An almost textbook definition of mainstreaming is to integrate something into another so seamlessly, that it becomes unseen as a separate entity. It does not stand out as an add-on, but is interwoven into the very fabric of being. It has been a long held hope and goal of many who have worked with Intervention that one day the proper attention to mental health and psychosocial support will be interwoven into the very fabric of all humanitarian aid work. With this issue, we hope to have taken one step closer to that goal, by proudly presenting a Special section: ‘Mainstreaming psychosocial approaches into other sectors’.
For this section, we have collaborated closely with two special guest editors: Rebecca Horn (an independent psychosocial specialist, member of the Church of Sweden psychosocial roster and a member of Intervention's Editorial board) and Djoen Besselink (a social psychologist and consultant specialising in psychosocial humanitarian interventions and management). Additionally we are very grateful to UNICEF and the Church of Sweden for having made these extra pages financially possible.
This is far from the first time that Intervention has focused on how mental health and psychosocial support (MHPSS) should be integrated into other fields. Indeed it has been a subject that has been interwoven into the journal for the past decade. In 2006, Williamson and Robinson pleaded for an integrated model in these pages. In the Introduction to the Special section our Guest editors elaborate on this and discuss the differences between an intervention and an approach. The key element of mainstreaming MHPSS into other sectors is that MHPSS becomes an approach, meaning that all of those involved in aid work think and look through a MHPSS lens, even if working in completely different sectors. This is not something that is easy to show, or to highlight, as if achieved it remains often unseen. For that reason, it is also essential that policy makers and funders are aware how important proper attention to include MHPSS in all sections of humanitarian aid is for beneficiaries. That means that advocacy also needs to be included in the MHPSS toolbox. Last year, the Dutch government decided that every time they support organisations working in emergency settings, a percentage would be spent on MHPSS. This was the result of advocacy.
Four important articles and two field reports address these issues of mainstreaming into other sectors in very different fields, and on very different levels, as well provide possibilities and challenges for the future. I will not dwell on these more here, as they are eloquently discussed in the Introduction to the Special section that may be found after the Current affairs section.
For the second time, our new section Current affairs, addresses current crises and questions that arise from theses crises from the perspective of MHPSS. We have two contributions in this section that may be said to show the negative aspects of remaining ‘unseen’: one is on the long-lasting impact of bomb blasts and other violent attacks for political or religious reasons, the other on those who have been working in areas of violence that have been going on for so long, as to be almost forgotten.
Although not often in the news, the concealed and often tragic results of political or religious violence has increased dramatically over the past few years, as have the number of those traumatised by it. It is perhaps fitting that we go to press as the 15 year anniversary of 9/11 is commemorated and highlights the need to pay more attention to the long-term impact of this sort of violence.
Dilwar Hussain and Prakasah Sarma describe the social-economic and psychological effects of terrorist bomb blasts on the lives of survivors. They interviewed survivors of a terrible bomb attack in India several years ago and show that these people still struggle with psychological problems, but also that the experiences has had dramatic influence on their social and economic position, affecting the children and families of these survivors as well. Sadly, there is little support for those who have been impacted, or their families.
In his personal reflection, Maximilien Zimmermann addresses his experience in supporting psychosocial workers in Palestine who, in turn, support family members who have lost their loved ones and were victims of violent attacks by Israeli settlers. He pleads for more tools and interventions to support these psychosocial workers who are working in an area of long standing and ongoing violence.
Next to these two sections, we have also our ‘normal’ contributions in what is a hugely packed issue.
Constanze Quosh addresses case management. She describes the approach, implementation and evaluation of a pilot mental health and psychosocial support case management programme in Syria. She discusses different forms of case management approaches based on a multi-layered, stepped care model. This approach presents a functional case management system and shows positive mental health outcome results.
The following three articles all addresses the difficulties of refugees and displaced people, but in very different ways: through a perceived needs survey, a qualitative research among parents and a personal account of internally displaced women. All three are, in their own way, important, not only to be seen and understood, but also continue to highlight the theme of the importance of mainstreaming MHPSS into other sectors.
Boris Budosan, Sabah Aziz, Marie Theres Benner and Batouel Abraspresent their ‘Humanitarian Emergency Settings Perceived Needs Scale (HESPER) survey’. The survey shows how diverse the needs and how difficult the life for Syrian refugees in Turkey, and as such, it HESPER may answer the need for a quick assessment instrument within emergency settings. Their use of the instrument in this study showed a variety of perceived needs and daily stressors, as well as the hardship impacting the urban, Syrian refugee community. Again, we see that wellbeing is connected to such myriad aspects that mainstreaming MHPSS has become a necessity.
In their article, ‘Youth resilience makes a difference in mitigating stress: teacher mediated school intervention in Bethlehem’, Mohammed Shaheen and Shani Opperheim present a study of the implementation of the ‘Enhancing resiliency amongst students experiencing stress’ intervention’. Their hypothesis was that posttraumatic stress levels can be reduced when youth have higher levels of ego resilience, and that this could be though a teacher mediated school intervention. The study did not support their hypothesis, but offers much to learn, and they plead for a more holistic approach in areas where people are exposed to continuous violence.
The field report of Elvia Ramírez, Arely del Pilar Gómez Ramírez, Clara Gesteira Santos, Roberto Chaskel, Zelde Espinel and James M. Schultz is a blend of a personal reflection and a field report. In this paper, two Colombian internal displaced women, a mother and her daughter, tell the reader their experiences and the difficulties displaced people face when they, coming from rural areas, have to survive in Bogotá, as ‘ghosts in the big city’. Yet, another of the negative aspects of being ‘unseen’, often these stories have gone unheard in this decades long, brutal violence that has resulted in Colombia having a huge internally displaced population who have survived the hardship of displacement due to the war. While the peace agreement was signed recently (24 August), even though the population voted it down in a referendum, it, therefore, remains to be seen how many of those IDPs will now feel safe enough to come out of the shadows and speak.
The final contribution is a personal reflection of Jack Obali Odolla who describes the difficulties young people face when they are forced to return to Ethiopia, after working abroad. These young people usually went abroad for economic reasons and instead of bringing money home to their families (as was expected) they have experienced exploitation, violence and trafficking. Back in Ethiopia, their problems are not over as many families do not understand the problems these returnees have faced, are disappointed and sometimes reject those returning home.
Finally, I would like to highlight a call for papers. After the Special section in 2013 on peacebuilding and psychosocial work, Interventionhas the opportunity to publish an extra issue on linking mental health and psychosocial support to peacebuilding. The Institute for Justice and Reconciliation (IJR) in South Africa and the Netherlands based War Trauma Foundation would like to jointly try to narrow the gaps between workers in the field of MHPSS and ‘peacebuilders’. With this extra issue, aimed at workers in both groups, we hope to strengthen the nexus, linkage and mutual understanding between these two essential fields.