Statement about the Importance of Psychosocial Resilience and Mental Health and Wellbeing in Humanitarian Crises
The World Humanitarian Summit, Istanbul, Turkey, 23-24 May 2016
Sponsors: International Association of Applied Psychology, Society for the Psychological Study of Social Issues, ATOP Meaningful World, International Council of Psychologists, International Union of Psychological Science, World Council of Psychotherapy, Institute for Multicultural Education and Services, and other Members of the Psychology Coalition of NGOs accredited at the UN
As NGOs accredited at the United Nations we are deeply pleased to endorse the draft statement about health, “Putting health at the centre of collective humanitarian action,” proposed by the health special session for the World Humanitarian Summit. The document addresses the multi-dimensional aspects of health, and comprehensively covers the critical issues for affected populations as well as for health actors, agents and aid workers in emergencies and all humanitarian crises. We recognize that primary concerns of humanitarian aid after emergencies are to provide food, water, sanitation, shelter and medical care. But considerable research and experiences of humanitarian actors on missions worldwide have shown that mental wounds are also critical and deserve immediate attention, especially for children. The emotional sequelae of such emergencies are vast, including suffering from stigma, isolation, fears, and depression. In this statement, emergencies refers to natural and man-made disasters as well as disease outbreaks and epidemics. Mental disorders affect one in four in the world at some point in their lives, and about 20 percent of the world’s youth experience a mental health condition each year. The poor suffer the most. Human dignity, emphasized in the Secretary-General’s report, One humanity: Shared responsibility, is at the core of mental health and well-being.
It is therefore recommended that in the outcome document of the World Humanitarian Summit (WHS) section on “Putting health at the centre of collective humanitarian action,” it should be pointed out that “throughout this document, ‘health’ is defined as ‘physical and mental health and well-being,’ which further includes psychosocial resilience.”
The rationale for including these points is considerable, given that:
- The definition of health in the World Health Organization (WHO) 1948 constitution is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
- Considerable research has been done about the mental health needs for populations after emergencies.Numerous UN conventions and conference outcome documents mention mental health and well-being.
- The relationship is reciprocal between physical and mental health.
- The costs to people is considerable, with 450 million people worldwide suffering, and the cost to governments is estimated to escalate from over $2T to $6T by 2030.
- “Promote mental health and well-being” is included in Goal 3, target 3.4, in the 2030 Agenda for Sustainable Development; additionally, mental health and well-being are cross-cutting issues in the agenda, with strong inter-linkages to poverty eradication, education, women’s and girls’ empowerment, economic growth, climate change, peaceful and inclusive societies and others.
The following recommendations apply to all groups involved in emergencies, with particular emphasis on at-risk and vulnerable populations, e.g. women, children, persons with disabilities, the marginalized and the poor. Further, in all situations, cultural traditions, practices and sensitivities must be respected and considered.
PCUN further recommends that the WHS recommend that all Member States, UN agencies, NGOs, and civil society and humanitarian groups:
I. Ensure that Psychosocial Well-being and Mental Health are Promoted and Fulfilled as Human Rights for Survivors of Emergencies and all Health Workers Human rights standards and documents of UN processes increasingly recognize psychosocial well-being and mental health as basic human rights. Psychological literature and research confirm that maltreatment from abuse, rape, torture, war, and deprivation due to conditions including poverty inflict persistent psychological and mental health wounds. Research further affirms the inclusion by the World Health Organization (WHO) of mental health as a crucial factor in overall health, defined as a “state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community” (WHO website).
II. Promote the Psychosocial Empowerment and Resilience of Disaster Survivors Psychosocial empowerment occurs when people are enabled to participate in decisions affecting them and to exercise some control over their life choices (WHO, 2010). Empowerment is essential to the sustainability of individual and societal progress. Psychosocial empowerment develops in three stages: (1) the reduction of psychological distress and encouragement of social and economic participation; (2) the reduction of isolation through developing social relationships and networks: and (3) the support of rights to voice opinions and participate in decision-making at all levels. Recognizing rights to ownership and participation in decisions is critical to psychosocial empowerment. Empowerment and resilience are protective factors to be nurtured as psychological buffers for avoiding and recovering from stressors and emergencies.
- Highlight the importance of psychosocial resilience, distinct from infrastructural resilience.
- Educate survivors about their human rights and their personal strengths, skills and resources.
- Encourage opportunities for survivors to participate in economic, social and other development activities.
- Provide access to productive employment and decent work, that promotes psychosocial empowerment.
- Strengthen access to quality primary, secondary and higher education asimportant pathways to psychosocial empowerment, decent work, and thealleviation of poverty.
- Provide access to quality mental health care, including accessible multidisciplinary social service centers and mobile vans to provide one-stop services. Include literacy, continuing education, and entrepreneurial training in these centers.
- Use a life-span, rights-based approach to implementation of the Social Protection Floor Initiative to take care of basic needs, including access to mental health care within primary health care, to prevent multigenerational and intergeneration poverty.
- Promote community engagement and the re-integration of survivors into the community.
- Follow established guidelines, e.g. the IASC (Interagency Standing Committee) Guidelines.
III. Eradicate All Forms of Violence Against Survivors of Disasters and Health Workers
- Establish laws against all forms of physical, sexual and psychological violence and institutionalize processes for apprehending and penalizing violators.
- Educate about human rights and all forms of violence, including their social, cultural and psychological causes and consequences in all settings including schools.
- Provide training for health, social services, government, law enforcement and other public service personnel on observance of human rights standards, for detecting and preventing violence.
- Provide human resources, policies, programmes, facilities, and services to promote mental health and psychosocial recovery and well-being of those who have experienced physical, sexual or psychological violence, including services delivered by psychologists or other trained mental health providers.
- Develop research and programme evaluation to assess the effectiveness of strategies to treat, eliminate and prevent violence, and establish a best practices database.
IV. Monitor and Evaluate Progress Monitor and evaluate the effectiveness of policies and programmes for psychosocial support of survivors so that data are available for different ages, races/ethnicities, disability status, cultural origins, and geographic regions.
Supportive Documents and Conferences:
The Hyogo Framework for Action 2005-2015: Building the Resilience of Nations and Communities to Disasters (A/CONF.206/6)recommends social and economic development practices, inparagraph 4,ii,g, to: “Enhance recovery schemes including psycho-social training programmes in order to mitigate the psychological damage of vulnerable populations, particularly children, in the aftermath of disasters.”
Report of the 2012 High-Level Panel on Global Sustainability: Resilient People, Resilient Planet: A Future Worth Choosing (A/66/700) has specific mention: (1) on page 3, in paragraph 8: “More than anything, we need to mobilize public support and excite citizens around the world with the vision of finally building a sustainable world which guarantees the well-being of humanity, while preserving the planet for future generations”; (2) on page 67, in paragraph 198: “Efforts in a number of countries to include happiness and well-being in national progress indicators are also important steps.”
The WHO report, Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group (2010) presents compelling evidence that poor mental health impedes an individual’s capacity to realize their potential, work productivity, and make a contribution to their community.
One Humanity: Shared Responsibility. Report of the United Nations Secretary-General for the World Humanitarian Summit (UNGA 70thsession, Item 73(a) 2 Feb 2016), calls upon global leaders to place “the concern for dignity, safety and the well-being of our citizens at the forefront of all policies, strategies and decision-making.”
An historic conference “Out of the Shadows” in April 2016, sponsored by the World Bank and WHO, resulted in commitment by governments, UN agencies, and civil society to make mental health a global priority.
Kar, N. (2009). Psychological impact of disasters on children: review of assessment and interventions. World Journal of Pediatrics, 5(1), 5-11.
Neria, Y., Nandi, A., and Galea, S. (2007). Post-traumatic stress disorder following disasters: a systematic review. Psychological Medicine, 38(4), 467-480.