Psychosocial support in emergencies - Basic principles -

Awareness raising module for Health ERU staff

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Definitions of psychosocial support

“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)5

Aim of psychosocial support in emergency settings

•To assist affected people and communities in their collective recovery

•This means assisting them to Regain a sense of

normality Restore hope and dignity Improve psychological and

social well-being Attain a stable life and

integrated functioning

Terminology

Factors influencing psychosocial well-being

Physical reactions Emotional reactions Behavioural reactions

Physical pain, e.g. headache or aches in stomach

Feelings of fear and anxiety Change in temperament

Shortness of breath Loss of energy and motivation

Estrangement from friends and family

Tightness in chest Inability to make decisions, concentrate, remember

Apathy, inability to work

Disturbed sleep or nightmares

Feelings of numbness or detachment

Lost faith and spirituality

Fatigue or exhaustion Strong emotional reactions, e.g. anger, irritability, sadness

Loss of interest in care of family and self

Abdominal discomfort Hopelessness or helplessness

Change in interest in food or pleasure

Commonly recognised symptoms and reactions of stress

Meeting needs at different levels

The nature and origin of psychosocial problems

Social problems include Psychological problems include

Pre-existing problems

Belonging to a group that is discriminated against or marginalised; political oppression

Severe mental disorder; depression, alcohol abuse

Emergency-induced problems

Family separation; disruption of social networks; destruction of livelihoods, community structures, resources and trust

Grief, non-pathological distress; alcohol abuse; depression and anxiety disorders, including post-traumatic stress disorder (PTSD)

Humanitarian aid-induced problems

Undermining of community structures or traditional support mechanisms; exclusion due to lack of access to services

Anxiety due to a lack of information about food distribution; aid dependency

Ensuring protection from further harm

Potentially vulnerable groups:• Women • Men• Children• Elderly• Those who are mentally ill

Always verify during assessment who are the vulnerable group/s

Key tools and resources

• Inter-Agency Guidelines on Mental Health and Psychosocial Support in Emergencies (2007)

• Sphere Handbook (2004 edition) pp. 291-294

• ERU Psychosocial support component – Delegate manual and Resource folder

Sphere social indicators - 1

• Access to Information• Maintain normal cultural and religious events• Formal or informal schooling for children and

recreational activities (safe places)• Participation in concrete, purposeful activities• Shelter for displaced, with the aim of keeping

families and communities together

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Sphere social indicators - 2

• Special attention to facilitate social networks for isolated persons – orphaned children, – child combatants, – Widows and widowers, – elderly

• Tracing services, reunite families• Consult the community

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Sphere psychological indicators

• Psychological First Aid to individuals that experience acute mental distress

• Referral of urgent psychiatric complaints to primary health care system (if available)

• Ensure continuation of treatment of individuals with pre-existing psychiatric disorders

• In case of protracted emergency take steps to develop a more comprehensive range of community-based psychological interventions for the post-disaster phase

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Possible early intervention activities

Group work – option A

Psychosocial effects of disasters• Read through the report that your group is being

given• Discuss the possible psychosocial consequences of

this particular emergency• Report back to plenary describing your

understanding of the situation and what would be the suitable ERU psychosocial interventions

Psychosocial role plays• Read through the role play that your group is being

assigned• Assign the roles to group members• Play through the role play – do not try to act but be

the role• Provide feedback to other group as assigned by

instructor

Group work – option B

Background• Previous ERU deployments have

shown high numbers of patients presenting multiple somatic complaints

• Very little possibility to assist this group in the ERU context

• The Federation has wished to address this issue through the establishment of a psychosocial support component for inclusion in the health ERU

ERU psychosocial support component

Purpose of the ERU psychosocial component

Terminology

Limitations

What the psychosocial component and its delegate/volunteers will NOT do

• Perform mental health triage• Engage in treatment of psychiatric disorders• Counselling conducted by volunteers• Deal with stress or psychological problems of ERU

staff

1. Three psychosocial kits 2. Information education and communication

materials3. Manual for delegates and training purposes4. Training requirements for health ERU staff

ERU Psychosocial support component

1. Establishment of three kits

1. Play and activity items for children aged zero to six years old

2. Play and activity items for children aged six to 18 years old

3. Training kit to enable facilitation of trainings, workshops and group activities

Complete items overview brochure lists all items in kits

2. Information education and communication (IEC) materials

3. Delegate manual

• Provides background and supports the work of the delegate as described in the job description

• Enables the implementation of ERU psychosocial support component and contains training programmes for volunteers

• Draft version - the manual will be finalised based on feedback and field testing

• To be harmonised with and integrated into the package of ERU manuals

4. Training requirements for ERU staff

Two-tier approach developed

1. General orientation and practical exercise for all health ERU staff (three hours)

2. In-depth training for ERU psychosocial delegates (three days)

Tier 2 - Pilot training workshop

• 3-day workshop held in Oslo in February• 19 participants - five National Societies + one

Federation delegate• All potential psychosocial delegates with field

experience• Aim of training

To convey key messages and practise modes of intervention for future delegates

To test the materials and approaches developed-

Role of psychosocial delegate

The overall task of the psychosocial delegate • Set up the psychosocial component where appropriate in

the vicinity of the ERU• Interface with ERU colleagues, agree on modes of

collaboration• Take part in health assessment activities with specific

focus on psychosocial issues• Assess existing mental health and psychosocial resources • Interact with Host National Society to identify volunteers

• Facilitate training of volunteers in psychological first aid and emotional support

• Instruct volunteers on how to organise games and play activities for children

• Launch psychosocial activities• Organise outreach activities• Inform ERU team members on psychosocial issues • Liaise with local health authorities, WHO, UNICEF and

others • Continuously asses, monitor and evaluate needs and

activities

Role of psychosocial delegate

Delegate role – key features

Delegate must possess • communication skills necessary to enable close

collaboration with community leaders • pedagogical skills to transfer knowledge and skills to

community volunteers who will conduct most of the activities

• holistic public health oriented approach to health in emergencies and related sectors

• a the view that culture, belief systems, established habits, attitudes, behaviour, and religion are to be respected and leveraged to facilitate improvements in the health of the public

Thank you! Questions and comments?