IASC Guidelines

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IASC Guidelines

• "A significant gap has been the absence of a
  multi-sectoral, inter-agency framework that
  enables coordination, identifies useful
  practices, flags harmful practices and clarifies
  how different approaches to mental health and
  psychosocial support complement one another."

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Orientation on the IASC Guidelines on Mental
health and Psychosocial Support in Emergencies
Education ClusterAmanda Melville, occupied
Palestinian territory 12 Feb 2009
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• Introductions and agenda
• Handouts
• Brochure with matrix
• Print out of Field Use Version
• Full Guidelines on CD ROM (explain)
• True False Exercise
• Local expertise

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IASC Task Force UN and non-UN agencies wrote
Guidelines

• INEE
• IRC
• MdM-E
• Mercy Corps
• MSF-H
• Oxfam GB
• RET
• SC/UK
• SC/USA

• Ref Group now
• also has
• CARE Int.
• Ch of Sweden
• COOPI
• GP-SI
• RedR
• REPSSI
• TdH
• UNRWA
• World Vision

• ICVA
• IFRC
• Interaction
• IOM
• OCHA
• UNFPA
• UNHCR
• UNICEF
• WFP
• WHO

• ACF
• Am. Red Cross
• ACT International
• Action Aid
• International
• CARE Austria
• CCF
• HealthNet TPO
• IMC
• ICMC

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Exercise 1 First reaction(1 minute)

• Reflect on experiences that you had or aware of
  related to mental health and psychosocial support
  during and after emergencies.
• Reflect on the following question. Is there a
  potential need for applying here internationally
  endorsed inter-agency mental health and
  psychosocial support guidelines?

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Some typical answers to this exercise are

• Inter-agency guidelines are needed because
• Need to strengthen coordination and have common
  comprehensive framework for action
• Need for guidance on most effective practices and
  how to avoid doing harm or using ineffective
  practices
• Need to bring together diverse actors with strong
  views in common framework
• Need guidance on how to prioritise in situations
  where need is huge and strains existing
  capacities
• But
• Should be culturally sensitive/adaptable
• Should take local situation, capacities and
  resources into account
• Should cover/not cover/ go beyond PTSD

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Inclusive framework mental health and
psychosocial support covers both

• protecting or promoting psychosocial well-being
• and/or
• (b) preventing or treating mental disorder.

PS
MH
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Diverse needs in midst of emergencies

• Emergencies erode normally protective supports
  and increase risks for a range of problems
• pre-existing social problems
• E.g. social tensions/divisions
• emergency-induced social problems
• E.g. overcrowding in housing, loss of jobs,
  protection threats, weakening of social support
  networks
• pre-existing psychological/psychiatric problems
• E.g. psychosis, severe alcohol use, depression
• emergency-induced psychological/psychiatric
  problems
• E.g. normal fear (past, present, future),
  depression, PTSD
• humanitarian aid-induced problems
• E.g. conflict between communities, anxiety about
• lack of information on services

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Core Principles

• Human rights and equity
• Participation
• Do No Harm
• Building on available
• resources and capacities
• Integrated support systems
• Multi-layered supports

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Matrix of Mental Health and Psychosocial Support
All Have Impact on Protecting Well-being

• Coordination
• Assessment, monitoring and evaluation
• Protection and human rights standards
• Human resources
• Community mobilisation and support
• Health services
• Education
• Dissemination of information
• Food security and nutrition
• Shelter and site planning
• Water and sanitation

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Multilayered support

• Need to ensure support is appropriately divided
  across layers with good coordination/referral
• E.g. not overly focused on focused support
• Many of the professional animosities disappear as
  soon as one adopts a pyramid model of
  multi-layered supports with different tasks for
  different sectors
• Referral system required but will not work well
  if not appropriately layered

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Exercise Do's and Dont's for Education

• Purpose to learn what the IASC Guidelines
  recommend regarding Education
• Fill in the TRUE OR FALSE questionnaire together
  with somebody in the room who you do not know

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1. Coordination

• 1.1 Coordination of inter-sectoral MHPSS

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Proposed Gaza humanitarian response mental
health and psychosocial support (MHPSS)
coordination structure MH mental health PS
psychosocial
Humanitarian Coordinator
Health Cluster
Education Cluster
Protection Cluster (with Child protection
Sub-cluster)
MHPSS inter-sectoral coordination subgroup
MoH, MoE, MoSA
Working groups as Required eg Psychosocial And
education
MHPSS Technical Support Group
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2. Assessment, monitoring evaluation

• 2.1 Assessments of MHPSS issues
• 2.2 Participatory ME

Photo courtesy of REUTERS/Finbarr O' Reilly
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3. Protection human rights standards

• 3.1 Human rights framework
• 3.2 Social protection
• 3.3 Legal protection

Photo courtesy of REUTERS/Finbarr O' Reilly
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4. Human resources

• 4.1 Local staff volunteers
• 4.2 Codes of conduct ethical guidelines

Photo Danish Red Cross
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4. Human resources

• 4.3 Training of aid workers in MHPSS
• 4.4 MHPSS well-being of staff volunteers

Photo Nana Wiedemann, International Federation
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5. Community mobilisation support

• 5.1 Mobilisation, ownership control
• 5.2 Community social support

Photo Rita Plotnikova, International Federation
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5. Community mobilisation support

• 5.3 Cultural, spiritual religious healing
  practices
• 5.4 Support for
• young children
• care-givers

Photo Ulrik Norup Jørgensen, Danish Red Cross
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7. Education

• 7.1 Safe supportive education

Photo Patrick Fuller / Internaitonal Federation
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Promote Safe and Supportive Education

• Education is a key PS intervention provides a
  safe and stable environment restores a sense of
  normalcy, dignity and hope.
• Key Actions
• Promote safe learning environments.
• Make formal and non-formal education supportive
  and relevant.
• Strengthen access to education for all.
• Prepare and encourage educators to support
  learners PS well-being.
• Indicators Percent access to formal and
  non-formal education - girls and boys of
  different ages. Percent teachers trained in PSP.
  Teachers refer children with severe MHPS
  difficulties to specialised services.

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8. Dissemination of information

• 8.1 Information to population on emergency,
  relief efforts legal rights
• 8.2 Information on positive coping methods

Photo courtesy of REUTERS/Eduard Kornienko
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Community and family supports
Social and psychological considerations in basic
services and security
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Examples in Education sector

• Social and psychological considerations in basic
  services and security
• Advocating for schools to be protected during
  conflict
• Rescheduling exams or gradually returning to
  formal curriculum
• Community and family supports
• Training teachers to provide PS support in
  classrooms
• Facilitating peer support among teachers
• Establishing child friendly spaces
• Parents discussion groups or involvement of
  parents in supportive
• Focused,non-specialised supports
• Strengthening school counselling
• Structured group sessions for children (e.g. by
  NGOs)
• Referral of children or families to social
  services
• Support groups for teachers
• Specialised services
• Referral to clinical mental health services

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What ?
Community and family supports
Social and psychological considerations in basic
services and security
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Beyond education Social and Psychological
Considerations in Basic Services and Security

• All members of the community have responsibility
  to ensure there is a suitable environment for
  psychosocial development.
• These activities help to establish a suitable
  environment to protect and promote psychosocial
  healing and well-being.
• Usually these programmes are conducted by other
  organisations or under an existing sector
• Psychosocial and mental health programmes should
  advocate for ensuring these basic needs are met
• cooperate with sectoral programmes to ensure that
  are implemented in a way that supports
  psychosocial development and healing

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Level 1 Social and Psychological Considerations
in Basic Services and Security

• Document impact of lack of services and security
  on MHPS wellbeing and use this for advocacy
• For children, advocate for the protection of
  children from violence, abuse and exploitation,
  the promotion of family unity, re-establishing
  safe and supportive education
• Advocate for delivery of humanitarian assistance
  in a manner that promotes well-being
• Work to promote ways of delivering aid that
  promote self-reliance and dignity
• Facilitate community involvement in
  decision-making and assistance
• Disseminate essential information to affected
  populations on situation and emergency response

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Level 2 Community and Family Supports

• Support play, art, recreational and sporting
  activities
• Provide structured groups activities for
  expression and the development of life skills and
  coping mechanisms
• Support children and youth friendly
  spaces/environments
• Promote meaningful opportunities to participate
  in rebuilding society
• Provide information on positive coping mechanisms
  
• Activities that facilitate the inclusion of
  isolated individuals (orphans, widows, widowers,
  elderly people, people with severe mental
  disorders or disabilities or those without their
  families) into social networks

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Level 2 (contd)

• Strengthening the family
• Provide culturally appropriate guidance on how
  parents and family members can help children
• Support parents and families to cope with their
  own difficulties
• Support and facilitate the establishment of
  parent groups/committees
• Early childhood stimulation (with nutrition)
• Informal family visits for caregivers in need of
  extra support
• Support family access to basic services

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Level 2 (contd)

• Strengthening community supports
• Helping caregivers and educators to better cope
  and to support children
• Strengthen community based supports for adult
  caregivers
• Strengthen child-to-child or youth support
• Resumption of cultural and spiritual activities,
  including appropriate grieving rituals
• Strengthening social networks
• teacher training on psychosocial care and support
• Group discussions on how the community may help
  at-risk groups identified in the assessment as
  needing protection and support

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Level 3 Focused Supports

• For people who are
• struggling to cope within their existing care
  network
• Not progressing in terms of their development
• Unable to function as well as their peers
• In need of activities that address their
  psychosocial needs more directly

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Level 3 (contd)

• Focused psychosocial support activities require
  trained and experienced staff
• Activities may include
• Case management
• Family visits
• Psychological first aid
• Support groups
• Structured play activities
• Psychosocial hotlines
• Non-clinical family or individual counselling
  (e.g. school counselling)

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Level 4 Specialized Services

• Traditional specialized healing (e.g. cleansing
  and purification rituals)
• Clinical social work or psychological treatment
• Psychotherapy
• Drug or alcohol treatment
• Specialised mental health care

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Examples of how the guidelines have been used

• Used for identification of gaps in Myanmar
• Use picture version to mobilize community in Peru
• Influenced a lot of PS programming in Jordan
• Limit harmful practive in Kenya (widespread
  trauma counselling)
• Adopted by 4 ministries Gov in Philippines as
  policy
• Training in Iran informed by and consistent with
  IASC
• Some donors only fund consistent with IASC
  Guidelines
• Highlight importance of engaging with unusual
  sectors on MHPSS
• How could the Guidelines be used in Gaza?

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Key messages

• IASC Guidelines provide a common framework and
  language to communicate and coordinate with one
  other during large crises
• There is substantial technical know how on how to
  meaningfully reduce suffering and this involves
  different types of complimentary supports
• Using them effectively must be an ongoing process
  involving multiple humanitarian actors

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Mapping MHPSS in education using guideline matrix

• Complete matrix