IASC Guidelines on Mental Health and The IASC Guidelines ... · 6 This document summarizes the IASC...

Specifc action sheets offer useful guidance on mental health and

psychosocial support, and cover the following areas:

Coordination

Assessment, Monitoring and Evaluation

Protection and Human Rights Standards

Human Resources

Community Mobilisation and Support

Health Services

Education

Dissemination of Information

Food Security and Nutrition

Shelter and site Planning

Water and Sanitation

Reading the full IASC Guidelines on Mental Health and Psychosocial Support in

Emergency Settings from cover to cover may not be possible during an emergency. This

limitation led to the development of this check-list for programme planning and

emergency response. This checklist cannot capture all the important points in the

Guidelines. Readers are encouraged to use this cheklist only in conjunction with the full

Guidelines.

The IASC Guidelines for Mental Health and Psychosocial

Support in Emergency Settings reflect the insights of numerous

agencies and practitioners worldwide and provide valuable

information to organisations and individuals on how to respond

appropriately during humanitarian emergencies. CHECKLIST FOR FIELD USE

IASC Guidelineson Mental Health andPsychosocial Supportin Emergency Settings

Published by the Inter-agency Standing Committee (IASC), the Guidelines

give humanitarian actors useful inter-agency, inter-sectoral guidance and

tools for responding effectively in the midst of emergencies.

Hecho el Depósito Legal en la Biblioteca Nacional del Perú Nº 2008-14673

CHECKLIST FOR FIELD USE


Contents

Chapter 1INTRODUCTION 5

Purpose of these guidelines 5Core principles 7Do´s and Don´ts 11

Chapter 2MATRIX OF MINIMUM RESPONSES IN MIDST OF EMERGENCIES 14

Chapter 3SUMMARY OF ACTION SHEETS: CHECKLISTS FOR MINIMUM RESPONSE 17

1. Coordination 172. Assessment, monitoring and evaluation 183. Protection and human rights standards 194. Human resources 215. Community mobilisation and support 246. Health services 277. Education 318. Dissemination of information 319. Food security and nutrition 33

10. Shelter and site planning 3411. Water and sanitation 35

5Before implementing, please read relevant text in the full version of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings

C H A P T E R 1

Introduction

One of the priorities in emergencies is to protect and improve people's mental healthand psychosocial well-being.

A significant gap has been the absence of a multi-sectoral, inter-agency framework thatenables effective coordination, identifies useful practices, flags potentially harmfulpractices, and clarifies how different approaches to mental health and psychosocialsupport complement one another.

These Guidelines reflect the insights of practitioners from different geographical regions,disciplines and sectors, and reflect an emerging consensus on good practice amongpractitioners. The core idea behind them is that, in the early phase of an emergency,social supports are essential to protect and support mental health and psychosocialwell-being. In addition, the Guidelines recommend selected psychological andpsychiatric interventions for specific problems.

The composite term mental health and psychosocial support is used in this documentto describe any type of local or outside support that aims to protect or promotepsychosocial well-being and/or prevent or treat mental disorder.

PURPOSE OF THESE GUIDELINES

The primary purpose of these guidelines is to enable humanitarian actors andcommunities to plan, establish and coordinate a set of minimum multi-sectoralresponses to protect and improve people's mental health and psychosocial well-beingin the midst of an emergency.

The focus of the guidelines is on implementing minimum responses, which are essential,high-priority responses that should be implemented as soon as possible in an emergency.Minimum responses are the first things that ought to be done; they are the essential

6 This document summarizes the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings

first steps that lay the foundation for the more comprehensive efforts that may beneeded (including during the stabilised phase and early reconstruction).

Implementation of the guidelines requires extensive collaboration among varioushumanitarian actors: no single community or agency is expected to have the capacityto implement all necessary minimum responses in the midst of an emergency.

These guidelines are not intended solely for mental health and psychosocial workers.Numerous action sheets in the guidelines outline social supports relevant to the corehumanitarian domains, such as protection, general health, education, water andsanitation, food security and nutrition, shelter, camp management. Mental health andpsychosocial workers seldom work in these domains, but are encouraged to use thisdocument to advocate with communities and colleagues from other disciplines toensure that appropriate action is taken to address the social risk factors that affectmental health and psychosocial well-being. The clinical and specialised forms ofpsychological or psychiatric supports indicated in the guidelines should only beimplemented under the leadership of mental health professionals.

How to use this checklist for field use

Reading the full IASC Guidelines on Mental Health and PsychosocialSupport in Emergency Settings from cover to cover may not be possibleduring an emergency. This limitation led to the development of this fieldversion, which may be used as a check-list for programme planning andemergency response. This brief version cannot capture all the importantpoints in the Guidelines. Readers are encouraged to use this field versiononly in conjunction with the full Guidelines.

A good way to begin is to scan the table in Chapter 2 and search for theitems of greatest relevance and go directly to the corresponding actionsheets that are summarized in Chapter 3. For more detailed guidance onany particular action, one needs to consult the relevant action sheet in thefull IASC Guidelines on Mental Health and Psychosocial Support inEmergency Settings:(http://www.humanitarianinfo.org/iasc/content/products)


CORE PRINCIPLES

1. Human rights and equity

Humanitarian actors should promote the human rights of allaffected persons and protect individuals and groups who are atheightened risk of human rights violations. Humanitarian actorsshould also promote equity and non-discrimination.

2. Participation

Humanitarian action should maximise the participation of localaffected populations in the humanitarian response. In mostemergency situations, significant numbers of people exhibitsufficient resilience to participate in relief and reconstructionefforts.

3. Do no harm

Work on mental health and psychosocial support has thepotential to cause harm because it deals with highly sensitiveissues. Humanitarian actors may reduce the risk of harm invarious ways, such as:

Participating in coordination groups to learn from others and tominimise duplication and gaps in response;Designing interventions on the basis of sufficient informationCommitting to evaluation, openness to scrutiny and externalreview;Developing cultural sensitivity and competence in the areas in whichthey intervene/work; andDeveloping an understanding of, and consistently reflecting on,universal human rights, power relations between outsiders andemergency-affected people, and the value of participatory approaches.


4. Building on available resources and capacities

All affected groups have assets or resources that supportmental health and psychosocial well-being. A key principle,even in the early stages of an emergency, is building localcapacities, supporting self-help and strengthening theresources already present. Externally driven and implementedprogrammes often lead to inappropriate mental health andpsychosocial support and frequently have limitedsustainability. Where possible, it is important to build bothgovernment and civil society capacities.

5. Integrated support systems

Activities and programming should be integrated as far aspossible. The proliferation of stand-alone services, such asthose dealing only with rape survivors or only with peoplewith a specific diagnosis, can create a highly fragmentedcare system.

6. Multi-layered supports

In emergencies, people are affected in different ways andrequire different kinds of supports. A key to organising mentalhealth and psychosocial support is to develop a layeredsystem of complementary supports that meets the needs ofdifferent groups (see Figure 1). All layers of the pyramid areimportant and should ideally be implemented concurrently.


Specialisedservices

Focused,non-specialised

supports

Community and family supports

Basic services and security

Figure 1. Intervention pyramid for mental health and psychosocial supportin emergencies. Each layer is described below.

i. Basic services and security

The well-being of all people should be protected through the (re)establishmentof security, adequate governance and services that address basic physical needs.A mental health and psychosocial response to the need for basic services andsecurity may include: advocating that these services are put in place withresponsible actors; documenting their impact on mental health and psychosocialwell-being; and influencing humanitarian actors to deliver them in safe, dignified,socio-culturally appropriate ways that promote mental health and psychosocialwell-being.

ii. Community and family supports

The second layer represents the emergency response for a smaller number ofpeople who are able to maintain their mental health and psychosocial well-beingif they receive help in accessing key community and family supports. Useful


responses in this layer include family tracing and reunification, assisted mourningand communal healing ceremonies, mass communication on constructive copingmethods, supportive parenting programmes, formal and non-formal educationalactivities, livelihood activities and the activation of social networks, such asthrough women's groups and youth clubs.

iii. Focused, non-specialised supports

The third layer represents the supports necessary for the still smaller number ofpeople who additionally require more focused individual, family or groupinterventions by trained and supervised workers (but who may not have hadyears of training in specialised care). For example, survivors of gender-basedviolence might need a mixture of emotional and livelihood support fromcommunity workers. This layer also includes psychological first aid (PFA) andbasic mental health care by primary health care workers.

iv. Specialised services

The top layer of the pyramid represents the additional support required for thesmall percentage of the population whose suffering, despite the supports alreadymentioned, is intolerable and who may have significant difficulties in basicdaily functioning. This assistance should include psychological or psychiatricsupports for people with severe mental disorders whenever their needs exceedthe capacities of primary/general health services.


Do's Don'ts

DO´S AND DON´TS

Experience from many different emergencies indicates that some actions are advisable,whereas others should typically be avoided. These are identified below as 'Do's' and'Don'ts' respectively.

Establish one overall coordination groupon mental health and psychosocialsupport.

Support a coordinated response,participating in coordination meetings andadding value by complementing the workof others.

Collect and analyse information todetermine whether a response is neededand, if so, what kind of response.

Tailor assessment tools to the localcontext.

Recognise that people are affected byemergencies in different ways. Moreresilient people may function well,whereas others may be severely affectedand may need specialised supports.

Ask questions in the local language(s) andin a safe, supportive manner that respectsconfidentiality.

Pay attention to gender differences.

Do not create separate groups on mentalhealth or on psychosocial support that donot talk or coordinate with one another.

Do not work in isolation or withoutthinking how one's own work fits withthat of others.

Do not conduct duplicate assessments oraccept preliminary data in an uncriticalmanner.

Do not use assessment tools not validatedin the local, emergency-affected context.

Do not assume that everyone in anemergency is traumatised, or that peoplewho appear resilient need no support.

Do not duplicate assessments or ask verydistressing questions without providingfollow-up support.

Do not assume that emergencies affectmen and women (or boys and girls) inexactly the same way, or that programmesdesigned for men will be of equal help oraccessibility for women.


Do's Don'ts

Do not use recruiting practices thatseverely weaken existing local structures.

Do not use one-time, stand-alone trainingsor very short trainings without follow-upif preparing people to perform complexpsychological interventions.

Do not use a charity model that treatspeople in the community mainly asrecipients of services.

Do not organise supports that undermineor ignore local responsibilities andcapacities.

Do not assume that all local culturalpractices are helpful or that all local peopleare supportive of particular practices.

Do not assume that methods from abroadare necessarily better or impose them onlocal people in ways that marginalise localsupportive practices and beliefs.

Do not create parallel mental healthservices for specific sub-populations.

Do not provide one-off, single-sessionpsychological debriefing for people in thegeneral population as an early interventionafter exposure to conflict or naturaldisaster.

Check references in recruiting staff andvolunteers and build the capacity of newpersonnel from the local and/or affectedcommunity.

After trainings on mental health andpsychosocial support, provide follow-upsupervision and monitoring to ensure thatinterventions are implemented correctly.

Facil i tate the development ofcommunity-owned, managed and runprogrammes.

Build local capacities, supporting self-helpand strengthening the resources alreadypresent in affected groups.

Learn about and, where appropriate, uselocal cultural practices to support localpeople.

Use methods from outside the culturewhere it is appropriate to do so.

Build government capacities and integratemental health care for emergency survivorsin general health services and, if available,in community mental health services.

Organise access to a range of supports,including psychological first aid, to peoplein acute distress after exposure to anextreme stressor.


Do's Don'ts

Do not provide psychotropic medicationor psychological support without trainingand supervision.

Do not introduce new, brandedmedications in contexts where suchmedications are not widely used.

Do not establish screening for people withmental disorders without having in placeappropriate and accessible services to carefor identified persons.

Do not institutionalise people (unless aninstitution is temporarily an indisputablelast resort for basic care and protection).

Do not use agency communication officersto communicate only with the outsideworld.

Do not create or show media images thatsensationalise people's suffering or putpeople at risk.

Do not focus solely on clinical activitiesin the absence of a multi-sectoral response.

Train and supervise primary/general healthcare workers in good prescription practicesand in basic psychological support.

Use generic medications that are on theessential drug list of the country.

Establish effective systems for referring andsupporting severely affected people.

Develop locally appropriate care solutionsfor people at risk of being institutionalised.

Use agency communication officers topromote two-way communication withthe affected population as well as withthe outside world.

Use channels such as the media to provideaccurate information that reduces stress andenables people to access humanitarianservices.

Seek to integrate psychosocialconsiderations as relevant into all sectorsof humanitarian assistance.


C H A P T E R 2

Matrix of minimum responsesin midst of emergencies

Area A. Common functions

1 Coordination

2 Assessment,monitoring andevaluation

3 Protection andhuman rightsstandards

4 Humanresources

1.1 Establish coordination of intersectoral mental healthand psychosocial support (page 17)

2.1 Conduct assessments of mental health andpsychosocial issues (page 18)

2.2 Initiate participatory systems for monitoring andevaluation (page 18)

3.1 Apply a human rights framework through mentalhealth and psychosocial support (page19)

3.2 Identify, monitor, prevent and respond to protectionthreats and failures through social protection (page 19)

3.3 Identify, monitor, prevent and respond to protectionthreats and abuses through legal protection (page 20)

4.1 Identify and recruit staff and engage volunteers whounderstand local culture (page 21)

4.2 Enforce staff codes of conduct and ethical guidelines(page 22)

4.3 Organise orientation and training of aid workers inmental health and psychosocial support (page 23)

4.4 Prevent and manage problems in mental health andpsychosocial well-being among staff and volunteers(page 24)


Area B. Core mental health and psychosocial supports

5 Communitymobilisationand support

6 Healthservices

7 Education

8 Disseminationof information

5.1 Facilitate conditions for communitymobilisation, ownership and control ofemergency response in all sectors (page 24)

5.2 Facilitate community self-help and socialsupport (page 25)

5.3 Facilitate conditions for appropriate communalcultural, spiritual and religious healing practices(page 26)

5.4 Prevent separation and facilitate support foryoung children (0-8 years) and their care-givers(page 27)

6.1 Include specific psychological and socialconsiderations in provision of general healthcare (page 27)

6.2 Provide access to care for people with severemental disorders (page 28)

6.3 Protect and care for people with severe mentaldisorders and other mental and neurologicaldisabilities living in institutions (page 29)

6.4 Learn about and, where appropriate, collaboratewith local, indigenous and traditional healthsystems (page 30)

6.5 Minimise harm related to alcohol and othersubstance use (page 30)

7.1 Strengthen access to safe and supportiveeducation (page 31)

8.1 Provide information to the affected populationon the emergency, relief efforts and their legalrights (page 31)

8.2 Provide access to information about positivecoping methods (page 32)


Area C. Social considerations in sectors

9 Food securityand nutrition

10 Shelter andsite planning

11 Water andsanitation

9.1 Include specific social and psychologicalconsiderations (safe aid for all in dignity,considering cultural practices and householdroles) in the provision of food and nutritionalsupport (page 33)

10.1 Include specific social considerations (safe,dignified, culturally and socially appropriateassistance) in site planning and shelter provision,in a coordinated manner (page 34)

11.1 Include specific social considerations (safe andculturally appropriate access for all in dignity)in the provision of water and sanitation (page 35)

The full guidelines include 25 action sheets that explain how to implement each of theabove minimum responses (See Chapter 3).


C H A P T E R 3

Summary of Action Sheets:Checklists for Minimum Response

1.1

Each of the checklists below summarise key actions of a minimum response. The checklistscorrespond to the 25 action sheets of the full version of the IASC Guidelines on MentalHealth and Psychosocial Support in Emergency Settings, which provide more detailedinformation and instruction.

1. COORDINATION

Establish coordination of intersectoral mental health and psychosocial support

Activate or establishmechanisms for intersectoralMHPSS coordination(e.g., establish a MHPSScoordination group).Coordinate programmeplanning andimplementation,including developmentof a MHPSS strategicplan.Adapt/develop anddisseminate guidelinesand coordinateadvocacy on MHPSS.Coordinate fundraisingand advocacy for resources.

For a detailed explanation, see pages 33-37 of the IASC Guidelines on MentalHealth and Psychosocial Support in Emergency Settings.


2.2

2.1

2. ASSESSMENT, MONITORING AND EVALUATION

Conduct assessments of mental health and psychosocial issues

Ensure that assessments are coordinated.Collect and analyse keyinformation relevant tomental health andpsychosocial support.Conduct assessments in anethical, rigorous andappropriatelyparticipatory manner.Collate, disseminate anduse assessment resultswith the community andhumanitarian actor,ensuring confidentialityand respecting the Do NotHarm principle, includingprotection risks.

For a detailed explanation, see pages 38-45 of the IASC Guidelines.

Initiate participatorysystems for monitoringand evaluation

Define a set of indicators formonitoring, according to definedobjectives and activities.Apply monitoring andevaluation methods in anethical and appropriatelyparticipatory manner.Use monitoring for reflection,learning and positive change.

For a detailed explanation, see pages46-49 of the IASC Guidelines.


3. PROTECTION AND HUMAN RIGHTS STANDARDS

Apply a human rights framework through mental health and psychosocialsupport

Advocate for compliance with international human rights standards in all formsof mental health and psychosocial support in emergencies.Implement mental health andpsychosocial supports in a waythat that promotes and protectshuman rights.Include a focus on humanrights and protection in thetraining of all relevanthumanitarian and humanrights actors.Establish - within the contextof humanitarian andpre-existingservices - mechanisms for themonitoring and reporting ofabuse and exploitation byhumanitarian agencies.Advocate and provide advice to states on bringing relevant national legislation,policies, programmes and practices into line with international law andstandards.


Identify, monitor, prevent and respond to protection threats and failuresthrough social protection

Learn from protection experts or their specialised protection assessments whether,when and how to collect information on protection threats.Conduct a multi-sectoral, participatory assessment of protection threats andcapacities.Activate or establish social protection mechanisms, building local protectioncapacities where needed.Respond to protection threats by taking appropriate, community-guided action.

3.1

3.2


3.3

Monitor on anongoing basisprotectionthreats invenues such asschools andmarketplaces,sharinginformationwith relevantagencies andprotectionstakeholders.Preventprotection threatsthrough acombination of programming and advocacy.


Identify, monitor, prevent and respond to protection threats and abusesthrough legal protection

Identify the mainprotection threatsand the status ofexistingprotectionmechanisms,especially forpeople atparticular risk.Increase affectedpeople'sawareness of theirlegal rights and theirability to assert theserights in the safest possibleway, using culturallyappropriate communication methods.


4. HUMAN RESOURCES

Identify and recruit staff and engage volunteers who understand local culture

Designate knowledgeable and accountable personnel to undertake recruitment.Apply recruitment and selection principles.Balance gender in the recruitment process and include representatives of keycultural and ethnic groups.Establish terms and conditions for volunteer work.Check references and professional qualificationswhen recruiting national and international staff,including short-term consultants, translators,interns and volunteers.Aim to hire staff who haveknowledge of, and insight into,the local culture andappropriate modes ofbehaviour.Carefully evaluate offersof help from individual(non-affiliated) foreignmental healthprofessionals.

For a detailed explanation, seepages 71-75 of the IASCGuidelines.

4.1

Support mechanisms for monitoring, reporting and responding to violations oflegal standards.Advocate for compliance with international law and standards, and with nationaland customary laws consistent with international standards.Implement legal protection in a manner that promotes psychosocial well-being,dignity and respect.Provide psychosocial support and legal protection services in a complementaryfashion.



Enforce staff codes of conduct and ethical guidelines

Establish within each organisation a code of conduct that embodies widely acceptedstandards of conduct for humanitarian workers.Inform and regularly remind all humanitarian workers, both current and newlyrecruited workers, about the agreed minimum required standards of behaviour,based on explicit codes of conduct and ethical guidelines.

Establish an agreed inter-agency mechanism (e.g. Focal Point Network proposedby the United Nations Secretary-General) that builds consistency, coordinationand best practices to implement of codes of conduct and ethical guidelines.Establish accessible, safe, confidential and trusted complaints mechanisms.Inform communities about the standards and ethical guidelines, and of how andto whom they can raise concerns confidentially.Ensure that all staff understand that they must report all concerns as soon as theyare raised.Use investigation protocols that comply with an agreed standard, such as the IASCModel Complaints and Investigations Procedures.Take appropriate disciplinary action against staff for confirmed violations of thecode of conduct or ethical guidelines.

4.2


Establish an agreed response in cases in which the alleged behaviour constitutes acriminal act in either the host country or the home country of the alleged perpetrator.Maintain written records of workers who have been found to have violated codesof conduct, to increase the effectiveness of subsequent referral/recruitment checks.


4.3 Organise orientation and training of aid workers in mental health andpsychosocial support

Prepare a strategic, comprehensive, timely and realistic plan for training.Select competent, motivated trainers.Utilise learning methodologiesthat facilitate the immediateand practical application oflearning.Match trainees' learning needswith appropriate modes oflearning through brieforientation seminars ortraining seminars.Prepareorientation andtrainingseminarcontentdirectlyrelated to theexpectedemergencyresponse.Consider Training of Trainers (ToT)programmes to prepare trainers to train others.After any training, establish a follow-up system for monitoring, support,feedback and supervision of all trainees, as appropriate to the situation.Document and evaluate orientation and training to identify lessons learned, tobe shared with partners and to enhance future responses.



Prevent and manage problems in mental health and psychosocial well-beingamong staff and volunteers

Ensure the availability of a concreteplan to protect and promote staffwell-being for the specific emergency.Prepare staff for their jobs andfor the emergency context.Facilitate a healthy workingenvironment.Address potential work-relatedstressors.Ensure access to healthcare and psychosocialsupport for staff.Provide support tostaff who haveexperienced orwitnessed extremeevents (criticalincidents, potentiallytraumatic events).Make support availableafter the mission/employment.


5. COMMUNITY MOBILISATION AND SUPPORT

Facilitate conditions for community mobilisation, ownership and control ofemergency response in all sectors

Coordinate efforts by different stakeholders to mobilise communities.Assess the political, social and security environment at the earliest possible stage.Talk with a variety of key informants and formal and informal groups, learninghow local people are organising and how different agencies can participate in therelief effort.Facilitate the participation of marginalised people.

4.4

5.1


Establish safe andsufficient spaces earlyon to supportplanning discussionsand thedissemination ofinformation.Promotecommunitymobilisationprocesses.

For a detailedexplanation, see pages93-99 of the IASCGuidelines.

Facilitate community self-help and social support

Identify human resources in the local community.Facilitate the process of community identification of priority actions throughparticipatory rural appraisal and other participatory methods.

5.2


Support community initiatives, actively encouraging those that promote familyand community support for all emergency-affected community members, includingpeople at greatest risk.Encourage and support additional activities that promote family and communitysupport for all emergency-affected community members and, specifically, for peopleat greatest risk.Provide short, participatory training sessions where appropriate, coupled withfollow-up support.When necessary, advocate within the community and beyond on behalf ofmarginalised and at-risk people.


5.3 Facilitate conditions for appropriate communal cultural, spiritual andreligious healing practices

Approach local religious and spiritual leaders and othercultural guides to learn theirviews on how people havebeen affected and onpractices that would supportthe affected population.Exercise ethicalsensitivity.Learn about cultural,religious and spiritualsupports and copingmechanisms.Disseminate theinformationcollected amonghumanitarian actorsat sector andcoordinationmeetings.Facilitate conditionsfor appropriate healing practices.



6. HEALTH SERVICES

Include specific psychological and social considerations in provision ofgeneral health care

Include specific social considerations in providing general health care.Provide birth and death certificates (if needed).Facilitate referral to key resources outside the health system.Orient general health staff and mental health staff in psychological components ofemergency health care, including psychological first aid.

5.4

6.1

Prevent separation and facilitate support for young children (0-8 years) andtheir care-givers

Keep children with theirmothers, fathers,family or otherfamiliar care-givers:preventseparation,reunifychildren andparents, and- only whennecessary-facilitatealternativecarearrangements.Promote thecontinuation ofbreastfeeding.Facilitate age andculturally appropriate play, nurturing care and social support that gives childrena sense of routine and participation in normalizing activities.Care for care-givers by organizing meetings at which care-givers can discuss past,present and future; share problem-solving; and support one another in caringeffectively for their children.

For detailed guidance, see pages 110-115 of the IASC Guidelines.


Make availablepsychological support forsurvivors of extremestressors (also known astraumatic stressors).Collect data on mentalhealth in primary healthcare settings.

For a detailed explanation, seepages 116-122 of the IASCGuidelines.

6.2 Provide access to care for people with severe mental disorders

Assess existing services and identify people in need.Build a relationship with traditional healers and facilitate the use of supportivetraditional healing methods where appropriate.Ensure sustainable supplies of psychotropicmedication.Initiate rapid supervisedtraining for emergencyPHC staff.Establish an accessibleadvertised service.Avoid the creation ofparallel mentalhealth servicesfocused on specificdiagnoses (e.g.posttraumatic stressdisorder) or onnarrow groups (e.g. widows).Provide biological, psychological, andsocial interventions to relieve symptoms,provide protection and restore function.


Educate and support existing carers.Work with local community structures and groups to enable protection of thoseseverely disabled by mental disorder.With displaced populations, plan for return home (as appropriate).Collaborate with existing health services and authorities to facilitate sustainablecare.


Protect and care for people with severe mental disorders and other mentaland neurological disabilities living in institutions

Ensure that at least one agency involved in health care accepts responsibility forongoing care and protection of people in institutions.If staff have abandoned psychiatric institutions, mobilise human resources fromthe community and the health system to care for people with severe mental disorderswho have been abandoned.Protect the lives and dignity of people living in psychiatric institutions.Enable basic health and mental health care throughout the emergency.


6.3


6.4

6.5 Minimise harm related to alcohol and other substance use

Conduct a rapid assessment.Prevent harmful alcohol andother substance use anddependence.Facilitate harm reductioninterventions in thecommunity.Manage withdrawal andother acute problems.

For a detailed explanation,see pages 142-147 of theIASC Guidelines.

Learn about and, where appropriate, collaborate with local, indigenous andtraditional healing systems

Assess and map theprovision of care.Learn aboutnational policyregardingtraditionalhealers.Establish rapportwith identifiedhealers.Encourage theparticipation oflocal healers ininformation sharing and training sessions.If possible, set up collaborative services.



8. DISSEMINATION OF INFORMATION

Provide information to the affected population on the emergency, reliefefforts and their legal rights

Facilitate the formation ofan informationand communicationteam.Regularly assess thesituation and identifykey informationgaps and keyinformation fordissemination.Develop acommunication andcampaign plan.

7.1

8.1

7. EDUCATION

Strengthen access to safe and supportive education

Promote safe learningenvironments.Make formal and non-formaleducation more supportiveand relevant.Strengthen access to qualityeducation for all.Prepare and encourageeducators to support learners'psychosocial well-being.Strengthen the capacity of theeducation system to supportlearners experiencing psychosocialand mental health difficulties.



Create channels to access and disseminate credible and valid information to theaffected population.Ensure coordination between communication personnel working in differentagencies.


Provide access to information about positive coping methods

Determine what information on positive coping methods is already available amongthe disaster-affected population.If no information on positive coping methods is currently available, developinformation on positive, culturally appropriate coping methods for use among thedisaster-affected population.Adapt the information to address the specific needs of sub-groups of the populationas appropriate.Develop and implement a strategy for effective dissemination of information.


8.2


9. FOOD SECURITY AND NUTRITION

Include specific social and psychological considerations (safe aid for all indignity, considering cultural practices and household roles) in the provisionof food and nutritional support

Assess psychosocial factors related to food security, nutrition and food aid.Maximise participation in the planning, distribution and follow-up of food aid.Maximise security and protection in the implementation of food aid.Implement food aid in a culturally appropriate manner that protects the identity,integrity and dignity of primary stakeholders.Collaborate with health facilities and other support structures for referral of recipientswho need special attention (e.g. under-stimulated, malnourished children; mentallyill persons).Stimulate community discussion for long-term food security planning.


9.1


10.1

10. SHELTER, SITE PLANNING

Include specific social considerations (safe, dignified, culturally and sociallyappropriate assistance) in site planning and shelter provision, in a coordinatedmanner

Use a participatory approach that engages women and people at risk in assessment,planning and implementation.Select sites that protect security and minimise conflict with permanent residents.Include communal safe spaces in site design and implementation to enable social,cultural and religious educational activities and dissemination of information.Develop and use an effective system of documentation and registration.Distribute shelter and allocate land in a non-discriminatory manner.Maximise privacy, ease of movement, opportunities for social support andmaintenance of social relations through site and shelter planning.Balance flexibility and protection in organising shelter and site arrangements.Avoid creating a culture of dependency among displaced people and promotedurable solutions.



11. WATER AND SANITATION

Include specific social considerations (safe and culturally appropriate accessfor all in dignity) in the provision of water and sanitation

Include social and cultural issues in water and sanitation and hygiene promotionassessments.Enable participation in assessment, planning and implementation, especiallyengaging women and other people at risk.Promote dignity, safety and protection in all water and sanitation activities, ensuringthat latrines and bathing areas are lockable and well-lit.Prevent and manage in a constructive manner conflict over water between affectedfamilies or between displaced groups and permanent residents.Promote personal and community hygiene.Facilitate community monitoring of, and feedback on, water and sanitation facilities,being sure to talk with people at risk.


11.1


Notes

Specifc action sheets offer useful guidance on mental health and

psychosocial support, and cover the following areas:

Coordination

Assessment, Monitoring and Evaluation

Protection and Human Rights Standards

Human Resources

Community Mobilisation and Support

Health Services

Education

Dissemination of Information

Food Security and Nutrition

Shelter and site Planning

Water and Sanitation

Reading the full IASC Guidelines on Mental Health and Psychosocial Support in

Emergency Settings from cover to cover may not be possible during an emergency. This

limitation led to the development of this check-list for programme planning and

emergency response. This checklist cannot capture all the important points in the

Guidelines. Readers are encouraged to use this cheklist only in conjunction with the full

Guidelines.

The IASC Guidelines for Mental Health and Psychosocial

Support in Emergency Settings reflect the insights of numerous

agencies and practitioners worldwide and provide valuable

information to organisations and individuals on how to respond

appropriately during humanitarian emergencies. CHECKLIST FOR FIELD USE


Published by the Inter-agency Standing Committee (IASC), the Guidelines

give humanitarian actors useful inter-agency, inter-sectoral guidance and

tools for responding effectively in the midst of emergencies.

Hecho el Depósito Legal en la Biblioteca Nacional del Perú Nº 2008-14673

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