This WHO report shares detailed accounts from 10 diverse emergency-affected areas, each of which built better-quality and more sustainable mental health systems despite challenging circumstances. Cases originate from countries small to large; low to middle-income; across Africa, Asia, Europe, and the Middle East; and affected by large-scale natural disasters, prolonged conflict, and large-scale influxes of refugees. While their contexts varied considerably, all were able to convert short-term interest in population mental health into sustainable, long-term improvements.
This WHO report goes beyond aspirational recommendations by providing detailed descriptions of how mental health reform was accomplished in these situations. Importantly, case contributors report not only their major achievements, but also their most difficult challenges and how they were overcome. Key overlapping practices emerging from these experiences are also summarized.
This report provides the proof of concept that it is possible to build back better, no matter how weak the existing mental health system or how challenging the emergency situation. I call upon all readers to take steps to ensure that those faced with future emergencies do not miss the important opportunity for mental health reform and development.
– Dr Margaret Chan, former Director-General WHO
Executive summary available in Arabic, Chinese, English, French, Russian and Spanish here.
“Today, there is no shortage of countries in conflict. UN estimates suggest that in 2019, nearly 132 million people in 42 countries around the world will need humanitarian assistance resulting from conflict or disaster. Nearly 69 million people worldwide have been forcibly displaced by violence and conflict, the highest number since World War II.
Fortunately, there’s a lot we can do to help them. Indeed, there’s a lot we are doing.
In 2019 WHO is addressing mental health in countries and territories with populations affected by large-scale emergencies across the world, in Bangladesh, Iraq, Jordan, Lebanon, Nigeria, South Sudan, Syria, Turkey, Ukraine and the West Bank and Gaza Strip, among others.
In many countries in the world, ignorance about mental health and mental illness remains widespread. The uptake of mental health care during conflict and other emergencies, in countries where such support has been limited, can lead to the identification of people who are tied up, locked in cages, hidden from society. In many cases, it is this very support that helps dispel myths about mental illness and leads to treatment and care and a path towards a more dignified life.
We have also learned that, when the political will exists, emergencies can be catalysts for building quality mental health services”, Dr Mark van Ommeren, WHO
While the conflict in Syria rages on, one psychiatrist and several psychologists, all of them Syrian refugees, have founded Syria Bright Future, a volunteer organisation that provides psychosocial and mental health services to Syrian refugees in Jordan. This field report describes how the organisation assists families in settling after their harsh journey, in adapting to new living conditions and circumstances, coping with difficulties they encounter and strengthening their resilience. Syria Bright Future does this by providing short term support and counselling, and by referring individuals and families to other international and Jordanian organisations, or to informal support networks of Syrian refugees for further assistance.
Reveals a disparity between refugee camps and urban areas: in camps there is a greater awareness about the needs of the disabled and better services than in urban environments, where refugees with disabilities are unable to access services offered by the host government and virtually no one is providing special assistance to them. The Women’s Refugee Commission also found greater discrimination and stigmatization towards the mentally disabled population; assistance programs, when available, tend to focus on those with physical and sensory disabilities.
Children are particularly at risk of harm and ill-treatment resulting from deprivation of liberty, a situation which is clearly recognized in international standards. This Handbook sets out the relevant provisions of the human rights standards that apply to monitoring places of detention for children, and provides guidance on implementing these in practice. PRI has a long experience in assisting states to implement international standards in the field of penal reform and juvenile justice and is well-placed to provide this expert guidance.