World Mental Health Day 2016

What is Psychological First Aid

Psychological First Aid (PFA) describes a “humane, supportive response to a fellow human being who is suffering and who may need support”. When humanitarian crises happen, those suffering the consequences not only encounter the physical damage and various losses, but have to find the way of recovering from the psychological distress that can result.

The World Health Organization (WHO), War Trauma Foundation (WTF), and World Vision International (WVI) developed the original PFA Guide through an extensive international peer review process with the inputs of low and middle-income countries and a variety of emergency contexts.

PFA involves, in the context of a humanitarian crises, providing practical care and support, which does not intrude; assessing needs and concerns; helping people to address basic needs (for example, food and water, information); listening to people, but not pressuring them to talk; comforting people and helping them to feel calm; helping people connect to information, services and social supports; protecting people from further harm.

Based in the 3 simple principles of Look, Listen and Link, PFA is easy to use by professionals and non-professionals, and the capacity of delivering the training in one day, makes it ideal to be added from the first response.

How does CBM work with PFA

CBM is a member of the Inter Agency Standing Committee's Mental Health and Psychosocial Support (MHPSS) Reference Group which advises IASC on mental health and psychosocial support in humanitarian settings. This group has been central to ensuring PFA plays its proper role in supporting its appropriate use within broader emergency responses globally.

In 2014, CBM’s programmes in Sierra Leone and Guinea were affected by the worse Ebola epidemic ever seen in Africa. Within a few months CBM adapted the PFA guide to be used in the Ebola context and, in collaboration with WHO, UNICEF and WVI, ensured that all the needed principles of PFA could be used in an environment where touching other human beings wasn’t recommended and so many prevention measures had to be put in place. In the adapted version, safety precautions to prevent spread of the disease while still providing support and encouragement, were provided. Also, input on how to combat stigma, fear and violence and how to balance people’s rights with responsibilities to follow mandates to contain the outbreak were highlighted. Focused activities related to helping family members keep contact with loved ones in isolation at treatment centers were added, and useful ideas to support bereaved people with social support, as well as safe burial rituals, were enraptured. All materials were adapted so safety was ensured while still providing comfort and compassionate care.

CBM also translated the adapted guide to French, which allowed its use in Guinea, and supported other countries in the region in getting PFA training as part of their preparedness plans for the epidemic, such as Togo and Nigeria.

The adapted PFA guide was used broadly by many international and local organizations involved in the Ebola psychosocial response and recovery.      

CBM continues including PFA as an essential element of its Emergencies Response Unit. It was used by partners in Nepal after the 2015 earthquake, and after just a few days of the earthquake in Ecuador this year, training for CBM’s partners in the country on MHPSS and PFA was set up and delivered.

More importantly, CBM is committed to integrating such rapid response into long term recovery after emergencies, for example in Haiti, Indonesia, the Philippines and several other countries. These look not only at the provision of PFA, but at the essential improvement of mental health services necessary for closing the treatment gap. In this sense, it is essential to remain faithful to the MHPSS model in emergencies, not only providing the much needed psychosocial support, but also contributing to the strengthening of mental health systems.

As an example of how PFA can be useful for everybody to be prepared to better respond and support of others in situations of crisis, CBM’s Safety and Security Team is also looking at expanding the current training provided across the countries were implementation is happening, to include PFA.

Why is this year's theme significant

The fact that 2016’s WMHD focuses on PFA is extremely significant:

• It reminds us that, in a world with regular humanitarian crises happening in all continents, we cannot forget how essential it is to support those affected psychologically, so they can strengthen their inner resources to find the resilience to overcome the tragedy. It reminds us that, now more than ever, the world is aware that there is no health without mental health.
   
• It reinforces the concept of task shifting by which non-professionals can play such an essential role in the prevention of mental illness, the promotion of wellbeing, and in co-facilitating and supporting treatments in the community.
   
• It emphasizes prevention as a core element of successful interventions.
  Human beings have coping mechanisms that help them overcoming difficult situations. By providing PFA, we are enabling such mechanisms to better function avoiding long term traumatic effects, therefore, preventing mental illness.