IASC Guidelines

"A significant gap has been the absence of a multi-sectoral, inter-agency framework that enables coordination, identifies useful practices, flags harmful practices and clarifies how different approaches to mental health and psychosocial support complement one another."

Orientation on the IASC Guidelines on Mental health and

Psychosocial Support in Emergencies

Orientation on the IASC Guidelines on Mental health and

Psychosocial Support in Emergencies

Education ClusterAmanda Melville,

occupied Palestinian territory 12 Feb 2009

Education ClusterAmanda Melville,

occupied Palestinian territory 12 Feb 2009

• Introductions and agenda• Handouts

• Brochure with matrix• Print out of Field Use Version• Full Guidelines on CD ROM (explain)• True False Exercise

• Local expertise

IASC Task Force: UN and non-UN agencies wrote

Guidelines20. INEE21. IRC22. MdM-E23. Mercy Corps24. MSF-H25. Oxfam GB26. RET27. SC/UK 28. SC/USA

1. ICVA2. IFRC3. Interaction4. IOM5. OCHA6. UNFPA7. UNHCR8. UNICEF9. WFP10. WHO

11. ACF12. Am. Red Cross13. ACT International14. Action Aid International11. CARE Austria12. CCF13. HealthNet TPO14. IMC15. ICMC

Ref Group now also has:29. CARE Int.30. Ch of Sweden31. COOPI32. GP-SI33. RedR34. REPSSI35. TdH36. UNRWA37. World Vision

Exercise 1: First reaction(1 minute)

• Reflect on experiences that you had or aware of related to mental health and psychosocial support during and after emergencies.

• Reflect on the following question. Is there a potential need for applying here internationally endorsed inter-agency mental health and psychosocial support guidelines?

Some typical answers to this exercise are

Inter-agency guidelines are needed because• Need to strengthen coordination and have common

comprehensive framework for action• Need for guidance on most effective practices and how

to avoid doing harm or using ineffective practices• Need to bring together diverse actors with strong views

in common framework• Need guidance on how to prioritise in situations where

need is huge and strains existing capacities

But: • Should be culturally sensitive/adaptable• Should take local situation, capacities and resources into

account• Should cover/not cover/ go beyond PTSD

Inclusive framework: mental health and psychosocial support covers both

(a)protecting or promoting psychosocial well-being

and/or

(b) preventing or treating mental disorder.

PSMH

Diverse needs in midst of emergencies

Emergencies erode normally protective supports and increase risks for a range of problems

• pre-existing social problems • E.g. social tensions/divisions

• emergency-induced social problems • E.g. overcrowding in housing, loss of jobs, protection threats,

weakening of social support networks

• pre-existing psychological/psychiatric problems• E.g. psychosis, severe alcohol use, depression

• emergency-induced psychological/psychiatric problems• E.g. normal fear (past, present, future), depression, PTSD

• humanitarian aid-induced problems• E.g. conflict between communities, anxiety about lack of information on services

Core Principles

• Human rights and equity• Participation• Do No Harm• Building on available

resources and capacities• Integrated support systems• Multi-layered supports

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Matrix of Mental Health and Psychosocial Support: All Have Impact on Protecting Well-

being

1. Coordination2. Assessment, monitoring and evaluation3. Protection and human rights standards4. Human resources5. Community mobilisation and support6. Health services7. Education8. Dissemination of information9. Food security and nutrition10.Shelter and site planning11.Water and sanitation

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Multilayered support

• Need to ensure support is appropriately divided across layers with good coordination/referral

• E.g. not overly focused on focused support• Many of the professional animosities

disappear as soon as one adopts a pyramid model of multi-layered supports with different tasks for different sectors

• Referral system required but will not work well if not appropriately layered

Exercise : Do's and Don’t's for Education

• Purpose: to learn what the IASC Guidelines recommend regarding Education

• Fill in the TRUE OR FALSE questionnaire together with somebody in the room who you do not know

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1.1 Coordination of inter-sectoral MHPSS

1. Coordination

HumanitarianCoordinator

Health Cluster Education ClusterProtection Cluster(with Child protection

Sub-cluster)

MHPSS inter-sectoralcoordination subgroup

Working groups as Required eg Psychosocial

And educationMHPSS Technical Support Group

Proposed Gaza humanitarian response mental health and psychosocial support (MHPSS) coordination structure

MH = mental health; PS = psychosocial

MoH, MoE, MoSA

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2.1 Assessments of MHPSS issues2.2 Participatory M&E

2. Assessment, monitoring & evaluation

Photo courtesy of REUTERS/Finbarr O' Reilly

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3.1 Human rights framework3.2 Social protection

3.3 Legal protection

3. Protection & human rights standards

Photo courtesy of REUTERS/Finbarr O' Reilly

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4.1 Local staff & volunteers4.2 Codes of conduct & ethical guidelines

4. Human resources

Photo: Danish Red Cross

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4.3 Training of aid workers in MHPSS4.4 MHPSS well-being of staff & volunteers

4. Human resources

Photo: Nana Wiedemann, International Federation

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5.1 Mobilisation, ownership & control5.2 Community social support

5. Community mobilisation & support

Photo: Rita Plotnikova, International Federation

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5.3 Cultural, spiritual & religious healing practices

5.4 Support foryoung children& care-givers

5. Community mobilisation & support

Photo: Ulrik Norup Jørgensen, Danish Red Cross

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7.1 Safe & supportive education

7. Education

Photo: Patrick Fuller / Internaitonal Federation

Promote Safe and Supportive Education

• Education is a key PS intervention – provides a safe and stable environment & restores a sense of normalcy, dignity and hope.

• Key Actions:1. Promote safe learning environments.2. Make formal and non-formal education supportive and

relevant.3. Strengthen access to education for all.4. Prepare and encourage educators to support learners’ PS

well-being.• Indicators: Percent access to formal and non-formal

education - girls and boys of different ages. Percent teachers trained in PSP. Teachers refer children with severe MHPS difficulties to specialised services.

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8.1 Information to population on emergency, relief efforts & legal rights

8.2 Information on positive coping methods

8. Dissemination of information

Photo courtesy of REUTERS/Eduard Kornienko

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Specialisedservices

Focused,non-specialised supports

Social and psychological considerations in basic services and security

Community and family supports

Examples in Education sector

Social and psychological considerations in basic services and security

• Advocating for schools to be protected during conflict• Rescheduling exams or gradually returning to formal curriculumCommunity and family supports• Training teachers to provide PS support in classrooms• Facilitating peer support among teachers• Establishing child friendly spaces• Parents discussion groups or involvement of parents in supportiveFocused,non-specialised supports• Strengthening school counselling• Structured group sessions for children (e.g. by NGOs)• Referral of children or families to social services• Support groups for teachersSpecialised services• Referral to clinical mental health services

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Specialisedservices

Focused,non-specialised supports

Social and psychological considerations in basic services and security

Community and family supports

What %?What %?

Beyond education: Social and Psychological Considerations in Basic

Services and SecurityAll members of the community have

responsibility to ensure there is a suitable environment for psychosocial development.

These activities help to establish a suitable environment to protect and promote psychosocial healing and well-being.

Usually these programmes are conducted by other organisations or under an existing sector

Psychosocial and mental health programmes should

advocate for ensuring these basic needs are met • cooperate with sectoral programmes to ensure

that are implemented in a way that supports psychosocial development and healing

Level 1: Social and Psychological Considerations in Basic Services and Security Document impact of lack of services and security on

MHPS wellbeing and use this for advocacy For children, advocate for the protection of children

from violence, abuse and exploitation, the promotion of family unity, re-establishing safe and supportive education

Advocate for delivery of humanitarian assistance in a manner that promotes well-being

Work to promote ways of delivering aid that promote self-reliance and dignity

Facilitate community involvement in decision-making and assistance

Disseminate essential information to affected populations on situation and emergency response

Level 2: Community and Family Supports

Support play, art, recreational and sporting activities Provide structured groups activities for expression and

the development of life skills and coping mechanisms Support children and youth friendly

spaces/environments Promote meaningful opportunities to participate in

rebuilding society Provide information on positive coping mechanisms Activities that facilitate the inclusion of isolated

individuals (orphans, widows, widowers, elderly people, people with severe mental disorders or disabilities or those without their families) into social networks;

Level 2 (cont’d)

Strengthening the family:• Provide culturally appropriate guidance on how

parents and family members can help children• Support parents and families to cope with their own

difficulties• Support and facilitate the establishment of parent

groups/committees• Early childhood stimulation (with nutrition)• Informal family visits for caregivers in need of extra

support• Support family access to basic services

Level 2 (cont’d)

Strengthening community supports:• Helping caregivers and educators to better cope and

to support children• Strengthen community based supports for adult

caregivers• Strengthen child-to-child or youth support• Resumption of cultural and spiritual activities,

including appropriate grieving rituals• Strengthening social networks • teacher training on psychosocial care and support• Group discussions on how the community may help

at-risk groups identified in the assessment as needing protection and support

Level 3: Focused Supports

For people who are:

• struggling to cope within their existing care network

• Not progressing in terms of their development

• Unable to function as well as their peers

• In need of activities that address their psychosocial needs more directly

Level 3 (cont’d)

• Focused psychosocial support activities require trained and experienced staff

• Activities may include:• Case management• Family visits• Psychological first aid• Support groups• Structured play activities• Psychosocial hotlines• Non-clinical family or individual

counselling (e.g. school counselling)

Level 4: Specialized Services

• Traditional specialized healing (e.g. cleansing and purification rituals)

• Clinical social work or psychological treatment

• Psychotherapy

• Drug or alcohol treatment

• Specialised mental health care

Examples of how the guidelines have been used

• Used for identification of gaps in Myanmar• Use picture version to mobilize community in Peru• Influenced a lot of PS programming in Jordan• Limit harmful practive in Kenya (widespread “trauma

counselling”)• Adopted by 4 ministries Gov in Philippines as policy• Training in Iran informed by and consistent with IASC• Some donors only fund consistent with IASC

Guidelines • Highlight importance of engaging with unusual sectors

on MHPSS

How could the Guidelines be used in Gaza?

Key messages

• IASC Guidelines provide a common framework and language to communicate and coordinate with one other during large crises

• There is substantial technical know how on how to meaningfully reduce suffering and this involves different types of complimentary supports

• Using them effectively must be an ongoing process involving multiple humanitarian actors

Mapping MHPSS in education using guideline matrix

Complete matrix