1. Syrian Refugees in Iraq, Jordan, Lebanon and Turkey

2. Syrian refugee numbers increased 7 times since April-12 Government and/or Internationally-Assisted Syrian Refugees 245,183 131,952 96,383 78,137 x2 x7 53,531 33,789 x3 x4

3. Syrian refugees in only three months… Lebanon Jordan Turkey More than tripled in Jordan Iraq More than doubled in Lebanon More than tripled in Turkey More than tripled in Iraq

4. Turkey Syrian Arab Republic Iraq Jordan Lebanon 245,183 Syrian refugees assisted in Iraq, Jordan, Lebanon and Turkey as of 5 September 2012 80,410 18,681 64,636 81,456 Damascus Homs Aleppo Europe 15,000 Syrian asylum claims North Africa 4,733

5. 75 percent of Syrian refugees are women and children Note: Demographic breakdown is not available for refugees registered in Iraq © UNHCR/J.Ghosn 2012 More than half are children

6. Internally Displaced Persons in Syria 3 Phases of Multiple Displacement

7. Phase 1: Temporary & sparse 1

8. Phase 2: Exacerbated displacement to urban centers 2

9. Phase 3: Displacement within urban centers 3

10. Syrian Humanitarian Response Plan (SHRP) and Sector Structure

11. 1 st SHRP in June 2012, currently revised Planning figures: – 3 Mio affected – 2.5 Mio in urgent need of humanitarian assistance – incl. 1.2 Mio who had to leave their homes Aims at supporting Government’s efforts in providing humanitarian assistance Background

12. Community Services Education Food Health and Nutrition Livelihoods NFIs/Shelter WASH Coordination Logistics and Emergency Telecommunications Staff Safety Services 10 Sectors / 58 Projects

13. PSS MH Coordination PSS MH Sub-working group

14. Technical sub-working group Main purpose: ensure coordination, provide technical advice Primarily reporting to Community Services and Health Sector working groups Responsibilities: – Coordination, Inter-agency collaboration, Mainstreaming and coherence/harmonization of action – Coordination of assessments and sharing results, helping identification of priority needs and mapping resources available – Technical support, Information sharing and regular update – Advocacy for integrated, comprehensive, multi-layered and complementary approaches in providing appropriate MHPS supports and services – Sharing existing tools, training materials and other related documents and discussing the lessons learned PSS MH Sub-working group

15. Group Structure: – > 20 members from 13 organizations – Technical staff from UN agencies (Unicef, UNHCR, UNFPA, WHO, UNRWA, UNDP) – NGO and national members from SARC, DRC, DRC, IMC, PU, Syria Trust, Tdh It, and others – Chairs (Unicef and UNHCR) Regular Meetings (2-3 weeks) Technical cross-sectoral PSS MH framework Current Support Activities – 4 Ws mapping – Preparing stand alone mixed method PSS MH Needs Assessment – Preparing materials PSS MH Sub-working group

16. Nine-day UN-OIC joint mission, March 2012  Mental health and psycho-social support were found to be one of the most urgent needs due to the crises  Planned Interagency mixed method MH PSS needs assessment Impact of the Situation on MH /WB Stakeholders perception, August 2012 (N:14) Psychological well-being: Social well-being: 1. Fear 1. Separated and scattered families 2. Anxiety 2. Lack of social support, social relations 3. Grief, Mourning, Bereavement 3. Change in gender roles, lack of activities 4. Depressed mood and loss of trust Resources: Adaptation, Acceptance, Community outreach &support, new social networks, involvement in planning, activated charities, NGOs & volunteerism Key concern: Increased family and sexual violence

17. Lack of joint N/A and common tools Lack of field coordination Primary capacity building focus on PFA (> 1800 trainees) Focus on supports and services in urban areas Limited integration of MH and CM in PhC Lack of monitoring regarding access to hospitals and availability of medication 4 W Mapping Trends

18. Benefit from solid refugee response Flexibibility and adjustment re communication, logistics, coordination and services Physical safe spaces remain open depending on security and access, in addition many services go mobile (community based and specialized), re-grouping Shift capacity building focus from PFA to more advanced PSS MH training Re-emphasize coordination and field coordination More emphasis on mainstreaming into other sectors Adjusted Response

19. UNHCR Syria, PSS MH Programme

20. Capacity-Building for > 500 trainees 10% Human Resources 39% Financial Resources Comprehensive PSS MH Case Management for > 6700 Beneficiaries 43% Human Resources 27% Financial Resources Community Based PS Outreach & Psychosocial Center / Safe Spaces for > 1900 Beneficiaries 40% Human Resources 27% Financial Resources Transition to national partner organization Assessment Management Supervision Coordination Monitoring Evaluation Documenation 7% HR & Financial Resources Staff Stress Counseling  Established in 2008  3 complementing, linked components  Total Number of Beneficiaries 2008-2012: > 9100 Mainstreaming PSS MH into other sectors UNHCR Syria, PSS MH Programme Components

21. 1. PSS MH Case Management Standard operating procedures and training package 2. Community Based PS Support / Safe Spaces & Outreach Standard operating procedures and training package Tools in Development

22. Best/Good Practice Guides – Suggestion to write BP Guide on 1) MH PSS CM & 2) CB PSS comparing different model programs – Integrate both subjects as 1 day workshops in next urban PSS MH programming conference – Publish Outcome of workshops With particular attention to specific characteristic of Urban & Protracted & Multiple Displacement Settings Tools Missing

23. UNHCR Global Updates Independent global evaluation / review of PSS MH programmes in UNHCR is ongoing Development of operational guidance for MH PSS for refugee operations Offer to host RG meeting in Geneva next year