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Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings

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Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings How Are We Doing? Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings @ Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support, November, 2014 Disclaimer This study was prepared by external consultants Sarah Meyer and Maryanne Loughry. The content of the report does not necessarily reflect the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support policies or views. Any part of this review may be freely reproduced with appropriate acknowledgement. Cover photos (left to right): Top: © The Good Practice Group; ©World Vision; © International Organization for Migration Bottom: © UNICEF/NYHQ2012-2092/Friedman; © The Good Practice Group; © UNICEF/SUDA2014-XX815/Noorani For further information please contact: Margriet Blaauw, Co-chair of the Reference Group, War Trauma Foundation Email: [email protected] Saji Thomas, Child Protection Specialist, UNICEF HQ, New York, Co-chair of the Reference Group Email: [email protected] Acknowledgements The study was made possible with the cooperation of a number of individuals and agencies who took time out to speak to the researchers, take part in the survey, review the initial reports and provide inputs for the snapshots and case studies. 72 individuals from 35 countries responded to the survey; their names are not included below. The Inter-Agency Standing Committee (IASC) Reference Group on Mental Health and Psychosocial Support (The Reference Group) thanks them for their time and support. A special note of thanks to the following individuals and organizations: Alison Shafer (World Vision), Ananda Galapatti (Good Practice Group,Sri Lanka), Ann Willhoite (CVT), Arafat Jamal(IASC), Benedicte Weyl (AFD), Bryan Schaaf (BPRM), Cecile Bizouerne (ACF), Chris Underhill (Basic Needs), Elise Griede( War Child), Else Berglund, Guglielmo Schininà (IOM), Inka Weissbecker (IMC), Janis Risdel (Plan International), Jorge Castilla-Echenique (ECHO), Katja Laurila (IASC), Leslie Snider (WTF), Margriet Blaauw (IASC Reference Group on MHPSS), Mark van Ommeren (WHO), Martha Bragin, Mike Wessells, Miriam Rivera Holguin, Nana Wiedemann (IFRC), Nancy Baron, Peter Ventevogel (UNHCR), Pierre Bastin (ICRC), Ruth O’Connell (UNICEF), Sabine Rakotomalala( CPWG), Saji Thomas (UNICEF), Sarah Harrison (IMC), Saudamini Siegrist (UNICEF), Siobhan Foran (IFRC),Tineke van Petersom (Antares Foundation) We also thank the following organizations and individuals for providing all the support in putting the case studies together: South Sudan: Duku Boniface, Erin Joyce (World Vision), Harriet Holder (Save the Children), Helene Villeneuve (UNICEF), Lasu Joseph (War Child) Sri Lanka: Ganesan Mahesan, Marsha Cassiere-Daniel State of Palestine: Dyah Saymah (WHO), Frank Roni (UNICEF), Safa Nasr (UNICEF), Ureib Amad (formerly ECHO), Ylva Vandenberg (War Child) Central African Republic (CAR): Capucine de Fouchier, Julie Bodin (Save the Children), Stephanie Duberger (ACF) Jordan (Syria response): Ahmad Bawaneh (IMC), Laetitia Clouin (ACF), Zein Ayoub (WHO) Libya: Fahmy Bahgat (WHO) The Reference Group appreciates the hard work put in by Sarah Mayer and Maryanne Loughry to undertake this study. The study was commissioned by UNICEF, Headquarters, New York on behalf of the Reference Group. The Reference Group is grate- ful to UNICEF for providing the leadership in facilitating the study. We also thank Office of U.S. Foreign Disaster Assistance (OFDA)/U.S. Agency for International Development (USAID) for their financial support for the study through UNICEF. Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings 1 Foreword In 2007, the Inter-Agency Standing Committee (IASC) published the IASC Guidelines on Mental Health and Psychosocial Support (MHPSS) in Emergency Settings to enable humanitarian actors to plan, establish and coordinate a set of minimum multi-sectoral responses to protect and improve people’s mental health and psychosocial well-being in the midst of an emergency. Following the publication of the Guidelines, the IASC MHPSS Reference Group was formed to support global implementation of the guidelines and integration of MHPSS in the Cluster system. The Reference Group has conducted orientations on the guidelines, advocated for the integration of the guidelines into cluster and organizational policies, and for their implementation in emergencies. The Reference Group has also released a series of supplementary implementation tools to accompany the full guidelines. The Guidelines are now available in Arabic, Chinese, English, French, Japanese, Nepali, Spanish and Tajik. This review looks at the level of implementation of the Guidelines and supplementary tools, and the mainstreaming and in- tegration of the Guidelines across the humanitarian system since the Guidelines were first published. The results are based on key informant interviews, extensive document review, and an on-line survey. In addition, implementation is explored in specific emergency contexts through a combination of in-depth and brief case studies. Findings of the review indicate that that the impact of the Guidelines has been widespread and significant. Seven years of dissem- ination, utilization and implementation of the Guidelines in a range of vastly differing contexts has offered an opportunity for reflection, consolidation and mapping of the next steps towards strengthening and improving MHPSS response in emergencies. The review includes in-depth case studies on implementation of the Guidelines in the Central African Republic, Peru, the Phil- ippines, South Sudan and State of Palestine. The report also includes shorter snapshots on MHPSS response in Libya, Sri Lanka and the response to the Syrian refugee crisis in Jordan. I hope that the findings, suggestions and recommendations in this review will further support the practical implementation of the Guidelines and will continue to contribute to reduced suffering and improved mental health and psychosocial well-being of people affected by emergencies. Kyung-wha Kang, Chair of the Inter Agency Standing Committee Working Group Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings 2 Table of Contents Acronyms . 5 Executive Summary . 6 I. Background . 10 Key questions of the review . 11 What are the Guidelines? . 12 What is implementation? . 13 Outline of the review . 13 II. Literature review . 14 Literature inclusive of core principles in the Guidelines . 14 Literature that directly refers to and discusses the Guidelines . 17 Literature providing evidence for aspects of the Guidelines . 18 III. Overall influence of the Guidelines . 22 Interagency consensus and the role of MHPSS in emergencies . 23 The role of the Reference Group . 23 MHPSS – a term used for communication and consolidation of the field . 23 Influence of core principles . 25 IV. Awareness . 26 Views on awareness of the Guidelines . 26 Methods used to build awareness . 28 Recommendations . 31 V. Utilization . 33 Communication between and within agencies . 33 Utilization of the Guidelines with donors . 34 Influence on programmes and activities in the field . 36 Coordination . 42 Utilization and influence in clusters . 45 Who is using the Guidelines? . 48 Recommendations . 48 VI. Institutionalization . 51 Policies and procedures . 51 Human resources . 52 Guidance for institutionalization . 54 Recommendations . 54 VII. Conclusion . 55 Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings 3 References . 56 Annexes: . 59 Annex 1: On-line survey questions . 59 Annex 2: Case studies . 63 Annex 3: Detailed recommendations . 75 Annex 4: Report from on-line survey . 79 Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings 4 Acronyms CCCM Camp Coordination and Camp Management CFS Child Friendly Space CPWG Child Protection Working Group ECD Early Childhood Development IASC Inter-Agency Standing Committee IFRC International Federation of Red Cross and Red Crescent Societies IMC International Medical Corps IOM International Organization for Migration M AND E monitoring and evaluation MHGAP Mental Health Gap Action Programme MHPSS mental health and psychosocial support MOH Ministry of Health OCHA Office for the Coordination of Humanitarian Affairs PFA Psychological First Aid PTSD Post-traumatic Stress Disorder RG MHPSS Reference Group SGBV Sexual and Gender Based Violence UNHCR UN High Commissioner for Refugees [UN Refugee Agency] UNICEF UN Children’s Fund WASH Water, Sanitation and Hygiene WHO World Health Organization 4WS who is where, when and doing what in humanitarian settings (the 4Ws mapping tool). Review of the Implementation of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings 5 Executive Summary © ACTION CONTRE LA FAIM /VERONIQUE BURGER /PHANIE - LIBERIA CONTRE LA FAIM © ACTION In 2007, the IASC released the IASC Guidelines key interventions spanning emergency preparedness, minimum on Mental Health and Psychosocial Support in responses and comprehensive responses. These key interven- Emergency Settings [henceforth referred to as tions are across areas including coordination, human resources, the Guidelines] . One of the factors
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