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(4Ws) in Mental Health and Psychosocial Support Libya 2017 WHO IS WHERE, WHEN, DOING WHAT (4WS) IN MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT LIBYA 2017 WHO IS WHERE, WHEN, DOING WHAT (4WS) IN MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT LIBYA 2017 This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents of the presentation are the responsibility of MHPSS.net and do not necessarily reflect the views of USAID or the United States Government. Acknowledgements This report was prepared by MHPSS.net in Report written by: Renata Reali and Marcio partnership with WHO Libya and The Delegation Gagliato. of the European Union to Libya. The purpose of the report is to facilitate the exchange of Reviewers (in alphabetical order): Ananda knowledge and information on available services Galappatti (MHPSS.net), Edda Costarelli information among MHPSS actors and their (Delegation of the European Union to Libya), Dr. partners in Libya. Ghassan Karem (PHC Director, Libya Ministry of Health), Malak Ben Giaber (Libyan Clinical We are thankful for the collaboration with many Psychologist), Margriet Blaauw (MHPSS.net), Dr. Mental Health and Psychosocial Support (MHPSS) Sara Zarti (WHO Libya). actors, their efforts and contributions. We are especially thankful to the Libyan colleagues Tripoli Psychosocial Support Team1 generously involved in data collection across the country. provided the image on the front cover and section pages We would like to acknowledge the Libyans colleagues participating in this study, who The Mental Health & Psychosocial Support welcomed this initiative and shared valuable Network (MHPSS.net) is a growing global information. platform for connecting people, networks and organizations, for sharing resources and for Coordination: Marcio Gagliato (MHPSS.net). building knowledge related to mental health and psychosocial support both in emergency settings Project Team: Dr. Sara Zarti (WHO Libya); Renata and in situations of chronic hardship. Reali (MHPSS.net); Marcio Gagliato. For further information, please contact Marcio Libya Advisory & Data Collection Team (in Gagliato at [email protected], and Sara Zarti at alphabetical order): Ali Abdusamad (Psychiatrist [email protected] – Tripoli NCDC); Anwar Naser Farjah Allah (Psychologist – Tripoli MoH); Asiddiq Alhajali Shwehdi (Psychiatrist – Misrata Central Hospital); Khaled Hamidi (MHPSS – Tripoli Psychosocial Support Team); Khaled Adris Alhasi (Psychologist – Head of Social and Psychological Office of Education, East Libya); Nidhal Mohammed Ali Shaeban (Psychiatrist – Sabha Psychiatric Clinic); Ramadhan Salim Almusrati (Psychiatrist – Director General of Benghazi Mental Health Hospital); Saleh Mohamed Ali Elwelwal (Board member of Libyan Society for Psychological Sciences). 1Libyan Non-Governmental Organization 4 Who is Where, When, doing What (4Ws) in Mental Health and Psychosocial Support (MHPSS) in Libya Contents Acknowledgements 4 Contents 5 List of Abbreviations 6 Executive Summary 7 1. Introduction 11 1.1. MHPSS Coordination and Mapping 13 2. Contextual Information and MHPSS Background in Libya 15 2.1. Libya Country Statistics 16 2.2. Socio-political context 17 2.3. Libya Mental Health System 18 2.4. Prevalence of Mental Health Disorders in Libya 19 2.5. Migrants, Refugees and people on the move in Libya 20 2.6. Earlier MHPSS Assessments and Mapping Activities 20 3. The 4Ws MHPSS Mapping Exercise 23 3.1. Methods and the 4Ws Mapping Process 25 3.2. Findings 27 3.3. Challenges 33 3.4. Recommendations 33 References 34 Annex A - Detailed MHPSS activities provided in Libya 36 Annex B - Data collection - Excel Form 37 Annex C - List of resources available at Libya MHPSS Response - 2017 Group 38 Annex D - Organizations operating MHPSS programs/activities per governorate 47 Annex E - Organizations providing MHPSS services by IASC MHPSS Layers 48 Annex F - Actors currently active in MHPSS 50 MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT (MHPSS) 5 List of Abbreviations CBO Community-Based Organization EU European Union GNC General National Congress IASC Inter-Agency Standing Committee IMC International Medical Corps INGO International Non-Governmental Organization IOM International Organization for Migration MH Mental Health MHPSS Mental Health and Psychosocial Support MHPSS WG Mental Health and Psychosocial Support Working Group MoH Ministry of Health NCDC National Center for Diseases Control NGO Non-Governmental Organization NTC National Transitional Council OCHA United Nations Office for the Coordination of Humanitarian OFDA US Office of Foreign Disaster Assistance OFDA US Office of Foreign Disaster Assistance PSS Psychosocial Support PHC Primary Health Care PTSD Post-Traumatic Stress Disorder SWOT Strengths, Weaknesses, Opportunities and Threats UN United Nations UNSMIL United Nations Support Mission in Libya WHO World Health Organization 6 Who is Where, When, doing What (4Ws) in Mental Health and Psychosocial Support (MHPSS) in Libya Executive Summary This Who is Where, When, doing What (4Ws) in d) Improve the transparency and legitimacy Mental Health and Psychosocial Support (MHPSS) of MHPSS services through structured in Libya exercise was carried out by MHPSS.net documentation in partnership with the World Health Organization (WHO) Libya and the Delegation of European This mapping provides an overview of services Union to Libya, and with the generous financial currently available in Libya. It does not provide support of the US Office of Foreign Disaster information on the quality of these services, Assistance (OFDA). the number of interventions or the number of beneficiaries served. The findings are based on It also marked the first use of an online 4Ws tool, the data collected between July and October 2017. developed by MHPSS.net, that organizations can According to the findings there are diverse MHPSS use to provide their own information on ‘Where services available in all regions of Libya, targeting they are doing What and When’ in emergency different populations: settings and generate a real-time analysis and display of data related to the MHPSS services Number of organizations: This exercise identified available in Libya. a total of 190 organizations that deliver MHPSS services, programs, and activities across Libya, This 4Ws mapping seeks to: including 178 national actors and 12 international a) Enhance coordination, collaboration, referral actors. systems and accountability for all involved agencies Location: Despite MHPSS services being mapped as present in all regions of Libya, there is a b) Identify gaps in service provision, geographic, concentration of reported services in the Tripoli and target group coverage, human resources and area (58% of all activities). technical expertise Target groups: The majority of the reported c) Provide data on patterns to inform MHPSS activities target children, adolescents, recommendations, agency plans/proposals and local communities, and persons with disabilities. lessons learned for future responses, and MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT (MHPSS) 7 Activities targeting women, men, elders, layer; 52,8% are under “Community and family caregivers, refugees, migrants, and IDPs were also support”; 18,5% are under “Focused non- reported, but in lower numbers. specialized support”; and 22,7% are under “Specialized services”. Most reported activities: The most frequently reported MHPSS activities in Libya are linked to In addition, 30 organizations reported general strengthening communities and family through activities in support of MHPSS, such as trainings, recreational activities; psychological support in clinical supervision etc. “ education settings; and in lower numbers, services linked to clinical management of mental health Recommendations (MH) disorders. • Exploration of possibilities to expand MHPSS services to regions where people have limited Reported MHPSS Human Resources: There access to them is a relatively high number of health staff, social workers and psychologists2 providing MHPSS • Support coordination mechanisms and services compared to other actors. Other initiatives categories such as volunteers or case managers appear to be reported less frequently. • Build on this exercise with a further detailed assessment of MHPSS needs, capacities and IASC intervention pyramid: 5,9% of the reported resources MHPSS activities in Libya are under “Social considerations in basic service and security” • Enhance the capacity and quality of services in other regions, depending on the results of the detailed needs assessment proposed above 2 In Libya, psychology graduates are often not trained in providing any counseling or psychotherapeutic interventions 8 Who is Where, When, doing What (4Ws) in Mental Health and Psychosocial Support (MHPSS) in Libya MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT (MHPSS) 9 10 Who is Where, When, doing What (4Ws) in Mental Health and Psychosocial Support (MHPSS) in Libya 1. Introduction This mapping is based on the Inter Agency future responses, and to improve the transparency Standing Committee (IASC) MHPSS 4Ws (IASC, and legitimacy of MHPSS services through 2012) tool and aims to enhance coordination, structured documentation. Furthermore, the collaboration, referral systems and accountability mapping is available as a ‘living’ online 4Ws tool for all involved agencies; identify gaps in service provided by MHPSS.net, to which organizations provision, geographic, and target group coverage, can provide their own information and generate a human resources and technical expertise;
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