Background
Major gaps remain – especially in low- and middle-income countries – in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations’ mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development.
Case description

The mental health needs of people affected by emergencies are significant, but often overlooked by health-care providers. The world is facing an unprecedented number of humanitarian emergencies arising from conflict and disasters. In 2014, nearly 60 million people were forcibly displaced due to conflict, the highest number on record. Climatic and geological hazards continue to take their toll, as seen recently following the devastating earthquake in Nepal, cyclone in Vanuatu and flooding in China, Malawi and Myanmar.

Aims. To discuss the potential usefulness of a public health approach for ‘mental health and psychosocial support’ (MHPSS) interventions in humanitarian settings.

Objective: We examined the prevalence of mental health problems in refugees living in camps that emerged in Tanzania during the Rwanda crisis that started in 1994.
Method: Using the 28-item version of the General Health Questionnaire (GHQ-28), we examined two samples: a random sample (n=854) and a sample of clients of a psychosocial support programme in these camps (n=23). Sensitivity, specificity and positive- and negative predictive values were estimated for several cut-off scores of the GHQ-28.

Context Uncertainties continue about the roles that methodological factors and key risk factors, particularly torture and other potentially traumatic events (PTEs), play in the variation of reported prevalence rates of posttraumatic stress disorder (PTSD) and depression across epidemiologic surveys among postconflict populations worldwide.
Objective To undertake a systematic review and meta-regression of the prevalence rates of PTSD and depression in the refugee and postconflict mental health field.

People with severe mental disorders are a neglected and vulnerable group in complex emergencies. Here, we describe field experiences in establishing mental health services in five humanitarian settings. We show data to quantify the issue, and suggest reasons for this neglect. We then outline the actions needed to establish services in these settings, including the provision of practical training, medication, psychosocial supports, and, when appropriate, work with traditional healers.

Background: Population-based epidemiological research has established that refugees in low- and middle-income countries (LMIC) are at increased risk for a range of mental, neurological and substance use (MNS) problems. Improved knowledge of rates for MNS problems that are treated in refugee camp primary care settings is needed to identify service gaps and inform resource allocation.

Bij gezinnen die onzeker zijn over een verblijfsvergunning en/of dreigen uitgezet te worden, is vaak sprake van een hoog spanningsniveau dat een goede ontwikkeling van de kinderen belemmert. In deze handleiding wordt een preventief programma voor asielzoekers en vluchtelingen beschreven. Het is gebaseerd op de Multi Family Therapy, die in Engeland is ontwikkeld voor gezinnen met veel problemen. In Nederland heet dit de meergezinsgroepmethode.

Door een schokkende gebeurtenis wordt in één keer de vanzelfsprekendheid van het bestaan, en daarmee ook de vermeende voorspelbaarheid er van, teniet gedaan. Plotseling voelen we ons kwetsbaar en hebben we het gevoel dat elk moment het gevaar opnieuw kan ontstaan.

Wat rechtvaardigt een apart hoofdstuk over EMDR bij andere culturen? Is er sprake van een ander klinisch beeld dan bij autochtonen; heeft de psychiatrische of traumaproblematiek opvallende eigenschappen?