Mental Health and Psychosocial Health Programs Munia Islam School of Public Health Independent University, Bangladesh 02 March, 2018 Session- 15&16 HSC 556 Psycho-Social Dimensions of Behavioral Health

Mental Health and Psychosocial Support in Emergencies: Global Evidences Global Scenario Millions of people around the globe are affected by natural disasters, armed conflict, and other hazards. Large-scale injury and death, insecurity, displacement of people, malnutrition, disease can be the adverse outcome of emergency situations. Economic, political, health, and social institutions can be disrupted. For example, natural disasters caused the deaths of more than 30 000 people, affected 245 million more, and caused an estimated US$ 366 billion in damages in 2011

Mental Health Intervention Challenges Most Common challenges: Rates of mental health problems are increased Weaken mental health infrastructure Coordination difficulties of agencies that providing mental health relief services

Challenge 1: Increasing trend of wide range of mental disorders World Health Organization projections of mental disorders in adult populations affected by emergencies - Type of disorders Before the emergency: 12-month prevalence After the emergency: 12-month prevalence Severe disorder (e.g. psychosis, severe depression, severely disabling form of anxiety disorder) 2–3% 3–4% Mild or moderate mental disorder e.g. mild and moderate forms of depression and anxiety disorders, including mild and moderate PTSD) 10% 15–20% Normal distress (no disorder) No estimate Large percentage

Challenge 1: Increasing trend of wide range of mental disorders Robust studies (using random samples and diagnostic interviews) within conflict- affected population have unfolded that he prevalence of depression and post- traumatic stress disorder (PTSD) increases significantly. People with pre-existing severe mental disorders such as schizophrenia or bipolar disorder and pre-existing or emergency-induced mood, anxiety, and alcohol and drug use disorders becomes more vulnerable. Huge number of people who do not have mental disorders also experience psychological distress.

Challenge 2: Weaken Mental Health Infrastructure Buildings can be damaged Electricity and water supplies can be affected Supply lines for essential medicines can be disrupted Health workers (HW) may themselves fall victim to the emergency situation through injury, death, or forced displacement

HWs need to look after their own families or friends before fulfilling their professional duties- can create critical shortages of qualified HWs As a result of new recruitment, people who were previously receiving mental health care may no longer have access. These treatment gap causes negative economical outcome as poor mental health impedes an individual’s capacity to work productively and can lead rp worsened poverty.

Challenge 3: Coordination difficulties A sudden flow of aid agencies into a country can result in a chaotic situation Failure to coordinate services creates repetition of efforts, while segments of the population remain underserved.

Other challenges Over focus on PTSD can undermine the other mental health problems. Psychological harm may take place because of managing mental health problems without empirical support or which are culturally unsuitab. Stand alone programs can jeopardize the existing mental health infrastructure

Intervention pyramid for mental health and psychosocial support in emergencies Mental Health care mental Health specialists (psychiatric nurse, psychologist, psychiatric etc. ) Specialized services Basic Mental Health care by PHC doctors Basic emotional and practical support by community workers Focused (person- to person) non- specialized supports Activating social networks Communal traditional support Supportive child friendly spaces Strengthening community and family supports Advocacy for basic services that are safe, socially appropriate and protect dignity Social considerations in basic services and security

Mental Health Opportunities Media often focus on the plight of surviving people, including their psychological responses to the stressors they face. In some countries, senior government leaders express serious concern about their nation’s mental health for the first time This is frequently followed by national and international agencies’ willingness and financial ability to support mental health and psychosocial assistance to affected people. Positive mental health has been linked to a range of development outcomes, including better health status, higher educational achievement, enhanced productivity and earnings, improved interpersonal relationships, better parenting, closer social connections, and improved quality of life. Helped to reform the policy for better mental and psychosocial health

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