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

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INTRODUCTION

The present Manual aims to facilitate mental health and psychosocial support (MHPSS) experts and managers in designing, implementing and evaluating community-based MHPSS (CB MHPSS) programmes, projects and activities for emergency-affected and displaced populations in humanitarian settings. It is specifically designed to support managers and experts hired by the International Organization for Migration (IOM).

However, it can also be used, in its entirety or in some of its components, by MHPSS experts and managers working for IOM’s partners, including international and national governmental organizations, non-governmental organizations (NGOs), countries, donors and civil society groups. For this reason, 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 organizations. Although it is written for an international intergovernmental organization, smaller non-governmental agencies can make use of parts of the manual, based on identified priorities of their own programmes.

There 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 wellbeing 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 2019, the Inter-Agency Standing Committee (IASC) Reference Group on MHPSS issued Community-Based Approaches to MHPSS Programmes: A Guidance Note (IASC, 2019a) to respond to this widely perceived need. The guidance aims at better defining principles of MHPSS in emergencies based on the understanding:

...that communities can be drivers for their own care and change and should be meaningfully involved in all stages of MHPSS responses. Emergency-affected people are first and foremost to be viewed as active participants in improving individual and collective well-being, rather than as passive recipients of services that are designed for them by others. Thus, using community-based MHPSS approaches facilitates families, groups and communities to support and care for others in ways that encourage recovery and resilience. These approaches also contribute to restoring and/or strengthening those collective structures and systems essential to daily life and well-being. An understanding of systems should inform community-based approaches to MHPSS programmes for both individuals and communities (IASC, 2019a).

This Manual aims to give operational and programmatic indications on how to make this happen within IOM MHPSS programmes, and those of partners working with relatable populations in similar contexts.

IOM has provided MHPSS to emergency-affected, migrant, displaced, returnee populations and host communities since 1999, in more than 70 countries worldwide. Based on its experiences and engagements, the Organization has developed holistic and systemic practices of MHPSS that are community based. Community is indeed a central concept in the Organization’s MHPSS approach, due to its mandate and target populations. 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.

For many years, the harmonization of IOM MHPSS programmes in emergencies has been based on face-to-face trainings for the IOM experts and managers, but this approach has proved difficult to sustain, unless accompanied by a factual manual. From the one side, requests for MHPSS programmes have increased dramatically in the last few years, making it difficult to deploy managerial and expert teams that are already trained, or to train the deployed teams in a timely manner. On the other side, the need for a manual that could instruct newly hired managers and experts in the various steps of setting up a CB MHPSS programme with displaced populations has emerged in the evaluation of several IOM MHPSS programmes in emergencies, such as those in Libya in 2013 and the Syrian Arab Republic in 2016.

The Manual can be used by:

• IOM managers, to be instructed on IOM’s approach to CB MHPSS programming;

• Managers and experts in the wider MHPSS community, to respond to the need to identify and harmonize practices of CB MHPSS.