Building Back Better: Sustainable mental health care after emergencies
Humanitarian emergencies, an opportunity for fresh start in providing sustainable, long-term mental health services
GENEVA | 16 AUGUST 2013 – Humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies, but too often opportunities are missed to strengthen mental health systems for the long-term, according to a new World Health Organization (WHO) report, ‘Building back better: Sustainable mental health care after emergencies’ released for World Humanitarian Day (August 19).
“In spite of their tragic nature, emergency situations are opportunities to improve the lives of large numbers of people through improving mental health services,” says Dr Bruce Aylward, WHO’s Assistant Director-General overseeing the Organization’s work in humanitarian emergencies. "We can do better for emergency-affected populations by working with the government on sustainable mental health care from the outset.”
The report provides guidance for strengthening mental health systems after emergencies and examples from Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, Somalia, Sri Lanka, Timor-Leste, and West Bank and Gaza Strip. Contributors from each area report not only their major achievements, but also their most difficult challenges and how they were overcome. Key overlapping practices emerging from these experiences are summarized.
Findings from the report include:
Indonesia (Aceh): Like many provinces in Indonesia, Aceh had only institution-based care before the tsunami of 2004. Today, most districts have primary mental health services supported by secondary care at district general hospitals.
Iraq: Since 2004, significant progress has been made toward the creation of a comprehensive mental health system. More than 50% of general practitioners have received mental health training.
Kosovo: Starting from a hospital-based model of care in 1999 after the conflict, a system of community-based mental health care is now available.
Sri Lanka: Since the 2004 tsunami, a new national mental health policy has guided reform, which now extends to most parts of the country. Several new cadres of community-based mental health workers have been developed.
Timor-Leste: Building from a complete absence of mental health services in 1999, the country today has a comprehensive community-based mental health system.
The possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care.
“The current situation is alarming,” says Dr Shekhar Saxena, WHO Director for Mental Health. “Health systems have not yet adequately responded to the burden of mental disorders. We know that the vast majority of people with severe mental disorders receive no treatment whatsoever in low-income and middle-income countries.”
Transforming the mental health care systems in turn would improve the well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies, the report notes.
By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies. Already in 2013, the world has witnessed numerous emergency situations, from the crisis in Syria and neighbouring countries to heavy fighting in Mali and the Central African Republic, major flooding in parts of the Americas, Africa, and Asia, and others.
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