Addressing Community Mental Health
Community mental health is a vast concept with various initiatives and programmes under its umbrella. The area chosen for the purpose of the assignment is to address community mental health initiative addressing psychosocial needs of the people who have experienced massive forced displacement and/or identify as refugees. People migrate due to economic crisis, natural disasters, construction of dams and various others reasons that lead them into search for other opportunities, away from conflict and violence. There has been an observed increase in the number of refugees in low income nations (host community) with limited mental health care resources. Inflow of people further restricts the economy which impacts health, social, housing and educational
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capacities of the host nation. (World Bank, 2016)
Mental health is often not regarded as a significant aspect of healthcare.
This leads to insufficient allocation of resources towards promotion of mental health by the government, practitioners and the society itself. Mental illness comes with a sense of stigma and with marginalised population; proving mental health care becomes even more difficult due to challenges such as discrimination, lack of awareness, social support and resources. Most commonly reported mental disorders in the refugee populations are emotional disorders, such as depressive and anxiety disorders, including post-traumatic stress disorder (PTSD), generalized anxiety, panic attacks, adjustment disorder, and somatisation. However, they also possess skills and labour expertise that if encouraged would benefit the community.
The refugees experience pre-flight, flight and resettlement (World Bank, 2016). Pre-flight phase includes loss of family members, belongings, witness killings including physical and emotional trauma. Flight phase includes the journey to the host location including travelling, experience at camps and detention centres and further stressors. The third phase i.e. resettlement includes loss of identity, familiarity, community and language along with the struggle to adopt new culture and adapt to new …show more content…
surroundings.
One innovative CMH initiative in this area is the United Nations High Commissioner for Refugee (UNHCR) Mental Health Psychosocial services (MHPSS) Programme in Syria.
Description of the programme: In 2003, the beginning of war in Iraq led to an impact on Syria with an emergency situation in 2006 as a rush of Iraqi refugees from the urban areas began to migrate. In 2008, the UNHCR responded to the refugee crisis through a MHPPS Programme. The programme identified vulnerable persons at high risk and provided them with mental health care and psychosocial services. In order to achieve this goal it addressed issues such as need to eradicate stigma and discrimination against refugees and mental illness, and build capacity for the volunteers and other mental health care professionals.
The objective of the programme was to identify both, persons at high risk and other normative communal reactions and provide them with mental health care through psychosocial centres that were set up and worked towards community outreach, with link to livelihood projects. The programme’s long term goal was to build a national and community capacity for mental health and psychosocial services.
The programme was divided into three components namely, a) Case Management, b)Community Outreach and c) Capacity Building.
The aim of the first component, i.e., Case management, is to provide people with psychosocial assistance and mental health services by coordinating access and delivery of these services for refugees and other persons of concern. In order to achieve the first component, psychosocial centres were set up that worked towards ensuring continuity of care for both persons at high risk and people with basic psychosocial needs. According to the programme, while the former is high priority and requires more intensive case management with an immediate response, the latter is lower priority and often improves with focused supportive case management through family and community. On average, the MHPSS case management teams manage more than 1,400 people of concern, per year. According to data (Quosh, 2013), 63% of more than 6,000 cases between 2008-12 were referred to and received psychosocial care.
The second component envisaged a refugee volunteer programme for an urban, community based outreach by creating safe, healing spaces such as the psychosocial centre.
These spaces were then able to utilised to provide improved social support and empower the capacity of refugees as individuals and as a community. The activities conducted in these spaces such as yoga and peer support groups are separated by gender. A mixed gender group is employed for glass painting and handicraft sessions. One of the critiques of the programmes suggested that there was a lack of income generating activities which were integral for survival and development of the community. The programme in response established stronger links to self reliance and livelihood programmes. Data on the outcome of this initiative was not found.
Community outreach addressed issues such as alienation, stigma and challenges faced in having access to support and services. A large team of volunteers, almost 140, was divided into different sectors of the programme such as MHPSS, health, education, care of minors and elderly. This provided a multidisciplinary framework supporting the principle of community caring for the community thus, establishing the concept of “collective healing” as there is personal well being by helping others. This helped UNHCR maintain a direct and meaningful contact with the community and its resources and
networks.
The third component of the programme was to address resource gaps and generate interdisciplinary capacity building of volunteers and professionals in terms of knowledge, skills and competencies thus “fostering multi-professional teamwork and advocacy”. More than 660 trainees have benefited from the initiative which was achieved by mainstreaming psychosocial considerations into their activities. This component of the programme also addressed the psychosocial capacities and needs of humanitarian workers, especially the volunteers as they are one of the strongest resources of the programme. The staff stress counselling programme (SSCP) of UNHCR Syria provides staff support through acceptance of stress management as a tool. Internal individual and group peer support systems and confidential referral and fee compensation for quality mental health services, as well as joint initiatives to improve the office environment, team communication and cohesion, vision development and performance management, and feedback to management were also included in the initiative.
Effectiveness of the programme: Since 2008-12, the programme has served more than 10,000 persons of concern in Syria. The functioning of the identification system was evaluated and it was found that well being improved significantly through services provided by MHPSS programme through both specialised mental health services and community based psychosocial support. This improvement was most observed due to the pool of outreach volunteers.
capacities of the host nation. (World Bank, 2016)
Mental health is often not regarded as a significant aspect of healthcare.
This leads to insufficient allocation of resources towards promotion of mental health by the government, practitioners and the society itself. Mental illness comes with a sense of stigma and with marginalised population; proving mental health care becomes even more difficult due to challenges such as discrimination, lack of awareness, social support and resources. Most commonly reported mental disorders in the refugee populations are emotional disorders, such as depressive and anxiety disorders, including post-traumatic stress disorder (PTSD), generalized anxiety, panic attacks, adjustment disorder, and somatisation. However, they also possess skills and labour expertise that if encouraged would benefit the community.
The refugees experience pre-flight, flight and resettlement (World Bank, 2016). Pre-flight phase includes loss of family members, belongings, witness killings including physical and emotional trauma. Flight phase includes the journey to the host location including travelling, experience at camps and detention centres and further stressors. The third phase i.e. resettlement includes loss of identity, familiarity, community and language along with the struggle to adopt new culture and adapt to new …show more content…
surroundings.
One innovative CMH initiative in this area is the United Nations High Commissioner for Refugee (UNHCR) Mental Health Psychosocial services (MHPSS) Programme in Syria.
Description of the programme: In 2003, the beginning of war in Iraq led to an impact on Syria with an emergency situation in 2006 as a rush of Iraqi refugees from the urban areas began to migrate. In 2008, the UNHCR responded to the refugee crisis through a MHPPS Programme. The programme identified vulnerable persons at high risk and provided them with mental health care and psychosocial services. In order to achieve this goal it addressed issues such as need to eradicate stigma and discrimination against refugees and mental illness, and build capacity for the volunteers and other mental health care professionals.
The objective of the programme was to identify both, persons at high risk and other normative communal reactions and provide them with mental health care through psychosocial centres that were set up and worked towards community outreach, with link to livelihood projects. The programme’s long term goal was to build a national and community capacity for mental health and psychosocial services.
The programme was divided into three components namely, a) Case Management, b)Community Outreach and c) Capacity Building.
The aim of the first component, i.e., Case management, is to provide people with psychosocial assistance and mental health services by coordinating access and delivery of these services for refugees and other persons of concern. In order to achieve the first component, psychosocial centres were set up that worked towards ensuring continuity of care for both persons at high risk and people with basic psychosocial needs. According to the programme, while the former is high priority and requires more intensive case management with an immediate response, the latter is lower priority and often improves with focused supportive case management through family and community. On average, the MHPSS case management teams manage more than 1,400 people of concern, per year. According to data (Quosh, 2013), 63% of more than 6,000 cases between 2008-12 were referred to and received psychosocial care.
The second component envisaged a refugee volunteer programme for an urban, community based outreach by creating safe, healing spaces such as the psychosocial centre.
These spaces were then able to utilised to provide improved social support and empower the capacity of refugees as individuals and as a community. The activities conducted in these spaces such as yoga and peer support groups are separated by gender. A mixed gender group is employed for glass painting and handicraft sessions. One of the critiques of the programmes suggested that there was a lack of income generating activities which were integral for survival and development of the community. The programme in response established stronger links to self reliance and livelihood programmes. Data on the outcome of this initiative was not found.
Community outreach addressed issues such as alienation, stigma and challenges faced in having access to support and services. A large team of volunteers, almost 140, was divided into different sectors of the programme such as MHPSS, health, education, care of minors and elderly. This provided a multidisciplinary framework supporting the principle of community caring for the community thus, establishing the concept of “collective healing” as there is personal well being by helping others. This helped UNHCR maintain a direct and meaningful contact with the community and its resources and
networks.
The third component of the programme was to address resource gaps and generate interdisciplinary capacity building of volunteers and professionals in terms of knowledge, skills and competencies thus “fostering multi-professional teamwork and advocacy”. More than 660 trainees have benefited from the initiative which was achieved by mainstreaming psychosocial considerations into their activities. This component of the programme also addressed the psychosocial capacities and needs of humanitarian workers, especially the volunteers as they are one of the strongest resources of the programme. The staff stress counselling programme (SSCP) of UNHCR Syria provides staff support through acceptance of stress management as a tool. Internal individual and group peer support systems and confidential referral and fee compensation for quality mental health services, as well as joint initiatives to improve the office environment, team communication and cohesion, vision development and performance management, and feedback to management were also included in the initiative.
Effectiveness of the programme: Since 2008-12, the programme has served more than 10,000 persons of concern in Syria. The functioning of the identification system was evaluated and it was found that well being improved significantly through services provided by MHPSS programme through both specialised mental health services and community based psychosocial support. This improvement was most observed due to the pool of outreach volunteers.