IMC POSITION PAPER

Taking the Lead
In emergency interventions - from post-tsunami Sri Lanka and Indonesia, the earthquake-affected communities in Pakistan or civil war ravaged Chad and Sierra Leone to post-Katrina Mississippi – IMC has clearly shown the international donor community, peer humanitarian agencies and host country health officials that international NGOs have a significant role to play in piloting the provision of clinical mental health services. IMC has successfully integrated mental health services into primary care programs, reached out to affected communities and helped reducing the stigma of mental illness. IMC has made mental health a flagship initiative and is dedicated to promote the mental wellbeing of people in areas affected by disaster and conflict around the world.

Making Mental Health a Priority
Protecting and improving the mental health of people affected by natural disaster or armed conflict still has a low priority among humanitarian agencies and donors. IMC makes an effort to integrate mental and psychosocial health into its emergency response and development programs. Many people are mentally affected by disaster or conflict in the short-term and need help, but those with pre-existing mental disorders are particularly vulnerable during and after an emergency and deserve particular attention. IMC focuses on both groups by taking a long-term view on its mental health interventions. IMC strongly advocates that policy makers and donors prioritize mental health and psychosocial wellbeing with political will and a broad funding portfolio. More money must be made available and short funding cycles overcome to meet the demand in this heavily neglected area of emergency response.

Arriving Early – Leaving a Lasting Impact
IMC recognizes that dramatic events can undermine the long-term wellbeing of large populations. IMC aims at designing programs that provide mental health services to people long after the emergency phase is over by implementing them in existing structures. In countries with little or no institutional capacities IMC encourages local health authorities to include mental health and psychosocial services into their portfolios. IMC’s training and support programs are key to building sustainable mental health systems.

Cultural Sensitivities
IMC is aware that promoting and improving mental health is a particularly sensitive issue that needs to take culture, religion, language, and local circumstances into account. When outsiders are culturally insensitive, mental health assistance, like any other humanitarian interventions, can do more harm than good. In many societies, people with mental disorders are often stigmatized, isolated or neglected. IMC works closely with communities and local authorities to accept mental health as part of their primary health care system and encourages patients and their families to seek help from health professionals.

Local Partners
IMC works from within the affected communities. Ideally, the programs are driven by local groups and help building both government and civil society capacities. IMC does not view affected communities as passive victims but attempts to identify capacities and social networks within these groups when dealing with mental health issues. Local partners can include a wide range of actors including traditional healers, religious leaders, elders, etc. Identifying existing structures is the first step to addressing the need for assistance successfully. By emphasizing local ownership of the programs we increase the possibility of leaving behind a long lasting change in the public health sector.

Integrating Mental Health
Mental health and psychosocial support initiatives should be integrated into wider systems of community support. Single issue programs (rape survivors, PTSD) can lead to fragmented services. Community based mental health services are more sustainable, more accessible and less stigmatizing then centralized programs that focus on specific disorders. Therefore, IMC tries to make mental health part of its primary health care programs initiatives and encourages authorities in the host country to integrate it into existing structures. In cooperation with local authorities we formulate training curricula at all levels of the country’s health service.

Coordinating with Other Actors
As part of the Inter-Agency Standing Committee (IASC) Task Force on Mental Health and Psychosocial Support in Emergency Settings IMC helped developing the 2007 IASC guidelines that will close a gap in humanitarian coordination. These guidelines line out a consensus between agencies on responses to mental health needs in emergencies. IMC is committed to working closely with other agencies and adhere to all agreed principles in the guidelines.

Multi-layered Support
Mental health and psychosocial support must be integrated at every stage of an intervention and at every level. As laid out in the IASC guidelines, mental health and psychosocial support must be central to all phases of a minimum emergency response.

During an emergency all actors should include specific psychological and social considerations for the following key areas:

• Intersectoral Coordination
• Assessment, Monitoring and Evaluation
• Protections and Human Rights Standards
• Human Resources
• Community Mobilization and Support
• Health Services
• Education
• Dissemination of Information
• Food Security and Nutrition
• Shelter and Site-Planning
• Water and Sanitation

Human Rights and Equity
IMC is committed to maximize fairness in the availability and accessibility of mental health and psychosocial support. Because affected people are often stigmatized and neglected they are frequently mistreated and ostracized. IMC promotes the acceptance of mental disorders as an illness and offers communities ways to overcome fears and techniques to change behavior.