1. 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

2. 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 people, affected 245 million more, and caused an estimated US$ 366 billion in damages in 2011

3. 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

4. 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

5. 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.

6. 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

7. 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.

8. 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.

9. 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

10. 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

11. 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

12. Who Service organization Pyramid
Building bake better (page 20)