SPECIAL SECTION

This field report describes the author's deployment as a psychosocial delegate to the International Federation of Red Cross Ebola epidemic response in Sierra Leone during June and July 2014. He highlights the ongoing impact of an epidemic in a post conflict zone, how addressing fear and stigma is essential in social mobilisation and capacity building efforts, as well as providing empowering messages that give hope and foster collaboration between epidemic responders and community members.

This field report summarises some of the problems, challenges and psychosocial issues facing Sierra Leone Red Cross National Society staff and volunteers, related to the Ebola Virus Disease outbreak, as well as local responses at a time when the rest of the world was just becoming aware of the disease as a real threat.

We have long outgrown the capacity of the accepted clinical models of trauma, and a paradigm shift in our thinking is long overdue. The data on traumatic stress were posited from a certain cognitive-behavioural viewpoint, with particular emotional components based almost in their entirety on western, mostly white individuals seeking treatment for posttraumatic stress disorder, and focusing on that time frame.

In this paper, the authors elaborate on a model proposed in 2010 that identifies major sources of stress affecting mental health among war affected populations. That model emphasised the importance of what was termed ‘daily stressors’, as well as direct exposure to war related violence as predictors of mental health status The authors first summarise the original model and discuss the widespread response to the 2010 paper among researchers and practitioners working in conflict and post conflict settings.

Complex situations following war and natural disasters have a psychosocial impact not only on the individual, but also their family, community and the larger society. Fundamental changes in the functioning of the family and community can be observed as a result of these impacts. At the family level, the dynamics of single parent families, lack of trust among members, changes in significant relationships and child rearing practices are seen.

Mixed methods research, which combines elements of qualitative and quantitative research approaches, should be well suited to studying refugee mental health. However, this has not yet been adequately discussed nor demonstrated within the existing scientific literature. This paper aims to begin to fill this gap and describes how mixed methods have been used in refugee mental health research.

In this article, we suggest guidelines that should be followed in order to create a culturally sensitive cognitive behavioural therapy among refugees and in global contexts more generally, so as to maximise efficacy and effectiveness.

The burden of mental health problems in (post)conflict low and middle income countries is substantial. Despite growing evidence for the effectiveness of selected mental health programmes in conflict affected low resource settings and growing policy support, actual uptake and implementation have been slow.

Armed conflicts and other humanitarian crises impact mental health and psychosocial wellbeing. In contexts of overwhelming need and overstretched government health systems, nongovernmental organisations may play important roles. In this paper, we reflect on the role of Nepali nongovernmental organisations in providing mental health and psychosocial support services.

Complex humanitarian emergencies, whether arising from armed conflict or natural disaster, challenge the mental health system of a country in many ways. Not least because they increase the risk of mental disorder in the population, and undermine the pre-existing structures of care. They may, however, also bring new opportunities to create change. In this way, new structures and paradigms may emerge from the midst of a crisis. The probabilities for such a change to occur vary from one setting to another.