Manual on Community-Based Mental Health and Psychosocial Support in Emergencies and Displacement

"The psychosocial well-being of migrants is indeed strongly linked to factors that are strictly interrelated with the concept of community. These include a sense of belonging, social roles, culture and cultural adaptation, the dynamic between tradition and change, differences in paradigms of social support, a sense of identity, and in-group and out-group relations and stigma."

The main aim of this manual from the International Organization for Migration (IOM) is to provide those responsible for mental health and psychosocial support (MHPSS) in emergencies with a reference document that can help them in the practical implementation of their activities with a community-based (CB) approach.

According to the IOM, "[t]here has been a call in recent years to shift the focus of MHPSS programmes in emergencies from psychological symptoms, and their treatment and prevention, to collective and contextual elements of consequences of adversities. This includes the understanding of the importance of the collective reactions to adversity and of social cohesion, social supports, identities and social textures in determining individual and social well-being after disasters. It also includes the activation of context-specific, multidisciplinary support systems that build on existing strengths of affected communities, rather than limiting the intervention to the provision of services to respond to the deficits created by the emergency."

In that light, some of the activities aimed at strengthening the social fabric and helping people overcome their distress described in the manual include sociocultural, artistic, and educational programmes and workshops, sport and play, rituals and celebrations, counselling, and clinical and social support for those with severe mental disorders. The manual describes ways to integrate mental health and psychosocial support in other activities, like livelihood support, protection of vulnerable cases, and conflict transformation.

The manual is organised into 16 chapters and 2 annexes. The first chapter introduces concepts, models, and principles of CB MHPSS work; other chapters that have to do with process (operational and programmatic) considerations focus on:

• Engaging with communities;
• Assessing and mapping;
• Psychosocial mobile teams;
• Technical supervision and training;
• Monitoring and evaluation; and
• Coordination and ethical considerations.

The other chapters introduce specific CB MHPSS activities and feature case studies illustrating implementation in the field. For example, a LINC Community Resilience Intervention involves an entire community or its representatives in assessing a situation and designing its own intervention (Landau, 2007). The intervention uses a series of maps to assess demographics, attitudes, customs, family structures and important events in the community. Following this assessment, community forums are organised, each representing a comprehensive cross-section of the population. Small discussion groups identify the strengths, themes, scripts, and resources that are available within the community and discuss what the concept of resilience means. Each group then develops overarching goals for the future. They then work as collaborative teams to select their community "Links", or people from within their own group whom they trust and with whom they can communicate easily, to help them undertake projects to make their goals a reality.

Each chapter in the manual: provides a short theoretical background; lists essential information on the topic; describes step by step the process that needs to be undertaken in a community-based fashion; presents examples and best practices; refers and links to relevant internal and external tools, models of work, and case studies; identifies challenges; and provides a short list of additional readings, on the top of the articles and tools already hyperlinked in the text.

Although the manual is written for an international intergovernmental organisation (that is, IOM), smaller non-governmental agencies can make use of parts of the manual, based on identified priorities of their own programmes. The document is open source, refers to tools and researches of different agencies, and was conceived and reviewed by a variety of experts and practitioners from several organisations.

IOM Is interested in receiving feedback on the manual, aiming at regular revisions based on inputs received from the field. To contribute your thoughts, please send a message to contactpss@iom.int stating, "I am in for the feedback on the MHPSS manual."