Mental health and psychosocial support

Due out February 2021

Deadline for submissions: 19th October 2020

Questions about mental health and psychosocial support (MHPSS) have been written about in FMR at times over the years. This is the first time, however, that we have dedicated a full issue to it – reflecting its relevance in all situations pertaining to displacement and the level of interest in this subject shown by our readers.

People living in displacement may have specific, pre-existing mental health needs. Being displaced may mean disruption in treatment for any such pre-existing disorders, or new challenges to obtaining treatment while on the move or while in a host community. Others experience symptoms of mental ill health that have developed as a result of their displacement or the events that precipitated it. These may relate, for example, to the effects of conflict and loss, or to the consequences of social or financial exclusion in displacement. Uncertainties around status and length of stay, experiences of the asylum process, and the psychological implications of protracted displacement may also negatively affect mental well-being. Some MHPSS needs may have particularly time-bound and developmental importance for certain groups of displaced people, including children and young people.

Refugees and internally displaced people (IDPs) may look to various sources of informal, non-clinical social support. However, where difficulties exceed displaced people’s own coping mechanisms and informal support, more specific types of care may be required. In situations of humanitarian emergency and in resource-poor settings the provision of such care may be very limited and will take different forms in different displacement situations – in camp, out of camp, in resettlement or asylum contexts, and for those returning after being displaced. The effects of conflict and of disaster on training facilities, clinics and displacement of staff may contribute to demand for such services vastly outstripping supply.

Where provision is available, displaced people may encounter difficulties in accessing what services are available. These difficulties include lack of awareness of the treatment that is available and their rights to access it; language barriers; lack of mental health literacy; difficulties introduced by culturally specific modes of expressing mental ill health; concerns around stigma; and doubts about confidentiality.

MHPSS provision may be integrated into existing services such as primary health care, education and protection. Highly specialised provision, such as for those who have experienced torture, trafficking or detention, or who are currently in detention, may need to be delivered by separate means. However it is delivered, the effectiveness of care may depend on cooperation between multiple systems. Alternative forms of support may be delivered through non-specialist forms of support, and by strengthening community and family supports. Other interventions may include programming around access to exercise, spiritual or religious fellowship and peer psychological support to address specific needs and promote mental well-being more generally.

There is a need for those working with displaced people to integrate an awarenesss of MHPSS needs into their programming. At the same time, those delivering MHPSS services to a general population need to be aware of specific factors that may affect those who have experienced displacement. Finally, sufficient awareness must be paid to the psychological effects on those delivering humanitarian responses and working with those who have experienced traumatic events. Such trauma-sensitive programming can contribute to improving recognition and treatment of mental ill health, and support psychosocial well-being among displaced people, host communities and those working among them.

This issue of FMR will provide a forum for affected communities, practitioners, advocates, policymakers and researchers to share experience and good practice, debate perspectives and offer recommendations. In particular, the FMR Editors are looking for practice-oriented submissions, reflecting a diverse range of experience and opinions, which address questions such as the following:

  • What is known about the prevalence and nature of the MHPSS needs of those who have been displaced, and of responses to them? What are the particular challenges to conducting research in some areas and key gaps in knowledge?
  • How can the effectiveness of support be appropriately assessed in displacement contexts?
  • Have certain kinds of approaches proved more effective than others in providing appropriate support in situations where there are insufficient resources – infrastructure, personnel or financial – to meet large-scale and/or long-term MHPSS needs?
  • What barriers are there to integrating basic mental health care into primary health-care settings in emergency contexts where MHPSS provision is otherwise limited or does not exist, and what good practice exists in addressing these barriers?
  • Are there specific challenges to providing MHPSS for displaced people who are still on the move? What examples exist of good practice in cooperation across regional or country borders?
  • How can the experience and expertise built up by local communities of practice in the area of mental health inform programming that is executed at a much larger scale?
  • How do the MHPSS needs of displaced people differ across different settings – in systems of asylum, in resettlement, in integration and in return? What steps can be taken to promote resilience and to enable those who have been displaced to maintain psychosocial well-being, including on their return after displacement?
  • How effective are community-based means of psychosocial support such as those provided by faith communities? Have community-based models proven more successful in certain contexts, or in meeting specific certain needs over others?
  • What is the role of cultural mediators in assisting displaced people to access care? Can such mediators be effective in tackling stigma around mental ill-health, including among hard-to-reach groups?
  • Given that cultural bias (among practitioners, policymakers, researchers and hosts) may create barriers to the effective, appropriate, non-discriminatory identification of need for and provision of MHPSS services, how can this be recognised and mitigated for?
  • What part do new communication technologies have to play in the identification of needs and delivery of care? What are the settings in which such technologies have proven effective and what forms do these take?
  • How are existing guidelines and tools such as the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings and the WHO/UNHCR Assessing Mental Health and Psychosocial Needs and Resources toolkit for humanitarian settings applied across various contexts and how do they shape provision?
  • What requirements do those designing policy and programming need to take into account in relation to MHPSS service provision for displaced people and for host communities, and what are the challenges emerging from creating parallel structures? 
  • What design and delivery choices must be considered so that MHPSS programming takes into consideration the specific needs of certain groups including children and youth, older people, those living with disabilities and LGBTIQ+ individuals?
  • Are there examples of effective provision from humanitarian agencies in supporting the psychosocial well-being and MHPSS needs of staff working in situations of displacement and with survivors of displacement?
  • In what ways has the COVID-19 pandemic affected the provision of MHPSS to displaced people, and how have those providing MHPSS been able to adapt to the challenges presented? What has proven critical to the continuance of the effective delivery of services?

 

BEFORE WRITING YOUR ARTICLE: If you are interested in contributing, please email the Editors at fmr@qeh.ox.ac.uk with a few sentences about your proposed topic so that we can provide feedback and let you know if we are interested in receiving your submission.

WHEN WRITING/SUBMITTING YOUR ARTICLE: Please take note of our guidelines for authors and ensure your article, when submitted, complies with our submission checklist: details at www.fmreview.org/writing-fmrWe do not accept articles that do not comply with our checklist.

Please note: We ask all authors to give appropriate consideration to the particular relevance of their responses to persons with disabilities, to LGBTIQ+ persons, to older persons, and to other groups with specific vulnerabilities, and to seek to include a gendered approach as part of their articles.

While we are looking for examples of good, replicable practice and experience as well as sound analysis of the issues at stake, we also urge writers to discuss failures and difficulties: what does/did not work so well, and why?

We are particularly keen to reflect the experiences and knowledge of communities and individuals directly affected by these questions. If you have suggestions of colleagues or community representatives who may wish to contribute, please do email us; we are happy to work with individuals to help them develop an article and very keen to have displaced peoples perspectives reflected in the magazine.

Deadline for submission of articles: 19th October 2020

Maximum length: 2,500 words.

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Forced Migration Review
Refugee Studies Centre
Oxford Department of International Development
University of Oxford
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