Psychosocial Support in the IFRC APDC Definitions Any

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Psychosocial Support in the IFRC APDC

Psychosocial Support in the IFRC APDC

Definitions “Any type of local or outside support that aims to protect or promote

Definitions “Any type of local or outside support that aims to protect or promote psychosocial well-being and/or prevent mental disorder” (IASC Guidelines for Mental Health and Psychosocial Support) “Psychosocial support is a process of facilitating resilience within individuals, families and communities. Through respecting the independence, dignity and coping mechanisms of individuals and communities, psychosocial support promotes the restoration of social cohesion and infrastructure” (IRFC Psychosocial Framework)

What is psychosocial support? • Psychosocial support refers to actions that address psychological and

What is psychosocial support? • Psychosocial support refers to actions that address psychological and social needs of individuals, families and communities. • Psychosocial support can be delivered in specific programmes or be integrated within other activities. • The IFRC approach to psychosocial support is: – A community based approach to facilitate the resilience of the affected population. – A means of maintaining health and well-being of staff and volunteers.

Why provide psychosocial support? • Mobilizing early and adequate psychosocial support can prevent distress

Why provide psychosocial support? • Mobilizing early and adequate psychosocial support can prevent distress and suffering from developing into something more severe. • Psychosocial support helps people affected by crises to recover.

Factors affecting the psychosocial impact of crisis events 1. Characteristics of the event –

Factors affecting the psychosocial impact of crisis events 1. Characteristics of the event – – – – Natural versus man-made Intentionality Degree of preventability Scope of impact Suffering Degree of expectedness Duration of the event 2. Crisis/post-crisis environment – – – Weather Time of day Accessibility to area Amount of physical destruction Number of deaths Number of child deaths

Factors affecting the psychosocial impact of crisis events 3. Individual characteristics – – –

Factors affecting the psychosocial impact of crisis events 3. Individual characteristics – – – – Age - stage of life Mental health Social support systems Disabilities Social economic status Religion Disaster history Previous traumatic experiences 4. Family and community resources – – – Nature of relationship between children and caregivers Active social networks Community cohesion Religious system and rites Economic/educational opportunities

Psychosocial impact of crisis events Positive aspects Negative aspects • • • Reinforcing social

Psychosocial impact of crisis events Positive aspects Negative aspects • • • Reinforcing social fabric Cohesion Altruism, helping each other Empathy and understanding Positive meaning making Resilience Responsibility Preventing new disasters Increased preparedness Health improvement Fragmentation of human bonds Conflict Individualism Psychic numbing, denial Erosion of sense of community Vulnerability No sense of responsibility No plans for the future Hyper vigilance, overreactions Health deterioration Dr. Atle Dyregrov

How do we provide PSS? • Promote sense of safety • Calm anxiety and

How do we provide PSS? • Promote sense of safety • Calm anxiety and decrease physiological arousal • Increase self- and collective efficacy • Encourage social support and bonding • Instill hope and sense of positive future Stevan E. Hobfoll

How do we provide psychosocial support? Intervention pyramid for mental health and psychosocial support

How do we provide psychosocial support? Intervention pyramid for mental health and psychosocial support in emergencies

Matching needs

Matching needs

IFRC PSS resources • • Psychosocial Interventions – a handbook Community Based Psychosocial Support.

IFRC PSS resources • • Psychosocial Interventions – a handbook Community Based Psychosocial Support. The Children’s Resilience Programme. Caring for Volunteers – a toolkit. Emergency Response Unit PSS. Lay counselling. Psychosocial Life Skills (pending).

IFRC Reference Centre for PSS Established in 1993 to support National societies and the

IFRC Reference Centre for PSS Established in 1993 to support National societies and the IFRC secretariat to promote psychosocial wellbeing of staff, volunteers and beneficiaries. www. ifrc. org/psychosocial

IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings • a set

IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings • a set of minimum multi-sectoral responses to protect and improve people’s mental health and psychosocial well-being in the midst of an emergency • To be achieved through coordinated effort from various agencies

Core Principles 1. Human rights and equity 2. Participation 3. Do no harm 4.

Core Principles 1. Human rights and equity 2. Participation 3. Do no harm 4. Building on available resources and capacities 5. Integrated support systems 6. Multi-layered supports

Matrix of Interventions Emergency Preparedness Minimum Response Comprehensive Response Coordination Assessment, monitoring and evaluation

Matrix of Interventions Emergency Preparedness Minimum Response Comprehensive Response Coordination Assessment, monitoring and evaluation Protection and human rights standards Human resources Community mobilization and support Health services Education Dissemination of information Food security and nutrition Shelter and site planning Water and sanitation Common functions across domains Core mental health and psychosocial support domains Social considerations in sectoral domains

An example: Type of Information Including 1. Relevant demographics and contextual information üSize of

An example: Type of Information Including 1. Relevant demographics and contextual information üSize of (sub-)population üMortality and threats of mortality üAccess to basic physical needs (eg. Food, shelter, water and sanitation, health care) and education üHuman rights violations and protective frameworks üSocial, political, religious and economic structures and dynamics üChanges in livelihood activities and daily community life üBasic ethnographic information on cultural resources, norms, roles and attitudes

An example: Type of Information Including 2. Experience of the emergency üLocal people’s experiences

An example: Type of Information Including 2. Experience of the emergency üLocal people’s experiences of the emergency (perceptions of events and their importance, perceived causes, expected consequences) 3. Mental health and psychosocial problems üSigns of psychological and social distress, including behavioral and emotions problems üSigns of impaired daily functioning üDisruption of social solidarity and support mechanisms üInformation on people with severe mental disorders 4. Existing sources of psychosocial well-being and mental health üWays in which people help themselves and others üWays in which the population may previously have dealt with adversity üTypes of social support and sources of community solidarity

An example: Type of Information Including 5. Organizational capacities and activities üStructure, locations, staffing

An example: Type of Information Including 5. Organizational capacities and activities üStructure, locations, staffing and resources for mental health care in the health sector and the impact of the emergency on services üStructure, locations, staffing and resources of psychosocial support programs in education and social services and the impact of the emergency on services üMapping psychosocial skills of community actors üMapping of potential partners and the extent and quality/content of previous MHPSS training üMapping of emergency MHPSS programs 6. Programming needs and opportunities üRecommendations by stakeholders üExtent to which key actions outlines in IASC guidelines are implemented üFunctionality of referral systems between and within health and other social, education, community and religious sectors

More references for conducting assessment

More references for conducting assessment

How to obtain these information? Qualitative Methods: ØKey Informant Interviews • Who is where,

How to obtain these information? Qualitative Methods: ØKey Informant Interviews • Who is where, when, doing what (4 Ws) in mental health and psychosocial support: Summary of manual with activity codes • Checklist for site visits at institutions in humanitarian settings • Checklist for integrating mental health in primary health care (PHC) in humanitarian settings • Participatory assessment (with general community members/ community leaders/ people who are severely affected)

Participatory Assessment 1. Free listing (problems + descriptions) 2. List of mental health psychosocial

Participatory Assessment 1. Free listing (problems + descriptions) 2. List of mental health psychosocial problems 3. Ranking/ Voting 4. Top 3 (or whatever problems that you can manage) priority problems 5. Their impact on daily functioning and coping

How to obtain these information? Quantitative Methods: • validated scales and questionnaire in the

How to obtain these information? Quantitative Methods: • validated scales and questionnaire in the local communities • IASC’s Multi cluster/sector Initial Rapid Assessment (MIRA; IASC, 2012) • Humanitarian Emergency Setting Perceived Needs Scale (HESPER; WHO, 2011)

MHPSS operational challenges • Lack of awareness of mental health and psychosocial well-being among

MHPSS operational challenges • Lack of awareness of mental health and psychosocial well-being among community leaders • When conducting quantitative needs assessments: Ø Translations of scales. Ø Enough sample size. Ø Training of interviewers/ translators. • Human resources: lack of qualified local MH/PSS specialists, staff, volunteers. • Local staff/volunteers overwhelmed or traumatised. • High levels of stress cause psycho-somatic effects - as a result health facilities may be overloaded. • Tracing services not always available. • Monitoring and evaluation – developing measurable indicators

Thank you

Thank you