Integrating mental health care into existing systems of health care: during and after complex humanitarian emergencies: an Intervention Special Issue

Complex humanitarian emergencies, whether arising from armed conflict or natural disaster, challenge the mental health system of a country in many ways. Not least because they increase the risk of mental disorder in the population, and undermine the pre-existing structures of care. They may, however, also bring new opportunities to create change. In this way, new structures and paradigms may emerge from the midst of a crisis. The probabilities for such a change to occur vary from one setting to another.

From mathematics to psychosocial work: personal reflections on a decade of psychosocial work with children in Kosovo

 The author of this field report, originally a professor in mathematics, describes in a personal report how oppression and violent conflict in Kosovo effected a change in his career, and how he became the founder and director of a local nongovernmental organisation in the field of education and psychosocial support for children. After the conflict, many psychosocial activities were organised. Unfortunately, local experience was often ignored in these projects.

The IASC Guidelines and the International Disaster Psychology Program at the University of Denver

There is a growing recognition of the significant psychological and psychosocial damage caused by natural and manmade disasters. This phenomenon has increased the demand for trained professionals with the necessary skills to address these problems, in diverse populations around the world.

Field report: peer support supervision as a procedure for learning from practical experience in a mental health setting

This field report describes a ‘minimal budget project’ aimed at developing the expertise of a mixed group of workers. This project included nurses, community workers, counsellors and psychosocial workers attached to, or connected with, the mental health units in four hospitals in east Sri Lanka. In order to develop expertise, the project included a series of basic counselling training, as well as ongoing guidance during monthly peer supervision meetings.

The transition of teenage girls and young women from ex-combatants to civilian life: a case study in Sri Lanka

This paper describes the lives of young, female former Tamil Tiger fighters, in Batticaloa, after the civil war in Sri Lanka. It shows how the kinship and solidarity found in female networks, in a matri-lineal society, has helped them survive the conflict. In Batticaloa, female-headed households bear the main burden for caring for the traumatised, and sometimes injured, returning female, former soldiers. This is done in the absence of social welfare services or specific medical or psychosocial care.

Mental health training of primary health care workers: case reports from Sri Lanka, Pakistan and Jordan

Evidence suggests that providing support to primary health care with training, assistance and supervision by available mental health professionals is the best way to extend mental health care to the population. Three cases of mental health training programmes for primary health care workers were implemented in different countries, and are described in this article. The objective was to share the lessons learnt in different settings. Relevant primary and secondary data were used to present the cases.

Building meaningful participation in reintegration among war-affected young mothers in Liberia, Sierra Leone and northern Uganda

When young mothers, formerly associated with armed groups, return to communities, they are typically social isolated, stigmatised, and marginalised. This creates reintegration challenges for themselves, and their communities. Their children face child protection problems such as neglect, rejection and abuse. In this paper, the authors describe an innovative field practice - community based,participatory action research (PAR) - that meaningfully involved formerly associated young mothers, and other vulnerable young mothers, in their communities.

Spirituality and psychosocial work in emergencies: four commentaries and a response

The commentaries on the next few pages relate to the article ‘Spirituality and mental health in humanitarian contexts: an exploration based on World Vision’s Haiti earthquake response’ by Alison Schafer on page 121-130 of issue 8.2 of Intervention (2010). The author uses the experiences in the aftermath of the Haiti earthquake to substantiate her argument that nongovernmental organisations do not have a clear set of interventions to address the spiritual needs of an affected population, in conjunction with their mental health and psychosocial support needs.

Overcoming social/cultural practices and beliefs in setting up a community mental health programme in a complex emergency: reflections arising from the work done by TPO in Somalia

Since the collapse of the central government of Somalia in 1991, large parts of the country have been in turmoil. Fighting, poverty, hunger and gender based violence have all contributed to high levels of mental and psychosocial problems. Excessive consumption of khat may also be a major contributor to mental health problems, specifically in men. In Somalia, few services respond to the needs of people with mental health problems.

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