Focusing on Mental Health and Psychosocial Support in Disability-Inclusive Disaster Risk Reduction

Bimala's son was crushed under the falling roof and walls of her house when the tremors struck on the fateful day. His death pushed Bimala into posttraumatic stress. She has been receiving support through CBM’s emergency response for psychosocial and mental health care through partner Koshish since the Nepal Earthquake of 25th April 2015.
©CBM

Disability Inclusive Disaster Risk Reduction (DiDRR) is essential in a context where the Sustainable Development Goals (SDGs) aim at leaving no one behind.

CBM’s programmatic priorities echo this aim:

  • Build inclusive, resilient communities through a Community Based Inclusive Development (CBID) approach, which includes DRR.
  • Ensure persons with disabilities have equitable access to aid after a disaster.


In this sense CBM’s Inclusive Emergency Response Unit has been working with local partners to ensure that people with disabilities are included at all levels of disaster preparedness and response, and a clear frame has been created for the management of Disability Inclusive Disaster Risk Reduction initiatives.

The collaboration of the Community Mental Health unit with these areas of work has been extensive and has contributed to an understanding of the importance of bringing strong Mental Health and Psychosocial Support (MHPSS) responses into both priorities.


Mental health in emergencies

The significance of providing strong psychosocial support in the context of emergencies has been highlighted in programmes across the world, where providing psychosocial support to those affected by disasters and to the responders has been key in ensuring the wellbeing and psychological resilience of the affected communities.
CBM makes it a must to include within CBID programmes a strong MHPSS element that can contribute to the preparedness of communities in areas prompt to disaster. The way of achieving this is by ensuring a double process:
 

  1. On one hand, including MHPSS into the DRR of each community, by ensuring training and resources to have our communities well prepared to provide the essential support in terms of linking to resources, providing psychological first aid, and enabling natural coping mechanisms, in the event of a disaster.
  2. On the other hand, CBM’s Policy Brief “Mental Health is key to disaster risk reduction” highlights the impact of humanitarian crises on mental health, and the need to continuously work in collaboration with long term systems strengthening.


We must continue working in including strong MHPSS elements into humanitarian responses, where persons with disabilities are the key actors in bringing psychosocial support to those affected, and enabling in this way better recovery and resilience. 


Example from the Field: Psychosocial support after the 2015 Nepal Earthquake

CBM supported its partner KOSHISH, Nepal to run a project entitled ‘Emergency Psychosocial Response in Bhaktapur’. 60% of the population in Bhaktapur had been affected by the earthquake. Although many humanitarian organisations were already present and beginning to be active in relief work, not many were including activities which would address psychosocial needs.

“Emergency situations can trigger or worsen mental health problems, often at the same time that existing mental health infrastructure is weakened.” Dr Margaret Chan, Director-General of the World Health Organization
KOSHISH has been working in Bhaktapur for five years, so already had an active network with multiple groups. The project was implemented uses these links, recruiting psychologists, counsellors and volunteers, and worked through four Community based MHPSS Centres. This intervention began in May 2015 and went up to 31 March 2016.

By the project end:

  • 2,425 people had received MHPSS, including tailored Psychological First Aid (PFA)
  • 464 staff and/or partners’ staff had received training or refresher training on PFA

KOSHISH was also active in advocacy work, participating in cluster and coordination meetings and took a lead role in coordination of bi-weekly meetings of a psychosocial working group at the Division of Women and Children. At these events they have advocated for appropriate mechanisms of inclusion of persons with psychosocial disability in all relief measures, including shelter, health, Water, Sanitation and Hygiene (WASH) and nutrition.

Click to download the CBM Policy Brief which gives a clear overview and recommendations for countries where the state of mental health is already poor prior to a crisis. 

A more detailed version of this article is available on mhpss.net.