BMJ Global Health2020;5:e002014. doi:10.1136/bmjgh-2019-002014
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The MHPSS MSP is an easy-to-follow intersectoral package, which spells out the activities and actions that all humanitarian actors should put in place in all emergencies for an effective MHPSS response. It speaks to different actors at the global, regional, national, and local levels to plan, coordi...nate and implement an effective MHPSS response.
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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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Specific action sheets offer useful guidance on mental health and psychosocial support and cover the following areas coordination assessment monitoring and evaluation protection and human rights standards human resources community mobilisation and support health services education dissemination of i...nformation food security and nutrition shelter and site planning and water and sanitationthe guidelines include a matrix with guidance for emergency planning actions to be taken in the early stages of an emergency and comprehensive responses needed in the recovery and rehabilitation phases
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Armed conflicts and natural disasters cause significant psychological and social suffering to affected populations. The psychological and social impacts of emergencies may be acute in the short term, but they can also undermine the long-term mental health and psychosocial well-being of the affected ...population. These impacts may threaten peace, human rights and development. One of the priorities in emergencies is thus to protect and improve people’s mental health and psychosocial well-being.
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This brief document aims to provide a framework for WHO assistance in this area.
The CB MHPSS operational guidelines were developed in response to emerging evidence on the determinants of children’s resilience, lessons learned from the evaluation of existing approaches, and the unique challenges that today’s crises pose for children’s safety, wellbeing and optimal developm...ent.
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Despite growing evidence on the impact of psychosocial support interventions, there is an urgent need for a stronger evidence base on approaches that effectively support children affected by armed conflict. To contribute to this evidence base, and building on a pilot study conducted in Uganda in 200...9, War Child conducted an exploratory outcome evaluation of its psychosocial support intervention ‘I DEAL’ in South Sudan and Colombia in 2012. The objective of the evaluation was to explore the outcomes that I DEAL achieves for children and the factors that influence the achievement of those outcomes to further inform and strengthen the intervention
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Lunsar, Port Loko District, Sierra Leone
This paper was commissioned by the German Federal Ministry for Economic Cooperation and Development (BMZ) in 2015, and produced by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, in cooperation with German civil society actors and freelance psychologists working in the field... of Mental Health and Psychosocial Support (MHPSS) with refugees and internally displaced people (IDP) in both the Middle Eastern region and Germany. The commission arose from BMZ’s wish for guidance on the characteristics of good working practices in MHPSS and the desire expressed by GIZ’s civil society partners in the regional programme Psychosocial Support for Syrian and Iraqi Refugees and Internally Displaced People for more intensive dialogue to promote MHPSS in the context of the Syria and Iraq crises.
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Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ...ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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