF, WHO)

• Red Cross movement (IFRC and ICRC)• 3 large NGO consortia (InterAction, ICVA, SCHR) covering

100s of INGOs.• IOM• World Bank

IASC Task Force on Mental Health and Psychosocial Support in Emergencies4

IASC Task Force: 27 agencies - 1 year mandate

• IRC

• MdM-E

• Mercy Corps

• MSF-H

• Oxfam GB

• RET

• SC-UK

• SC-USA

IASC bodies

• ICVA

• IFRC

• Interaction

• IOM

• OCHA

• UNFPA

• UNHCR

• UNICEF

• WFP

• WHO

Individual INGOs:

• ACF

• Am. Red Cross

• Action Aid Int.

• CARE Austria

• CCF

• HNI-TPO

• IMC

• ICMC

• INEE

UN-NGO co-chaired (WHO & InterAction)

How the Guidelines Were Developed

• Broad consultative, participatory process• Task Force formed by IASC Working Group in

2005• Collaboratively developed content & structure• Agencies responsible for drafting different parts

of the Guidelines• Drew on field experience of leading practitioners• Multiple reviews by diverse actors

IASC Task Force on Mental Health and Psychosocial Support in Emergencies6

Target audience

• Disaster management• Human rights• Protection• Health• Education• Shelter

• Water and sanitation• Food security• Nutrition• Camp management,• Community development• Mass communication

• authorities, personnel and organizations operating in emergency settings at international, national and local levels.

• for use by workers of diverse disciplines and sectors:

IASC Task Force on Mental Health and Psychosocial Support in Emergencies7

Document structure

• Chapter 1: Pre-amble (6 pages)• Chapter 2: Matrix covering 26 minimum

response interventions

(7 pages)• Chapter 3: 26 action sheets (approx.

4 pages each) (total 104 pages)

Total: doc of approx 115 pages + matrix poster + CD-ROM

IASC Task Force on Mental Health and Psychosocial Support in Emergencies8

Core principles

1. Help, but foremost, do no harm

2. Promote human rights and equity

3. Maximize participation

4. Building on available

resources and capacities

5. Facilitate multi-layered supports

6. Facilitate integrated support systems

Basic services and security

Community and family supports

Specialisedservices

Focused (person-to-person) non-specialised

supports

Strengthening community and family supports

Social considerations in basic services and security

Advocacy for basic services that are safe, socially appropriate and protect dignity

Activating social networks Communal traditional supports Supportive child-friendly spaces

Basic mental health care by PHC doctors Basic emotional and practical support by community workers

Mental health care by mental health specialists (psychiatric nurse, psychologist, psychiatrist etc)

Key principle: multi-layered responses Key principle: multi-layered responsesExamples:

Multisectoral Guidance

• Example: The design of sites and shelters often causes distress owing to over-crowding, lack of privacy, and lack of safety at latrines

• Key Actions:

- organize shelters in ways that promote privacy and reduce overcrowding

- provide adequate lighting around lockable sanitation facilities

Examples of practical do's and don’t's in the IASC Guidelines (see pages 11-13, field guide)

• Build local capacities, supporting self-help and strengthening the resources already present in affected groups.

• After trainings on MHPSS provide follow up supervision and monitoring to ensure the interventions are implemented correctly.

• Do not organise supports that undermine or ignore local responsibilities and capacities.

• Do not use one-time stand alone trainings or very short trainings without follow-up if preparing people to perform complex psych interventions

12

Matrix of Mental Health and Psychosocial Support: All Have Impact on Protecting MHPS Well-being

1. Coordination

2. Assessment, monitoring and evaluation

3. Human rights standards

4. Human resources

5. Community mobilisation and support(*)

6. Health services

7. Education

8. Dissemination of information

9. Food security and nutrition

10. Shelter and site planning

11. Water and sanitation

MHPSS is an inter-sectoral, or mainstreaming concern. You can improve our MHPSS influence by taking A Mental Health & Psychosocial Support Lens across all our programs

See Chapter 2 matrix with columns

- Preparedness

- 25 minimum responses (see poster)

- Comprehensive responses

On early recovery

• Early recovery is about planning for recovery from day one of a crisis

• IASC Guidelines is mostly about minimum response for emergencies but Chapter 2 (full matrix) contains many suggestions for "comprehensive response"

Examples of ideas for early recovery (see Chap 2 of IASC Guidelines)

• Support safe community reintegration for displaced persons, especially isolated ones

• Provide the space for victims and survivors to discuss issues of reparation (economic, judicial, symbolic) to be addressed by responsible parties

• Facilitate recording of historical memory of how the community has dealt with the emergency

• Strengthen the MHPSS system, including referral mechanisms

• Strengthen mobilisation of community resources for self-help

Examples of ideas for early recovery (see Chap 2 of IASC Guidelines)

• Organise discussions on helpful and harmful traditional practices

• Build local organizations' capacities to help parents to provide quality care for young children

• Develop national plan/policy for mental health• Integrate mental health care in PHC• Develop community mental health services• Follow up on psychosocial support programmes offered

in schools• Support reliable and accessible systems of accurate

dissemination of information, including on returns/resettlement/repatriation

For health sector there is no other opportunity for mental health services development/reform than

the political aftermath of humanitarian crises

Positive examples

Albania

China

Indonesia

Iraq

Jordan

Kosovo

Macedonia

occupied Palestinian territory

Peru

Sri Lanka

Timor-Lesle

. . . among others

Applications of IASC Guidelines• Some major donors only

fund consistent with IASC Guidelines

• 30,000 copies in print• Available in many languages• Promoted heavily by

agencies• Special journal issue of

Intervention• Increasingly used also in rich

countries (Japan, Slovenia)• Used for identification of

gaps in Philippines

• Use picture version to mobilize community in Peru

• Moved people beyond counselling in Kenya

• Adopted by 4 ministries Gov in Philippines as policy

• Training in Iran informed by and consistent with IASC

• Used for planning in Ethiopia

• Common framework in Myanmar, Lebanon, Jordan and Gaza

Final remarks• There is a responsability of all (including Donors) to promote

and facilitate internationally accepted best practices

• There is a potential to do harm – Need to work on consensus and tested programms

The IASC Guidelines is the point of a hallmark and a consensus standard for best practices at the short and middle term after emergencies

Final remarks

You can download a copy of the Guidelines in English, French, Spanish, Arab on many web sites, the IASC website among them.

You can have a hard copy of the Field Version (not Full Version) at the entrance

Thanks

Sphere 2004: minimum standard for mental and social

aspects of health4 psychological/psychiatric interventions• Psychological first aid for people with acute anxiety• Care in PHC for urgent psychiatric problems• Continue care for people with severe mental illness in previous

care• Initiate more comprehensive response8 social interventions• Eg restart schooling, give information, community-self help, etc