MHPSS

What is MHPSS?

Introduction

The suffering caused by humanitarian emergencies can greatly affect people’s mental health and psychosocial well-being, both in the short and long-term. Globally, one in five (22%) people living in areas affected by conflict is estimated to have a mental health condition. Thus, a priority in emergencies needs to be protecting and improving people’s mental health and psychosocial well-being.  

Mental Health and Psychosocial Support (MHPSS) refers to ‘any type of local or outside support that aims to protect or promote psychosocial well-being and/or prevent or treat mental disorder,’ it is thus much broader than clinical interventions/the provision of specialised services (such as consultations by a mental health professional or psychological counselling). 

Humanitarian emergencies create stressors at the individual, family, community, and societal levels, which can have both immediate and long-term consequences. Examples of stressors include family separation, loss of loved ones, disruption of social networks and supports, exposure to violence, food insecurity, loss of livelihoods, poor living conditions, destruction of community structures, physical injuries, lack of information about available services and lack of access to essential services. People affected by emergencies may experience common reactions such as worry, fatigue, anger, and difficulty with sleeping. For the majority, these problems are manageable and improve with time, but for some they will experience impaired daily functioning. 

Mental health and psychosocial ‘problems’ can include a wide range of issues including social problems, emotional distress, common mental conditions (such as depression and anxiety disorders), severe mental health conditions (such as psychosis), alcohol and substance abuse, and intellectual, developmental or cognitive disabilities. The integration of MHPSS into emergency responses can enhance the impact of programming across sectors and can contribute to saving lives. 

Responsibilities

No one organisation or cluster is solely responsible for MHPSS; it is a multi-sectoral and cross-cutting area of work. In emergencies, people are affected in different ways and require different kinds of supports. A key to organising mental health and psychosocial support is to develop a layered system of complementary supports that meets the needs of different groups, as illustrated in the intervention pyramid for MHPSS in emergencies

All aspects of humanitarian response, including the behaviour and attitudes of staff and volunteers, can impact the psychological well-being of affected populations. Therefore, all sectors play a critical role in ensuring that their activities are delivered in a way that promotes mental health and psychosocial well-being (sometimes known as using a “MHPSS approach”).

MHPSS & CCCM Response

The mental health and psychosocial well-being of people residing in camps and camp-like settings is significantly impacted by the extent to which they can participate in decision-making that affects their lives, access information, and access appropriate facilities and services. The distress caused by their displacement can be exacerbated or mitigated depending on the degree to which their sense of agency and independence is promoted or diminished5. CCCM’s core activities, when done well, can contribute towards individual and communal wellbeing, for example through the engagement of site residents in decision making and the provision of support to community-led initiatives.  

The following practical guidance can be used by CCCM actors to integrate MHPSS into their programming, including in needs assessment, monitoring and advocacy, decision-making structures, ensuring sufficient communal space, dignified site environment, and community discussion and accessible feedback and complaint mechanisms.  

• IASC MHPSS Minimum Service Package is a user-friendly guidance containing activities that are considered to be of highest priority in meeting the immediate needs of crisis-affected people. The website allows for actors to filter the activities by sector, so CCCM actors can easily filter by ‘CCCM’ and see those activities that CCCM is well placed to deliver or contribute to the delivery of.  Key Consideration 8: Integrating MHPSS into CCCM programming, provides examples of how MHPSS can be integrated into CCCM programming and the links with different Minimum Standards for Camp Management. 
• IASC Checklist for Field Use on Guidelines on Mental Health and Psychosocial Support in Emergency Settings (2008) Developed as a field version of the 2007 IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, provides checklists for programme planning and emergency response. Readers are encouraged to use this field version in conjunction with the full Guidelines where Action Sheets provide further details. Of particular relevance to CCCM actors are the checklists relating to Human Resources; Community Mobilisation and Support; (parts of) Dissemination of Information; and Shelter and Site Planning. 
• IASC Mental Health and Psychosocial Support in Emergency Settings: What Should Camp Coordination and Camp Management Actors Know? (2014) developed for CCCM actors, based on the 2007 IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. 

See Camp Management Toolkit Chapter 11 Protection of persons with specific needs.

Cluster Responsibilities 

For further details and notes on the relevant Minimum Standards for Camp Management, see Key Consideration 8 of the IASC MHPSS Minimum Service Package: Integrating MHPSS into CCCM programming. 

Actions CCCM Cluster coordination teams should take to support Cluster members to integrate MHPSS into CCCM programming, include to:  

• Share resources on MHPSS with Cluster members, including the IASC MHPSS Minimum Service Package 
• Incorporate MHPSS in CCCM needs assessments 
• Work with MHPSS actors to ensure gaps and needs are monitored, and where gaps remain advocating that they be addressed  
• Ensure CCCM partners are aware of the ways in which humanitarian assistance should be provided to support mental health and psychosocial well-being, including through the activities noted in the IASC MHPSS Minimum Service Package 
• Support CCCM partners to organise orientation or trainings on basic psychosocial support (e.g. psychological first aid) as needed.  
• Work with MHPSS actors to develop key messaging on mental health and psychosocial support, as needed at the cluster level 
• Include consideration of MHPSS as a cross-cutting issue in Cluster strategic planning processes, including the HNO and HRP and CCCM Response Strategy 

Psychological First Aid (PFA)

Key Information

Psychological first aid (PFA) describes a humane, supportive response to a fellow human being who is suffering and who may need support. PFA involves providing practical care and support, which does not intrude; assessing needs and concerns; helping people to address basic needs; listening to people, but not pressuring them to talk; comforting people and helping them to feel calm; helping people connect to information, services and social supports; protecting people from further harm. 

Providing PFA responsibly means to:  

1. Respect safety, dignity and rights. 
2. Adapt what you do to take account of the person’s culture.  
3. Be aware of other emergency response measures. 
4. Look after yourself.  

In a displacement site, site management staff can frequently be the first point of contact for survivors or other affected people who may need help or support. The three basic action principles of PFA presented in the diagram below—look, listen and link—can help CCCM actors with how they view and safely enter a crisis situation, approach affected people and understand their needs, and link them with practical support and information. 

PFA Training

The Global Introduction to CCCM Training touches on PFA in one of the modules (Module 5), which all CCCM actors should have been trained in (see Toolkit Section 8.5 Technical Guidance & Standards – Capacity Building should further support be required in relation to the delivery of this training).  

Training on PFA is sometimes conducted for other humanitarian service providers by protection or MHPSS actors. You can contact the MHPSS Working Group, if there is one, or the Protection Cluster to see if PFA training is available in the response.  

If you would like further support on and/or training in MHPSS (including the Minimum Service Package and PFA), please contact the global CCCM Cluster team to see what can be arranged. 

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