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Technical note: Linking Disaster Risk Reduction (DRR) and Mental Health and Psychosocial Support (MHPSS) - Practical tools, approaches and case studies

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IMPORTANT OPERATIONAL DEFINITIONS

Recently, the approach to hazardous events has undergone a considerable shift, away from reactive activities focused on managing and responding to events and towards a more proactive process of emergency and disaster risk management (DRM). The ultimate goal of this shift in focus is to prevent new and reduce existing disaster risks, a process known as disaster risk reduction (DRR), while strengthening individual, community, societal and global resilience.

Hazardous events and emergencies continue to dramatically affect millions of people every year, with natural hazards causing thousands of deaths and US$ 2.6 trillion in total losses between 1994 and 2013 (CRED, 2015). Compounded by the developing global climate and environmental emergency, these damages are likely to increase, with an average of 25 million displaced annually by sudden-onset natural disasters since 2008 (Internal Displacement Monitoring Centre/Norwegian Refugee Council, 2016) and predictions of more than 143 million people being forced to move/migrate by 2050 due to climate-related risks in just three regions – Latin America, South Asia and sub-Saharan Africa (Rigaud et al., 2018). Meanwhile, epidemics were estimated to result in annual losses of approximately US$ 500 billion, 0.6% of annual global income (Fan, Jamison & Summers, 2018), even prior to the COVID-19 pandemic, and these losses may be exacerbated by continued environmental degradation (Settele, Diaz, Brondizio & Daszak, 2020). Violence and conflict have resulted in further devastation, with a global economic impact of $14.1 trillion in purchasing power parity (PPP), equivalent to 11.2% of the world’s gross economic product, in 2018 alone (Institute for Economics & Peace, 2019). Taken together, hazardous events and emergencies of all kinds present a complex and multifaceted set of challenges that require unique solutions to address their effects. Recently, the approach to hazardous events has undergone a considerable shift, away from reactive activities focused on managing and responding to events and towards a more proactive process of emergency and disaster risk management (DRM). The ultimate goal of this shift in focus is to prevent new and reduce existing disaster risks, a process known as disaster risk reduction (DRR), while strengthening individual, community, societal and global resilience. The Sendai Framework for Disaster Risk Reduction 2015–2030 has reinforced the move towards proactive measures, while the World Health Organization (WHO)’s recently published Health Emergency and Disaster Risk Management (Health EDRM) Framework describes the many capacities and functions in health and other sectors at all levels of society and across phases that are required to reduce health risks.

Despite these clear shifts in the risk-informed sustainable development and emergency management fields and the explicit inclusion of psychosocial support in both the Sendai and WHO Health EDRM Frameworks, the degree to which the mental health and psychosocial support (MHPSS) field has been integrated with or has followed this trend towards proactive action is relatively limited (Gray, Hanna & Reifels, 2020). Traditionally, MHPSS services have been focused in the areas of response and recovery. In the past decade, experience from these activities has suggested a need for guidance on MHPSS programming from the perspective of reducing risks in advance of events and linking these approaches with response and recovery actions aligned with DRR principles. Therefore, this technical note was commissioned by the Inter-Agency Standing Committee Reference Group on MHPSS in Emergency Settings (IASC RG, co-chaired by WHO and the International Federation of Red Cross and Red Crescent Societies (IFRC)) in order to design a replicable model and a set of tools for preparing MHPSS services linked with DRR. The intention of this effort was in part to expand the Building Back Better (BBB) approach (WHO, 2013) to include the notion of "building better before", thereby reducing risk from local to global levels, while strengthening the humanitarian and development nexus. This technical note is informed by a prior mapping exercise and literature review that identified current practices in integrating MHPSS and DRR as well as gaps in this integration (Gray, Hanna & Reifels, 2020) and is designed according to an iterative review and consensus-building process. It outlines the rationale, actions, indicators, tools and terminology to foster joint MHPSS-DRR integration and programming.

Purpose of this document and its target audience

This Technical Note on Disaster Risk Reduction (DRR) and Mental Health and Psychosocial Support (MHPSS): Practical Tools, Approaches and Case Studies was developed to assist humanitarian aid, development and disaster risk management organizations, national and local governments and community actors within and across sectors with the delivery of a priority set of actions to reduce suffering and improve mental health and psychosocial well-being through integration with risk management perspectives and approaches that link prevention, preparedness, response and recovery. Additionally, it was designed to assist governmental actors, domestic sources of financing and donors in understanding and supporting activities focused on MHPSS as part of DRR and sectoral programmes. It was developed in concordance with and was inspired by WHO’s Health EDRM Framework and the United Nations Office for Disaster Risk Reduction (UNDRR)’s Words into Action (WiA) guidelines for the many aspects of implementing the Sendai Framework for Disaster Risk Reduction 2015–2030. Further guidance on implementing DRR as part of humanitarian action can be found in the UNDRR Recommendations for the Humanitarian Programme Cycle (UNDRR, 2020).

It must be stated that this technical note is not intended to serve as a universal approach and should instead be used as a guide that requires local and contextual adaptation. Furthermore, the elements it contains need to be implemented through collaboration between a number of stakeholders and with local individuals and communities. No single agency or actor can be expected to implement all of the actions discussed in this technical note. Potential stakeholder roles and responsibilities are listed in Table 1.