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25 - Mental Health and Psychosocial Support in Humanitarian Settings

Considerations for Protecting and Promoting Human Rights

from Part III - Contemporary Issues in Psychology and Human Rights

Published online by Cambridge University Press:  02 October 2020

By
Inka Weissbecker ,
Peter Ventevogel ,
Fahmy Hanna  and
Soumitra Pathare
Edited by
Neal S. Rubin  and
Roseanne L. Flores
Neal S. Rubin
Affiliation:
Adler University
Roseanne L. Flores
Affiliation:
Hunter College, City University of New York
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Summary

Humanitarian crises such as armed conflicts and natural disasters frequently unfold in countries that are already struggling with underlying economic difficulties, political instability, social marginalization, and poor overall health indicators. Persons with mental health conditions are at increased risk for human rights violations during humanitarian crises. Exposure to human rights violations is rampant during humanitarian emergencies, which, in turn, negatively impacts mental health. This chapter describes key human rights instruments and guidelines on mental health and psychosocial support in humanitarian settings. Specific challenges and approaches for promoting and protecting the human rights of persons with mental health conditions living in communities and institutions in countries affected by conflict and crises are discussed. These include barriers to accessing basic needs, insufficient availability of appropriate mental health services and supports, and limited access to social and economic opportunities. Recommendations include promoting a human rights framework as part of programs and services, increasing access to mental health services at the community level (including for severe mental disorders), protecting persons with severe mental disorders in communities and institutions, and providing comprehensive social and community interventions that promote full inclusion and participation.

Keywords

Mental HealthHumanitarian EmergenciesSevere Mental IllnessUN human rights ConventionsInstitutionsCommunity
Type
Chapter
Information
The Cambridge Handbook of Psychology and Human Rights , pp. 373 - 388
Publisher: Cambridge University Press
Print publication year: 2020

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References

Abou-Saleh, M., & Mobayed, M. (2013). Mental health in Syria. International Psychiatry, 10(3), 58–60.Google Scholar
Amnesty International. (2016). “Our hearts have gone dark”: The mental health impact of South Sudan’s conflict (AFR 65/3203/2016). www.amnesty.org/download/Documents/AFR6532032016ENGLISH.PDFGoogle Scholar
Arias, D., Taylor, L., Ofori-Atta, A., & Bradley, E. H. (2016). Prayer camps and biomedical care in Ghana: Is collaboration in mental health care possible? PLOS ONE, 11(9), e0162305.Google Scholar
Brabo, M. (2016). Portraits of mental illness in times of war: Photographing mental health patients in institutions in Syria, Libya, Ukraine, Palestine and Haiti. Aljazeera, Qatar.Google Scholar
Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. (2019). New WHO prevalence estimates of mental disorders in conflict settings: A systematic review and meta-analysis. Lancet, 394, 240–248.Google Scholar
Committee on Economic Social and Cultural Rights. (2000). The right to the highest attainable standard of health, General Comment 14. E/C.12/2000/4. April 25– May 12, 2000.Google Scholar
De-Graft Aitkins, A. (2015). Mental illness and destitution in Ghana. In Akyeampong, E., Hill, A. G., & Kleinman, A. (Eds.), The culture of mental illness and psychiatric practice in Africa (pp. 112–143). Bloomington, IN: Indiana Universty Press.Google Scholar
Echeverri, C., Le Roy, J., Worku, B., & Ventevogel, P. (2018). Mental health capacity building in refugee primary health care settings in sub-Saharan Africa: Impact, challenges and gaps. Global Mental Health, 5, e28.Google ScholarPubMed
de Jong, J. T. (2002). Public mental health, traumatic stress and human rights violations in low-income countries. In de Jong, J. (Ed.), Trauma, war, and violence: Public mental health in socio-cultural context (pp. 1–91). New York, NY: Kluwer Academic/Plenum Publishers.Google Scholar
Diab, M., Veronese, G., Jamei, Y. A., Hamam, R., Saleh, S., & Kagee, A. (2018). Community work in the ongoing crisis context of Gaza: Integrating a public health and human rights approach. Australian and New Zealand Journal of Family Therapy, 39(3), 320–330.Google Scholar
Drew, N., Funk, M., Tang, S., Lamichhane, J., Chávez, E., Katontoka, S., … Saraceno, B. (2011). Human rights violations of people with mental and psychosocial disabilities: An unresolved global crisis. Lancet, 378(9803), 1664–1675.Google Scholar
Dudley, M., Silove, D., & Gale, F. (Eds.). (2012). Mental health and human rights: Vision, praxis, and courage. Oxford, UK: Oxford University Press.Google Scholar
El Chammay, R., Karam, E., & Ammar, W. (2016). Mental health reform in Lebanon and the Syrian crisis. Lancet Psychiatry, 3(3), 202–203.Google Scholar
Eleftherakos, C., Boogaard, W. V., Barry, D., Severy, N., Kotsioni, I., & Roland-Gosselin, L. (2018). “I prefer dying fast than dying slowly”: How institutional abuse worsens the mental health of stranded Syrian, Afghan and Congolese migrants on Lesbos island following the implementation of EU-Turkey deal. Conflict and Health,12(38).Google Scholar
Giacaman, R. (2018). Reframing public health in wartime: From the biomedical model to the “wounds inside.” Journal of Palestine Studies, 47(2), 9–27.Google Scholar
Gillis, C. M. (2013). Fear and loathing in Aleppo’s mental hospital. Syria Deeply.Google Scholar
Gloria, O., Osafo, J., Goldmann, E., Parikh, N. S., Nonvignon, J., & Kretchy, I. M. (2018). The experiences of providing caregiving for patients with schizophrenia in the Ghanaian context. Archives of Psychiatric Nursing, 32(6), 815–822.Google Scholar
Human Rights Watch. (2015). “Chained like prisoners”: Abuses against people with psychosocial disabilities in Somaliland. New York, NY: Human Rights Watch.Google Scholar
Humayun, A., Haq, I., Khan, F. R., Azad, N., Khan, M. M., & Weissbecker, I. (2017). Implementing mhGAP training to strengthen existing services for an internally displaced population in Pakistan. Global Mental Health (Cambridge), 4, e6.Google Scholar
International Committee of the Red Cross. (2003, April 17). Iraq: Latest news from ICRC staff in the field. https://reliefweb.int/report/iraq/iraq-latest-news-icrc-staff-field-17-apr-2003Google Scholar
International Medical Corps. (2015). Syria crisis: Addressing regional mental health needs and gaps in the context of the Syria crisis. Washington, DC: Author. https://internationalmedicalcorps.org/wp-content/uploads/2017/07/Syria-Crisis-Addressing-Mental-Health.pdfGoogle Scholar
Inter-Agency Standing Committee (IASC). (2007). IASC guidelines on mental health and psychosocial support in emergency settings. Geneva, Switzerland: United Nations. www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdfGoogle Scholar
Jones, L. (2011). The dispossessed: Diary of a psychiatrist at the Chad/Sudan border (2004). Intervention, 9(3), 364–372.Google Scholar
Jones, L. (2017). Outside the asylum. London, UK: Weidenfeld and Nicolson.Google Scholar
Jones, L., Asare, J. B., El Masri, M., Mohanraj, A., Sherief, H., & van Ommeren, M. (2009). Severe mental disorders in complex emergencies. Lancet, 374(9690), 654–661.CrossRefGoogle ScholarPubMed
Kane, J. C., Ventevogel, P., Spiegel, P., Bass, J. K., van Ommeren, M., & Tol, W. A. (2014). Mental, neurological, and substance use problems among refugees in primary health care: Analysis of the Health Information System in 90 refugee camps. BMC Medicine, 12(1), 228.CrossRefGoogle ScholarPubMed
Karokhel, D., & Zawab, E. (2003). Tough cure for mental problems: People with psychological problems are chained up at a holy shrine, hoping traditional methods will cure them. Insitute for War and Peace Reporting. https://iwpr.net/global-voices/tough-cure-mental-problemsGoogle Scholar
Lavoie, J. A. (2018). Relative invisibility: An integrative review of carers’ lived experiences of a family member’s emergency mental health crisis. Social Work in Mental Health, 16(5), 601–626.Google Scholar
Lund, C., Sutcliffe, T., Flisher, A., & Stein, D. J. (2012). Protecting the rights of the mentally ill in poorly resourced settings: Experiences from four African countries. In Dudley, M., Silove, D., & Gale, F. (Eds.), Mental health and human rights, vision, praxis and courage (pp. 527–537). Oxford, UK: Oxford University Press.Google Scholar
Mall, S., Hailemariam, M., Selamu, M., Fekadu, A., Lund, C., Patel, V., & Hanlon, C. (2017). “Restoring the person’s life”: A qualitative study to inform development of care for people with severe mental disorders in rural Ethiopia. Epidemiological Psychiatric Science, 26(1), 43–52.Google Scholar
Mhina, M. A. (2009). Coping with mental distress in contemporary Dar Es Salaam. In Haram, L. & Yamba, C. B. (Eds.), Dealing with uncertainty in contemporary African lives (pp. 141–158). Stockholm, Sweden: Nordiska Afrikainstitutet.Google Scholar
Mierlo, B. V. (2012). Community systems strengthening in Afghanistan. Intervention, 10(2), 134–145.Google Scholar
Missmahl, I. (2018). Value-based counselling: Reflections on 14 years of psychosocial support in Afghanistan. Intervention, 16(3), 256–260.CrossRefGoogle Scholar
National Council on Disability. (2006). The needs of people with disabilities with psychiatric disabilities during and after Hurricanes Katrina and Rita: Position paper and recommendations. Washington, DC: Author. https://ncd.gov/publications/2006/07142006Google Scholar
Parwiz, K. (2015). Implementation of WHO QualityRights assessment in Kabul Mental Health Hospital. (Master´s Dissertation in Mental Health Policy and Services), Universidade NOVA de Lisboa, Lisbon, Portugal.Google Scholar
Patel, V., Kleinman, A., & Saraceno, B. (2012). Protecting the human rights of people with mental disorders: A call to action for global mental health. In Dudley, M., Silove, D., & Gale, F. (Eds.), Mental health & human rights (pp. 362–375). Oxford, UK: Oxford University Press.Google Scholar
Raphelson, S. (2018). Afghanistan’s lone psychiatric hospital reveals mental health crisis fueled by war. USA: National Public Radio.Google Scholar
Read, U. M., Adiibokah, E., & Nyame, S. (2009). Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana. Globalization and Health, 5(1), 13.CrossRefGoogle ScholarPubMed
Rohwerder, B. (2013). Intellectual disabilities, violent conflict and humanitarian assistance: Advocacy of the forgotten. Disability & Society, 28(6), 770–783.Google Scholar
Saxena, S., & Hanna, F. (2015). Dignity: A fundamental principle of mental health care. Indian Journal of Medical Research, 142(4), 355–358.Google Scholar
Semrau, M., Lempp, H., Keynejad, R., Evans-Lacko, S., Mugisha, J., Raja, S., … Hanlon, C. (2016). Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: Systematic review. BMC Health Services Research, 16(79). https://doi.org/10.1186/s12913-016-1323-8.CrossRefGoogle ScholarPubMed
Silove, D., Ekblad, S., & Mollica, R. (2000). The rights of the severely mentally ill in post-conflict societies. Lancet, 355(9214), 1548–1549.Google Scholar
Simpson, E. L., & House, A. O. (2002). Involving users in the delivery and evaluation of mental health services. BMJ, 325(7375), 1265.Google Scholar
The Sphere Project. (2018). The Sphere handbook: Humanitarian charter and minimum standards in humanitarian response. Geneva, Switzerland: Sphere.Google Scholar
Thornicroft, G. (2011). Physical health disparities and mental illness: The scandal of premature mortality. British Journal of Psychiatry, 199(6), 441–442.Google Scholar
Tol, W. et al. (2011). Mental health and psychosocial support in humanitarian settings: Linking practice and research. Lancet, 378(9802), 1581–1591.Google Scholar
Toole, M. J., Waldmann, R. J., & Zwi, A. (2006). Complex emergencies. In Merson, M. H., Black, M. H., & Mills, A. J. (Eds.), International public health: Diseases, programs, systems, and policies (pp. 445–511). Boston, MA: Jones and Bartlett.Google Scholar
United Nations Committee on Economic, Social and Cultural Rights. (2000). General comment No. 14: The Right to the Highest Attainable Standard of Health (Art. 12 of the Covenant). E/C.12/2000/4. www.refworld.org/docid/4538838d0.htmlGoogle Scholar
United Nations General Assembly. (1948). Universal Declaration of Human Rights. Geneva, Switzerland: United Nations. 217 A (III). www.ohchr.org/en/udhr/Pages/UDHRIndex.aspxGoogle Scholar
United Nations General Assembly. (1951). Convention Relating to the Status of Refugees. Geneva, Switzerland: United Nations. Treaty Series, vol. 189, p. 137. www.ohchr.org/EN/ProfessionalInterest/Pages/StatusOfRefugees.aspxGoogle Scholar
United Nations General Assembly. (1966a). International Covenant on Economic, Social and Cultural Rights. Geneva, Switzerland: United Nations. A/RES/2200. www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspxGoogle Scholar
United Nations General Assembly. (1966b). International Covenant on Civil and Political Rights. Geneva, Switzerland: United Nations. Treaty Series, vol. 999, p. 171. www.ohchr.org/EN/ProfessionalInterest/Pages/CCPR.aspxGoogle Scholar
United Nations General Assembly. (1991). Principles for the Protection of Persons With Mental Illness and the Improvement of Mental Health Care (MI Principles) (1991). UN General Assembly Resolution 46/119 of December 17, 1991. www.unhchr.ch/html/menu3/b/68.htmGoogle Scholar
United Nations General Assembly. (2006). Convention on the Rights of Persons with Disabilities. Geneva, Switzerland: United Nations. A/RES/61/106, Annex I. www.ohchr.org/en/hrbodies/crpd/pages/crpdindex.aspxGoogle Scholar
United Nations General Assembly. (2018). Interim report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, 27 July 2018, A/73/216. https://undocs.org/A/73/216Google Scholar
United Nations High Commissioner for Refugees. (2018). Figures at a Glance. www.unhcr.org/figures-at-a-glance.htmlGoogle Scholar
United Nations Human Rights Council. (2017). Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, 28 March 2017, A/HRC/35/21. https://documents-ddsny.un.org/doc/UNDOC/GEN/G17/076/04/PDF/G1707604.pdfGoogle Scholar
van Ommeren, M., Hanna, F., Weissbecker, I., & Ventevogel, P. (2015). Mental health and psychosocial support in humanitarian emergencies. Eastern Mediterranean Health Journal, 21(7), 498–502.Google Scholar
Van Ommeren, M., Saxena, S., Loretti, A., & Saraceno, B. (2003). Ensuring care for patients in custodial psychiatric hospitals in emergencies. Lancet, 362(9383), 574.Google Scholar
Ventevogel, P., & Faiz, H. (2018). Mental disorder or emotional distress? How psychiatric surveys in Afghanistan ignore the role of gender, culture and context. Intervention, 16(3), 207–214.Google Scholar
Ventevogel, P., van Ommeren, M., Schilperoord, M., & Saxena, S. (2015). Improving mental health care in humanitarian emergencies. Bulletin of the World Health Organization, 93(10), 666–666A.Google Scholar
Ventevogel, P., van de Put, W., Faiz, H., van Mierlo, B., Siddiqi, M., & Komproe, I. H. (2012). Improving access to mental health care and psychosocial support within a fragile context: A case study from Afghanistan. PLOS Medicine, 9(5), e1001225.Google Scholar
Weissbecker, I., Hanna, F., El Shazly, M., Gao, J., & Ventevogel, P. (2019). Integrative mental health and psychosocial support interventions for refugees in humanitarian crisis settings. In Wenzel, T. & Drozdek, B. (Eds.), Uncertain safety: Understanding and assisting the 21st century refugees (pp. 117–153). Cham, Switzerland: Springer.Google Scholar
Williams, A. C., & Merwe, J. V. (2013). The psychological impact of torture. British Journal of Pain, 7(2), 101–106.Google Scholar
World Health Organization (WHO). (2010). Mental health and development: Targeting people with mental health conditions as a vulnerable group. Geneva, Switzerland. www.who.int/mental_health/policy/mhtargeting/en/Google Scholar
WHO. (2014, August). WHO and the Syrian Arab Red Crescent (SARC) reach eastern Aleppo and Mouadamiya in Rural Damascus. www.who.int/hac/crises/syr/releases/aleppo_medical_supplies/en/Google Scholar
WHO. (2017). Mental health atlas. Geneva, Switzerland: Author. www.who.int/mental_health/evidence/atlas/mental_health_atlas_2017/en/Google Scholar
WHO. (2018a). QualityRights Lebanon: Mental health innovation network. www.mhinnovation.net/innovations/qualityrights-lebanon?qt-content_innovation=0#qt-content_innovationGoogle Scholar
WHO. (2018b). WHO QualityRights initiative: Improving quality, promoting human rights. www.who.int/mental_health/policy/quality_rights/en/Google Scholar
World Health Organization and United Nations High Commissioner for Refugees. (2012). Assessing mental health needs and psychosocial needs and resources: Toolkit for humanitarian settings. Geneva, Switzerland: World Health Organization.Google Scholar
World Health Organization and United Nations High Commissioner for Refugees. (2015). mhGAP Humanitarian Intervention Guide (mhGAP-HIG): Clinical management of mental, neurological and substance use conditions in humanitarian emergencies. Geneva, Switzerland: World Health Organization.Google Scholar
World Organization of Family Doctors & World Health Organization. (2008). Integrating mental health into primary care: A global perspective. www.who.int/mental_health/resources/mentalhealth_PHC_2008.pdfGoogle Scholar

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