Mental Health & Psychosocial Support

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					Mental Health & Psychosocial Support

   Mental illness is one of the great invisible burdens on developing societies,
   accounting for four of the 10 leading causes of disability worldwide. In
   emergencies, the problem is greater still as the percentage of the population
   suffering severe mental disorders rises and those with pre-existing mental
   illnesses are exposed to new levels of stress.
Mental Health: A Cornerstone
of Our Work
The impact of mental illness on many of the world’s weakest
nations, coupled with an alarming shortfall in accessable
treatment options, led International Medical Corps to make
sustainable, accessible mental health care a cornerstone of our
relief and development programming. Today, we are one of the
few international emergency response organizations with the
capacity to address both the immediate psychosocial needs of
communities struck by disaster and help those with pre-existing
mental health disorders. As a leader in the field of mental
health care in emergency settings, our teams have broken new
ground, conducting evidence-based research on depression
rates among women in Darfur and designing innovative pilot
studies in northern Uganda that combine emergency feeding
with enhancing mother-child interaction and improving maternal           There is only one psychiatrist
mood. We have implemented mental health and/or psychosocial
programs in Asia, Africa, Latin America, and the Middle East, as         per every two million people
well as in the United States after Hurricane Katrina and Haiti after
the earthquake.
                                                                           in developing countries.
The social stigma of mental illness, together with the pressure of
more visible, urgent public health care needs means we invariably
begin our work in an environment with little — if any — existing
capacity. For example, Sierra Leone, a nation of 6 million that
endured a decade-long civil war through the 1990s, had just one
practicing psychiatrist when International Medical Corps launched
a pilot program there a few years ago to integrate mental health
care into the community health care system. Conditions elsewhere
in the developing world are little better.
To succeed in such conditions, International Medical Corps relies
on a two-fold strategy for the delivery of mental health care:

 u   Maximize the use of existing government health care
     infrastructure, while also building positive relationships with
     community leaders and traditional healers who can be valuable
     allies as well as important guides through the local culture;

 u   Strengthen host-nation capacity through training and
     mentoring professional staff and by promoting the creation
     of facilities that support care of the mentally ill, all with the
     ultimate goal of creating self-sustaining care.

Aside from being cost-effective, offering services through existing
primary health care centers at the community level is an accessible,
non-stigmatizing way to offer local populations assistance for
mental disorders without overtly singling out those who require
subsequent treatment. A key aspect of our strategy is to train
locals to recognize and treat the signs of mental disorders as part
of mainstream, community level primary health care and to work
at the grassroots level to change attitudes towards the mentally ill.

     14% of the global disease burden is attributed to mental illness.
Respecting Cultural Practices
Where possible, International Medical Corps combines mental health services offered through primary health
care centers with psychosocial support programs that address the community’s needs for a return to normalcy
and social reintegration. Because such needs are often shaped by the local culture, these psychosocial programs
vary from country to country as was underscored by International Medical Corps’ post-tsunami work in the
Indonesian territory of Aceh. After inquiring why so few mourners visited a mass grave site located along a busy,
noisy thoroughfare in the territory’s capital, Banda Aceh, an International Medical Corps mental health team
encouraged and supervised construction of a so-called Quiet House where relatives of victims could overlook
the grave from afar, and mourn with dignity in a quiet place decorated with flowers.

Innovative Solutions
In Northern Uganda, a region emerging from two decades
of brutal armed conflict, an International Medical Corps
program encouraged formation of mother-to-mother
support groups at food distribution centers where women
who once came only to weigh their children and get
nutritious food, could now also receive peer support and
encouragement to enhance mother-child interaction and
improve maternal knowledge of early child development.
Findings from a pilot research evaluation suggest
the program improves maternal mood and maternal
involvement. International Medical Corps is replicating
the program at nutrition sites serving Somali refugees
in Ethiopia.
                                                     Building Capacity in Haiti
                                                      Just 22 hours after the devastating January 2010 earthquake, International
                                                      Medical Corps’ Emergency Response Team arrived in Port-au-Prince
                                                      and began treating patients and training local health care workers to
                                                       deliver first aid. As many earthquake-affected Haitians were also at high
                                                       risk of developing mental illness, both because of the quake itself and
                                                       the symptoms of prolonged recovery such as displacement and lack
                                                       of employment, International Medical Care also made mental health
                                                       services an early priority in the country.
                                                        To date, we have worked with 166 mental health patients at the General
                                                        Hospital in downtown Port-au-Prince and integrated mental health care
   into primary health care at 8 mobile clinic sites throughout Haiti. In addition to training over 75 community health workers
   in critical areas such as primary and maternal/child health care to increase local capacity, we also trained 26 medical staffers
   on conducting psychiatric evaluations and performing mental status exams.We support the Mars Kline Psychiatric Hospital
   (the only psychiatric center in the capital) by providing supplies, food for patients, administrative guidance and training for
   staff members. We also trained institutional officers who now work with 67 children’s residential centers throughout the
   country to improve children’s well-being, safety, and development.

         A Safe Place for Children
         Following the war in Lebanon in the summer of 2006, International Medical Corps immediately mobilized
         to address the mental health needs of thousands of conflict-affected Iraqi refugees and Lebanese host
         populations by establishing nine child-friendly spaces and seven community development centers. In
         coordination with the Ministry of Education, we also developed and delivered a comprehensive child-
         friendly education and mental health training package to 450 school staff members from 28 schools, to
         address mental health issues stemming from the recent conflict.
         International Medical Corps currently trains local Primary Health Care providers to
         diagnose, treat and refer mild-to-moderate cases of mental illness and disorders.We also
         established outreach and mobile mental health services to increase access to therapy
         for Iraqi refugees in need of clinic and home-based psychotherapeutic services.

                                                                         We are one of the few international
                                                                         emergency response organizations with
                                                                         the capacity to address both the immediate
                                                                         psychosocial needs of communities
                                                                         struck by disaster and to help those with
                                                                         pre-existing mental health disorders.

Headquarters: 1919 Santa Monica Blvd., Suite 400 • Santa Monica, CA 90404 • Phone: 310-826-7800 • Fax: 310-442-6622
Washington, DC: 1313 L Street, NW, Suite 220 • Washington, DC 20005 • Phone: 202-828-5155 • Fax: 202-828-5156

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