Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T17:30:18.806Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental health and psychosocial support in humanitarian settings: a public mental health perspective

Part of: Special Articles

Published online by Cambridge University Press:  24 September 2015

W. A. Tol ,
M. Purgato ,
J. K. Bass ,
A. Galappatti  and
W. Eaton
W. A. Tol*
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Peter C. Alderman Foundation, Bedford, NY, USA and Kampala, Uganda
M. Purgato
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
J. K. Bass
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
A. Galappatti
Affiliation:
Good Practice Group, Colombo, Sri Lanka and Faculty of Graduate Studies, University of Colombo, Colombo, Sri Lanka
W. Eaton
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
*
*Address for correspondence: W. A. Tol, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA and Peter C. Alderman Foundation, Bedford, NY, USA and Kampala, Uganda. (Email: wtol@jhu.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims.

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

Methods.

Building on public mental health terminology in accordance with recent literature on this topic and considering existing international consensus guidelines on MHPSS interventions in humanitarian settings, this paper reflects on the relevance of the language of promotion and prevention for supporting the rationale, design and evaluation of interventions, with a particular focus on populations affected by disasters and conflicts in low- and middle-income countries.

Results.

A public mental health approach and associated terminology can form a useful framework in the design and evaluation of MHPSS interventions, and may contribute to reducing a divisive split between ‘mental health’ and ‘psychosocial’ practice in the humanitarian field. Many of the most commonly implemented MHPSS interventions in humanitarian settings can be described in terms of promotion and prevention terminology.

Conclusions.

The use of a common terminology across health, protection, education, nutrition and other relevant sectors providing humanitarian interventions has the potential to allow for integration of MHPSS activities in one overall framework, with diverse humanitarian practitioners working to achieve a common goal.

Keywords

Humanitarian settingslow- and middle-income countriesmental health psychosocial supportpublic health
Type
Special Article
Information
Epidemiology and Psychiatric Sciences , Volume 24 , Issue 6 , December 2015 , pp. 484 - 494
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ager, A, Metzler, J (2012). Child Friendly Spaces: A Structured Review of the Current Evidence-Base. From http://reliefweb.int/sites/reliefweb.int/files/resources/CFS_Literature_Review_final_Aug_2012.pdf Google Scholar
Allen, J, Balfour, R, Bell, R, Marmot, M (2014). Social determinants of mental health. International Review of Psychiatry 26, 392–407.CrossRefGoogle ScholarPubMed
Bhugra, D, Till, A (2013). Public mental health is about social psychiatry. International Journal of Social Psychiatry 59, 105–106.CrossRefGoogle ScholarPubMed
Bradshaw, CP, Koth, CW, Thornton, LA, Leaf, PJ (2009). Altering school climate through school-wide Positive Behavioral Interventions and Supports: findings from a group-randomized effectiveness trial. Prevention Science: the Official Journal of the Society for Prevention Research 10, 100–115.CrossRefGoogle ScholarPubMed
Bradshaw, CP, Waasdorp, TE, Leaf, PJ (2012). Effects of school-wide positive behavioral interventions and supports on child behavior problems. Pediatrics 130, e1136–e1145.CrossRefGoogle ScholarPubMed
Bragin, M, Onta, K, Janepher, T, Nzeyimana, G, Eibs, T (2014). To be well at heart: women's perceptions of psychosocial wellbeing in three conflict affected countries. Intervention 12, 1–23.CrossRefGoogle Scholar
O'Connell, ME, Boat, T, Warner, KE (Eds) (2009). Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. National Academies Press, Washington, DC.Google Scholar
Cuijpers, P (2003). Examining the effects of prevention programs on the incidence of new cases of mental disorders: the lack of statistical power. American Journal of Psychiatry 160, 1385–1391.CrossRefGoogle ScholarPubMed
de Jong, JT, Komproe, IH (2002). Closing the gap between psychiatric epidemiology and mental health in post-conflict situations. Lancet 359, 1793–1794.CrossRefGoogle Scholar
Diener, E (2012). New findings and future directions for subjective well-being research. American Psychologist 590–597.CrossRefGoogle ScholarPubMed
Eaton, W (2012). Public Mental Health (ed. Eaton, W). Oxford University Press: New York.CrossRefGoogle Scholar
Eaton, W, Alexandre, P, Bienvenu, OJ, Clarke, D, Martins, SS, Nestadt, G, Zablotsky, B (2012 a). The burden of mental disorders. In Public Mental Health (ed. Eaton, W), pp. 3–30. Oxford University Press: New York.CrossRefGoogle Scholar
Eaton, W, Alexandre, P, Kessler, RC, Martins, SS, Mortensen, PB, Rebok, G, Storr, C, Roth, K (2012 b). The population dynamics of mental disorders. In Public Mental Health (ed. Eaton, W), pp. 125–150. Oxford University Press: New York.CrossRefGoogle Scholar
Engel, GL (1977). The need for a new medical model: a challenge for biomedicine. Science 197, 129–196.CrossRefGoogle Scholar
Engel, GL (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry 137, 535–544.Google ScholarPubMed
Furr-Holden, CD, Ialongo, NS, Anthony, JC, Petras, H, Kellam, SG (2004). Developmentally inspired drug prevention: middle school outcomes in a school-based randomized prevention trial. Drug Alcohol Dependence 73, 149–158.CrossRefGoogle Scholar
Galappatti, A (2003). What is a psychosocial intervention? Mapping the field in Sri Lanka. Intervention 1, 3–17.Google Scholar
Guha-Sapir, D, Hoyois, P, Below, R (2014). Annual Disaster Statistical Review 2013: The Numbers and Trends. From http://file:///C:/Users/prgmnn32/Downloads/ADSR_2013.pdf Google Scholar
Helliwell, J, Layard, R, Sachs, J (2015). World Happiness Report 2015. From http://worldhappiness.report/ Google Scholar
Hobfoll, S, Watson, P, Bell, CC, Bryant, RA, Brymer, MJ, Friedman, MJ, Friedman, M, Gersons, BPR, de Jong, JTVM, Layne, CM, Maguen, S, Neria, Y, Norwood, AE, Pynoos, RS, Reissman, D, Ruzek, JI, Shalev, AY, Solomon, Z, Steinberg, AM, Ursano, R (2007). Five essential elements of immediate and mid–term mass trauma intervention: empirical evidence. Psychiatry 70, 283–315.CrossRefGoogle ScholarPubMed
Howard, LM, Oram, S, Galley, H, Trevillion, K, Feder, G (2013). Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS Medicine 10, e1001452.CrossRefGoogle ScholarPubMed
Inter-agency Standing Committee (IASC) (2007). IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. From http://www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdf Google Scholar
Jordans, MJ, Semrau, M, Thornicroft, G, van Ommeren, M (2012). Role of current perceived needs in explaining the association between past trauma exposure and distress in humanitarian settings in Jordan and Nepal. British Journal of Psychiatry 201, 276–281.CrossRefGoogle ScholarPubMed
Keyes, CL, Dhingra, SS, Simoes, EJ (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health 100, 2366–2371.CrossRefGoogle ScholarPubMed
Kirmayer, LJ (2004). The cultural diversity of healing: meaning, metaphor and mechanism. British Medical Bulletin 69, 33–48.CrossRefGoogle ScholarPubMed
Kleinman, A (1988). Rethinking Psychiatry: From Cultural Category to Personal Experience. The Free Press: New York.Google Scholar
Lund, C, De, SM, Plagerson, S, Cooper, S, Chisholm, D, Das, J, Knapp, M, Patel, V (2011). Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 378, 1502–1514.CrossRefGoogle ScholarPubMed
Mendelson, T, Pas, ET, Leis, JA, Bradshaw, CP, Rebok, GW, Mandell, W (2012). The logic and practice of the prevention of mental disorders. In Public Mental Health (ed. Eaton, W), pp. 459–509. Oxford University Press: New York.CrossRefGoogle Scholar
Mfoafo-M'Carthy, M, Huls, S (2014). Human rights violations and mental illness: implications for engagement and adherence. SAGE Open 4, 1–18. DOI: 10.1177/2158244014526209.Google Scholar
Milam, AJ, Furr-Holden, CD, Cooley-Strickland, MC, Bradshaw, CP, Leaf, PJ (2014). Risk for exposure to alcohol, tobacco, and other drugs on the route to and from school: the role of alcohol outlets. Prevention Science: the Official Journal of Society for Prevention Research 15, 12–21.CrossRefGoogle ScholarPubMed
Mrazek, PJ, Haggerty, RJ (1994). Reducing Risks for Mental Disorders. National Academy Press: Washington, DC.Google Scholar
Pedersen, CB, Mors, O, Bertelsen, A, Waltoft, BL, Agerbo, E, McGrath, JJ, Mortensen, PB, Eaton, WW (2014). A comprehensive nationwide study of the incidence rate and lifetime risk for treated mental disorders. Journal of American Medical Association Psychiatry 71, 573–581.Google ScholarPubMed
Petersen, I, Barry, M, Lund, C, Bhana, A (2014). Mental health promotion and the prevention of mental disorders. In Global Mental Health. Principle and Practice (ed. Patel, V, Minas, H, Cohen, A and Prince, MJ), pp. 224–249. Oxford University Press: New York.Google Scholar
Psychosocial Working Group (2003). Psychosocial Intervention in Complex Emergencies: A Conceptual Framework. From http://www.forcedmigration.org/psychosocial/papers/Conceptual%20Framework.pdf Google Scholar
Rasmussen, A, Nguyen, L, Wilkinson, J, Vundla, S, Raghavan, S, Miller, KE, Keller, AS (2010). Rates and impact of trauma and current stressors among Darfuri refugees in Eastern Chad. American Journal of Orthopsychiatry 80, 227–236.CrossRefGoogle ScholarPubMed
Steel, Z, Chey, T, Silove, D, Marnane, C, Bryant, RA, van Ommeren, M (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. Journal of American Medical Association 302, 537–549.CrossRefGoogle ScholarPubMed
Stein, A, Pearson, RM, Goodman, SH, Rapa, E, Rahman, A, McCallum, M, Howard, LM, Pariante, CM (2014). Effects of perinatal mental disorders on the fetus and child. Lancet 384, 1800–1819.CrossRefGoogle ScholarPubMed
Themner, L, Wallensteen, P (2014). Armed conflicts, 1946–2013. Journal of Peace Research 51, 541–554.CrossRefGoogle Scholar
Tol, WA (2015). Stemming the tide: preventing mental disorders and promoting psychosocial wellbeing and in low- and middle-income countries. Global Mental Health 2, e11. doi:10.1017/gmh.2015.9.CrossRefGoogle Scholar
Tol, WA, Barbui, C, Galappatti, A, Silove, D, Betancourt, TS, Souza, R, Golaz, A, van Ommeren, M (2011). Mental health and psychosocial support in humanitarian settings: linking practice and research. Lancet 378, 1581–1591.CrossRefGoogle ScholarPubMed
Tol, WA, Rees, SJ, Silove, DM (2013). Broadening the scope of epidemiology in conflict-affected settings: opportunities for mental health prevention and promotion. Epidemiology and Psychiatric Sciences 22, 197–203.CrossRefGoogle ScholarPubMed
Tol, WA, Jordans, M, Susanty, D, de Jong, J (2014). Trials for people with mental disorders and conditions associated with stress. In Global Mental Health Trials (ed. Thornicroft, G and Patel, V), pp. 141–159. Oxford University Press: New York.Google Scholar
UNHCR (2013). Operational Guidance Mental Health & Psychosocial Support Programming for Refugee Operations. From http://www.unhcr.org/525f94479.html Google Scholar
UNICEF (2009). Machel Study 10-Year Strategic Review: Children and Conflict in a Changing World. UNICEF: New York.Google Scholar
Verdeli, H, Clougherty, K, Bolton, P, Speelman, L, Ndogoni, L, Bass, J, Neugebauer, R, Weissman, MM (2003). Adapting group interpersonal psychotherapy for a developing country: experience in rural Uganda. World Psychiatry 2, 114–120.Google ScholarPubMed
Wahlbeck, K (2015). Public mental health: the time is ripe for translation of evidence into practice. World Psychiatry 14, 36–42.CrossRefGoogle ScholarPubMed
Wessells, MG, van Ommeren, M (2008). Developing inter-agency guidelines on mental health and psychological support in emergency settings. Intervention 6, 199–218.CrossRefGoogle Scholar
Whiteford, HA, Degenhardt, L, Rehm, J, Baxter, AJ, Ferrari, AJ, Erskine, HE, Charlson, FJ, Norman, RE, Flaxman, AD, Johns, N, Burstein, R, Murray, CJ, Vos, T (2013). Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382, 1575–1586.CrossRefGoogle ScholarPubMed
World Health Organization (1986). The Ottawa Charter for Health Promotion. From http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ Google Scholar
World Health Organization (2014 a). Mental Health: A State of Wellbeing. From http://www.who.int/features/factfiles/mental_health/en/ Google Scholar
World Health Organization (2014 b). Mental Health: Strengthening Our Response. From http://www.who.int/mediacentre/factsheets/fs220/en/ Google Scholar
World Health Organization (2005). The Bangkok Charter for Health Promotion in a Globalized World. From http://www.who.int/healthpromotion/conferences/6gchp/bangkok_charter/en/ Google Scholar
World Health Organization, War Trauma Foundation, World Vision International (2011). Psychological First Aid: Guide for Field Workers. From http://www.who.int/mental_health/publications/guide_field_workers/en/ Google Scholar
Xu, J, Liao, Q (2011). Prevalence and predictors of posttraumatic growth among adult survivors one year following 2008 Sichuan earthquake. Journal of Affective Disorders 133, 274–280.CrossRefGoogle ScholarPubMed
Zou, C, Schimmack, U, Gere, J (2013). The validity of well-being measures: a multiple-indicator-multiple-rater model. Psychol Assess 25, 1247–1254.CrossRefGoogle Scholar