Worldwide close to 80 million people are currently impacted by humanitarian emergencies arising from natural disasters and armed conflicts, such as those in the Central African Republic, South Sudan, Syrian Arab Republic, Yemen, and more recently, Nepal. WHO estimates 5% to 10% of these people suffer from a mental health condition such as depression as a result of the emergency.
People with mental health disorders rarely have access to specialized health workers trained in assessing and managing their conditions. WHO and the United Nations High Commissioner for Refugees (UNHCR) have therefore produced a Mental health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG), so non-specialist health workers can better identify, assess and manage mental health needs.
The new guide provides practical, first-line management recommendations for mental, neurological and substance use conditions. Contents include modules on assessing and managing conditions such as acute stress, grief, moderate-severe depressive disorder, post-traumatic stress disorder, epilepsy, and harmful use of alcohol and drugs.
Mental health in humanitarian emergencies
Most people, adults and children, experience grief and acute distress. But emergencies also trigger conditions such as depressive disorder, post-traumatic stress disorder or prolonged grief disorder, that can severely undermine a person’s daily functioning. People with severe pre-existing conditions such as psychosis, an intellectual disability or epilepsy are even more vulnerable.
Managing these conditions presents many challenges to health workers. In natural disasters, like the recent earthquake in Nepal, people have been displaced, facilities have been damaged, and supplies of medications are limited. Health workers are often in short supply and under enormous pressure to see as many people as possible in the shortest amount of time. And there are only very rarely specialist facilities available to take referrals. The new guide will give the available health responders the ability to begin to address these needs.
New guide enables general health workers to give mental health care
WHO and UNHCR hope all humanitarian partners will use the new guide to help reduce suffering and increase the ability of adults and children with mental health needs to cope in humanitarian emergencies.
The new guide will be used in Syrian Arab Republic, where the four-year conflict has displaced more than 7.6 million people within the country and left an additional 4 million seeking refuge in neighbouring countries. WHO started training Syrian non-specialist health workers in 2012. Since then over 500 health workers have been trained. The new guide will help accelerate and scale-up access to mental health care in Syria and other emergency settings.
The mhGAP is a WHO programme that seeks to address the lack of care for people suffering from mental, neurological and substance use conditions. In 2010, it published the mhGAP intervention guide, a widely-used evidence-based manual for the management of these conditions in non-specialized health settings, particularly in low- and middle-income countries. The new mhGAP humanitarian intervention guide is an adaptation of the original guide, which has been tried and tested in the field. It is written specifically for practitioners working in humanitarian emergencies.