This document describes what UNHCR operations can do to strengthen the integration of Mental Health and Psychosocial Support (MHPSS) within their programming. It builds on the Operational Guidance for Mental Health and Psychosocial Support in Refugee Programming and summarizes the main progress made by UNHCR towards strengthening MHPSS within the various sectors.
Scope of the problem
According to WHO, around 22% of adults in conflict settings have mental health conditions.
This is almost triple to non-conflict settings. There is no generally accepted estimate for children but it is clear that children who are refugees, IDPs or who live in conflict settings have high levels of mental health issues. This increased prevalence of mental health conditions and psychosocial problems of displaced communities is determined by:
⊲ adverse experiences and losses in the past in their homeplaces, during flight, and in refugee or IDP settings
⊲ current life conditions such as economic difficulties, daily stressors, a lack of supportive social systems and the adequacy of assistance and protection
⊲ how people perceive their future: solutions and real prospects to get a better life
The overarching goal is to ensure refugees, internally displaced people (IDPs), stateless persons and other persons of concern to UNHCR have access to national services.
However, in low- and middle-income countries that host most refugees and IDPs, services for mental health and psychosocial support are grossly insufficient. In high income countries such services are often available, but not always accessible for or adapted to the needs of displaced persons. Therefore, UNHCR uses a twin track approach: providing essential services for mental health and psychosocial support where needed and strengthening capacity of and access to national systems where feasible.
The COVID pandemic prompted UNHCR to scale up our response and adjust our modalities to identify and assist refugees and other persons of concern with mental health and psychosocial issues. Some mental health services were provided remotely, over telephone or internet, while essential clinical mental health care continued to be delivered safely and scaled up where possible. Trainings on basic psychosocial skills were conducted for health and protection staff, for partner staff, for community outreach volunteers, for helpline staff and for other frontline workers. Since the onset of the pandemic the 43 countries reporting on MHPSS in the Global Humanitarian Response Plan for COVID-19, recorded over a half million of people who have been provided with essential mental health and psychosocial support services.