World Mental Health Day is a day for global mental health education, awareness and advocacy against social stigma.

It is now widely recognized that humanitarian work carries inherent psychosocial risk and many organisations are making progress towards staff care. While this is true, on this Mental Health Day, we would like to highlight a challenge that we hear from our client organisations: How do we care for the psychosocial wellbeing of our national staff in places without adequate mental health structures.

In answering this question, we recognise that there are a number of considerations and one approach will not necessarily work for each country programme. These considerations include: 

  1. Local staff make up the majority of the humanitarian workforce, usually  90% or more.

  2. There are a wide variety of national labor laws and socio-political contexts.

  3. Cultural norms, expressions and treatments of mental illness vary from place to place.

  4. Staff may have personal exposure to trauma in the area they are to work.

  5. Staff may not be able to leave a location if violence or threat escalates

  6. Funding limitations/restrictions for provision of staff care services

 

Mental Health after a Crisis or Disaster

After a crisis or disaster, mild to moderate mental disorders increase to 15-20% in the effected population, and severe mental disorders increase to 3-4% in the effected population. Sometimes having a job with a large INGO can be a protective factor in individual and familial resilience, and sometimes it can be a risk factor, particularly if they are working close to home, and engaging in crisis similar to those personally experienced.  

The important localization of programmes that follow emergency requires that organisations plan for the long-term mental health of national staff.

For example scientists examined the mental health of 376 Ugandan workers at 21 humanitarian aid agencies and found that a significant number of the staff at these organizations experienced high levels of symptoms for depression (68 percent), anxiety disorders (53 percent), and post-traumatic stress disorder (26 percent), respectively. And 50% of [national] workers experienced five or more categories of traumatic events.

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Mental health services around the world vary greatly, as do perceptions of mental illness and viable treatment options.  Vikram Patel’s book “Where there is no psychiatrist” is as relevant today as when it was written in 2003. (There is a 2nd edition now, 2018).  

We recognize that there may not be adequate services available, but encourage your organisations to continue to creatively explore ways  to look after the wellbeing of your national staff. On top of having a location-specific list of providers, there are several low-cost interventions that help to prevent the onset or exacerbation of an existing condition.  It is important to note consultative leadership and team cohesion are the foundation for healthy teams.

 

Strategies to improve staff wellbeing:

  1. Enhancing team cohesion through robust human resources, team management techniques, away days and team building.

  2. Promoting social support through regular team meetings, supervision, joint working plans.

  3. Avoiding excessive hours spent at work, close the office on time, make sure staff are not taking their work home with them daily.

  4. Increasing access for personal communications during break times, especially when staff are away from their family. Consider increasing access to telephones and internet.

  5. Expressing job related appreciation on a regular basis to show that the staff member is a valued part of the team and their role and work is significant.

 

Thrive Worldwide caring for staff mental health

At Thrive we provide three different solutions to supporting both organisations and staff:

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1. Counselling:

  • Face to face support: We have counsellors & psychologists in Bangladesh, Kenya and the UK.

  • We offer online counselling services in Arabic, Dutch, English, French, Kiswahili, and Spanish

  • We travel onsite to visit your team and provide resilience or crisis management interventions depending on the need.

2. Learning programmes:

  • A Peer Support programme is a proactive way to support staff wellbeing and with appropriate supervision can also mitigate mental distress and illness.. We can support you to adopt the right Peer Support programme for you as well as to train and equip your responders.

  • We have a variety of other training programmes on subjects including Stress Management, Resilience, Psychological First Aid & more…

3. Consultancy services:

  • Do you need support thinking through your wellbeing strategy? We can advise you and consult in writing a wellbeing / staff health plan.

  • Our Wellbeing Survey will equip your organisation to identify trends and then we will co-create solutions to improve staff wellbeing & mental health.

 

References:

  • Post-disaster mental health and psychosocial support: Experience from the 2015 Nepal earthquake. WHO South-East Asia Journal of Public Health 6(1):22 · April 2017, citing IASC MHPSS in complex emergencies, 2007.
  • Alastair Ager, Eba Pasha, Gary Yu, Thomas Duke, Cynthia Eriksson, Barbara Lopes Cardozo. Stress, Mental Health, and Burnout in National Humanitarian Aid Workers in Gulu, Northern Uganda. Journal of Traumatic Stress, 2012; 25 (6): 713