Transcript IFRC Reference Centre for Psychosocial Support

IASC Guidelines
"A significant gap has been
the absence of a multisectoral, inter-agency
framework that enables
coordination, identifies
useful practices, flags
harmful practices and
clarifies how different
approaches to mental
health and psychosocial
support complement one
another."
Orientation on the IASC
Guidelines on Mental health and
Psychosocial Support in
Emergencies
Education Cluster
Amanda Melville,
occupied Palestinian territory 12 Feb 2009
• Introductions and agenda
• Handouts
• Brochure with matrix
• Print out of Field Use Version
• Full Guidelines on CD ROM (explain)
• True False Exercise
• Local expertise
IASC Task Force:
UN and non-UN agencies wrote
Guidelines
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6.
7.
8.
9.
10.
11. ACF
ICVA
12. Am. Red Cross
IFRC
Interaction13. ACT International
14. Action Aid
IOM
International
OCHA
11. CARE Austria
UNFPA
12. CCF
UNHCR
13. HealthNet TPO
UNICEF
14. IMC
WFP
15. ICMC
WHO
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27.
28.
Ref Group now
INEE
also has:
IRC
29.
CARE Int.
MdM-E
Ch of Sweden
Mercy Corps30.
31.
COOPI
MSF-H
GP-SI
Oxfam GB 32.
33.
RedR
RET
34.
REPSSI
SC/UK
35.
TdH
SC/USA
36.
UNRWA
37.
World Vision
Exercise 1: First reaction
(1 minute)
• Reflect on experiences that you had or
aware of related to mental health and
psychosocial support during and after
emergencies.
• Reflect on the following question. Is
there a potential need for applying here
internationally endorsed inter-agency
mental health and psychosocial support
guidelines?
Some typical answers to this exercise
are
Inter-agency guidelines are needed because
• Need to strengthen coordination and have common
comprehensive framework for action
• Need for guidance on most effective practices and how
to avoid doing harm or using ineffective practices
• Need to bring together diverse actors with strong views
in common framework
• Need guidance on how to prioritise in situations where
need is huge and strains existing capacities
But:
• Should be culturally sensitive/adaptable
• Should take local situation, capacities and resources into
account
• Should cover/not cover/ go beyond PTSD
Inclusive framework: mental health
and psychosocial support covers both
(a)protecting or promoting
psychosocial well-being
and/or
MH
(b) preventing or treating mental
disorder.
PS
Diverse needs in midst of
emergencies
Emergencies erode normally protective supports and increase risks
for a range of problems
• pre-existing social problems
• E.g. social tensions/divisions
• emergency-induced social problems
• E.g. overcrowding in housing, loss of jobs, protection threats,
weakening of social support networks
• pre-existing psychological/psychiatric problems
• E.g. psychosis, severe alcohol use, depression
• emergency-induced psychological/psychiatric problems
• E.g. normal fear (past, present, future), depression, PTSD
• humanitarian aid-induced problems
• E.g. conflict between communities, anxiety about
lack of information on services
Core Principles
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Human rights and equity
Participation
Do No Harm
Building on available
resources and capacities
• Integrated support systems
• Multi-layered supports
Matrix of Mental Health and Psychosocial
Support: All Have Impact on Protecting Wellbeing
1. Coordination
2. Assessment, monitoring and evaluation
3. Protection and 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
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Multilayered support
• Need to ensure support is
appropriately divided across layers
with good coordination/referral
• E.g. not overly focused on focused support
• Many of the professional animosities
disappear as soon as one adopts a pyramid
model of multi-layered supports with
different tasks for different sectors
• Referral system required but will not work
well if not appropriately layered
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Exercise : Do's and Don’t's for
Education
• Purpose: to learn what the IASC
Guidelines recommend regarding
Education
• Fill in the TRUE OR FALSE
questionnaire together with
somebody in the room who you do
not know
1. Coordination
1.1 Coordination of inter-sectoral
MHPSS
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Proposed Gaza humanitarian response mental health and psychosocial support (MHPSS)
coordination structure
MH = mental health; PS = psychosocial
Humanitarian
Coordinator
Protection Cluster
Health Cluster
MoH,
MoE, MoSA
(with Child protection
Sub-cluster)
Education Cluster
MHPSS inter-sectoral
coordination subgroup
MHPSS Technical
Support Group
Working groups as
Required eg Psychosocial
And education
2. Assessment, monitoring &
evaluation
2.1 Assessments of MHPSS issues
2.2 Participatory M&E
Photo courtesy of REUTERS/Finbarr O' Reilly
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3. Protection & human rights
standards
3.1 Human rights framework
3.2 Social protection
3.3 Legal protection
Photo courtesy of REUTERS/Finbarr O' Reilly
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4. Human resources
4.1 Local staff & volunteers
4.2 Codes of conduct & ethical guidelines
Photo: Danish Red Cross
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4. Human resources
4.3 Training of aid workers in MHPSS
4.4 MHPSS well-being of staff & volunteers
Photo: Nana Wiedemann, International Federation
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5. Community mobilisation &
support
5.1 Mobilisation, ownership & control
5.2 Community social support
Photo: Rita Plotnikova, International Federation
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5. Community mobilisation &
support
5.3 Cultural, spiritual & religious healing
practices
5.4 Support for
young children
& care-givers
Photo: Ulrik Norup Jørgensen, Danish Red Cross
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7. Education
7.1 Safe & supportive education
Photo: Patrick Fuller / Internaitonal Federation
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Promote Safe and Supportive
Education
• Education is a key PS intervention – provides a safe and
stable environment & restores a sense of normalcy, dignity
and hope.
• Key Actions:
1. Promote safe learning environments.
2. Make formal and non-formal education supportive and
relevant.
3. Strengthen access to education for all.
4. Prepare and encourage educators to support learners’ PS
well-being.
• Indicators: Percent access to formal and non-formal
education - girls and boys of different ages. Percent
teachers trained in PSP. Teachers refer children with severe
MHPS difficulties to specialised services.
8. Dissemination of information
8.1 Information to population on
emergency, relief efforts & legal rights
8.2 Information on positive coping methods
Photo courtesy of REUTERS/Eduard Kornienko
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Specialised
services
Focused,
non-specialised supports
Community and family supports
Social and psychological
considerations in basic
services and security
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Examples in Education sector
Social and psychological considerations in basic services and
security
• Advocating for schools to be protected during conflict
• Rescheduling exams or gradually returning to formal curriculum
Community and family supports
• Training teachers to provide PS support in classrooms
• Facilitating peer support among teachers
• Establishing child friendly spaces
• Parents discussion groups or involvement of parents in supportive
Focused,non-specialised supports
• Strengthening school counselling
• Structured group sessions for children (e.g. by NGOs)
• Referral of children or families to social services
• Support groups for teachers
Specialised services
• Referral to clinical mental health services
What %?
Specialised
services
Focused,
non-specialised supports
Community and family supports
Social and psychological
considerations in basic
services and security
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Beyond education: Social and
Psychological Considerations in Basic
Services and Security
All members of the community have
responsibility to ensure there is a suitable
environment for psychosocial development.
These activities help to establish a suitable
environment to protect and promote
psychosocial healing and well-being.
Usually these programmes are conducted by other
organisations or under an existing sector
Psychosocial and mental health programmes should
advocate for ensuring these basic needs are met
• cooperate with sectoral programmes to ensure
that are implemented in a way that supports
psychosocial development and healing
Level 1: Social and Psychological
Considerations in Basic Services and
Security
 Document impact of lack of services and security on
MHPS wellbeing and use this for advocacy
 For children, advocate for the protection of children
from violence, abuse and exploitation, the promotion of
family unity, re-establishing safe and supportive
education
 Advocate for delivery of humanitarian assistance in a
manner that promotes well-being
 Work to promote ways of delivering aid that promote
self-reliance and dignity
 Facilitate community involvement in decision-making
and assistance
 Disseminate essential information to affected
populations on situation and emergency response
Level 2: Community and Family Supports
 Support play, art, recreational and sporting activities
 Provide structured groups activities for expression and
the development of life skills and coping mechanisms
 Support children and youth friendly
spaces/environments
 Promote meaningful opportunities to participate in
rebuilding society
 Provide information on positive coping mechanisms
 Activities that facilitate the inclusion of isolated
individuals (orphans, widows, widowers, elderly people,
people with severe mental disorders or disabilities or
those without their families) into social networks;
Level 2 (cont’d)
Strengthening the family:
• Provide culturally appropriate guidance on how
parents and family members can help children
• Support parents and families to cope with their own
difficulties
• Support and facilitate the establishment of parent
groups/committees
• Early childhood stimulation (with nutrition)
• Informal family visits for caregivers in need of extra
support
• Support family access to basic services
Level 2 (cont’d)
Strengthening community supports:
• Helping caregivers and educators to better cope and
to support children
• Strengthen community based supports for adult
caregivers
• Strengthen child-to-child or youth support
• Resumption of cultural and spiritual activities,
including appropriate grieving rituals
• Strengthening social networks
• teacher training on psychosocial care and support
• Group discussions on how the community may help
at-risk groups identified in the assessment as
needing protection and support
Level 3: Focused Supports
For people who are:
• struggling to cope within their existing care
network
• Not progressing in terms of their
development
• Unable to function as well as their peers
• In need of activities that address their
psychosocial needs more directly
Level 3 (cont’d)
• Focused psychosocial support activities
require trained and experienced staff
• Activities may include:
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Case management
Family visits
Psychological first aid
Support groups
Structured play activities
Psychosocial hotlines
Non-clinical family or individual
counselling (e.g. school counselling)
Level 4: Specialized Services
• Traditional specialized healing (e.g.
cleansing and purification rituals)
• Clinical social work or psychological
treatment
• Psychotherapy
• Drug or alcohol treatment
• Specialised mental health care
Examples of how the guidelines have
been used
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Used for identification of gaps in Myanmar
Use picture version to mobilize community in Peru
Influenced a lot of PS programming in Jordan
Limit harmful practive in Kenya (widespread “trauma
counselling”)
Adopted by 4 ministries Gov in Philippines as policy
Training in Iran informed by and consistent with IASC
Some donors only fund consistent with IASC
Guidelines
Highlight importance of engaging with unusual sectors
on MHPSS
How could the Guidelines be used in Gaza?
Key messages
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IASC Guidelines provide a common framework
and language to communicate and coordinate
with one other during large crises
There is substantial technical know how on how
to meaningfully reduce suffering and this
involves different types of complimentary
supports
Using them effectively must be an ongoing
process involving multiple humanitarian actors
Mapping MHPSS in education
using guideline matrix
Complete matrix