emergencies

Abstract: In the Central African Republic, a political crisis started in 2013 that greatly affected the population. They were exposed to traumatogenic factors causing the emergence of symptoms of posttraumatic stress disorder in large segments of the population. The situation of high food insecurity, combined with high levels of psychological distress, have significantly limited the population's coping strategies.

Colombia is one of the first countries in the world to implement the IASC Guidelines for Mental Health and Psychosocial Support in Emergency Settings in the form of a ‘case study’. It was shown that the guidelines are in general terms applicable and adaptable to the Colombian context.

This case study describes the use of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings in Jordan. The fieldwork was carried out 17–27 August 2008 in Jordan and involved discussions with representatives of humanitarian organisations and UN agencies in Amman and Zarqa. This paper describes the ways in which the guidelines have been disseminated in Jordan and how they have ‘added value’ within the context of the Iraqi refugee crisis in Jordan.

This case study describes the use of the IASC Guidelines on Mental Health and Psychosocial Support in Kenya. The fieldwork was carried out 14–25 July 2008, and involved discussions with representatives of humanitarian organisations, UN agencies and government departments in Nairobi, Eldoret and Nakuru.

In this paper, several lessons are shared based on experiences in post conflict Timor Leste. In order to provide care to patients with mental disorders in their home settings, a specialist community based clinical service was developed as an alternative to using the (already) heavily dysfunctional primary health care system. We found that mental disorder accounted for a disproportionate amount of the disability in the community.

Five dilemmas inherent in emergency response are presented and discussed from a public mental health perspective in reference to the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. These are: (1) Who should take the lead in the planning and implementation of the guidelines? (2) At what level are the guidelines to be used? 3) What evidence do we have for the usefulness of the guidelines?

Both natural and human made disasters create distress in large populations. The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings set forth principles and a system for their employment, aimed at minimizing the psychological consequences of public health emergencies created by disasters. Guidelines cannot dictate which principle, or principles, of mental health and psychosocial support have the most relevance to the needs of a specific culture in a specific disaster.

People with psychiatric disorders in humanitarian emergencies are primarily neglected and lack appropriate treatment. This results in unnecessary suffering, stigmatisation, loss of dignity and increased mortality. This paper describes the experience of Médecins Sans Frontières in providing emergency psychiatric treatment as a component of a busy medical programme in Mweso, a conflict affected region of North Kivu, the Democratic Republic of the Congo.