Psychology in action
Addressing Mental Health and Psychosocial Wellbeing in Post-conflict Settings
By Inka Weissbecker, PhD
The screen showed a sad young girl in her teenage years wearing a traditional Nepali dress, with the Himalayas and the blue sky in the background. She looked down onto the ground as she described how she had been affected by the ten-year civil war. “I don’t feel like doing anything anymore” she said in a quiet voice, “I have nightmares and I’m afraid that people think I’m crazy…” Her story is part of a documentary by Kunda Dixit, a soft-spoken journalist from Nepal, who is shedding light on the human cost of the recent conflict between the Maoist movement and the government. After the abolition of the monarchy and the signing of the Comprehensive Peace Agreement, many challenges remain. Several Nepalis have lost friends and family members who have been killed, abducted, or forcefully conscripted. As the new Nepal emerges, individuals on both sides are reconciling, and former combatants are returning to their communities. As I was watching Dixits’ documentary, I could not help but wonder about the toll that the war had taken on the civilian population. In order to learn more about these issues, I had decided to travel to Nepal as part of a Harvard School of Public Health field study course on post-conflict peacebuilding. Our group met with government officials, UN agencies and NGOs involved in the peacebuilding process. I was the only psychologist in the course, and the one who kept raising her hand during meetings to ask about psychological aspects of peacebuilding and mental health.
Over the last few years, I have started to apply my knowledge of psychology to global issues such as conflict, humanitarian crises, and development. I also realized that I needed to know more about the workings of the international community if I wanted to effectively utilize empirical approaches in addressing real world problems. I decided to get my Masters in Public Health at Harvard University, which enabled me to take classes on human rights, post-conflict policies, the role of gender in conflict, political philosophy, and global health. To my knowledge, I am the only clinical psychologist among my entering class of over 400. Most are medical doctors, a few Psychology in Action of them psychiatrists. However, I think that psychologists can bring valuable expertise to aspects of humanitarian crises and development.
Although mental health and psychosocial issues have been cited as integral to peacebuilding and reconciliation after conflict, there is little resource allocation by state governments or international organizations. However, various key documents have recently been released to guide the work of psychologists in those areas. The “IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings provide guidance for including psychological issues within various humanitarian sectors, and the WHO recently launched the Mental Health Gap Action Program which suggests ways of addressing mental health problems in low-resource settings.
During my time in Nepal, I was curious about ways in which organizations were addressing mental health and psychosocial concerns. I organized a meeting with the Center for Mental Health and Counseling (CMC), in Kathmandu, a small local NGO which is accomplishing a lot with the few resources they have. They train paraprofessional healthcare workers and local community groups in psychological first aid and in recognizing mental health problems. They also work with children who have been affected by the conflict and train teachers in positive behavior management techniques and in refraining from corporal punishment. CMC is also working with the Transcultural Psychological Organization (TPO) on implementing the IASC guidelines in collaboration with organizations such as UNICEF, WHO, and the IRC. TPO is another organization which is not only involved in clinical work, but also in relevant empirical research. They developed “Child Led Indicators” for children involved in armed groups, for example. These indicators are based on the ways in which children themselves define psychological well-being and distress. During my work in Nepal, I have learned how much can be gained with more participatory approaches and how important it is to actively involve local communities in planning and evaluating interventions. Back in the US, I am part of a working group on mental health of the Humanitarian Action Summit, which is identifying ethical issues and best practices for collecting mental health and psychosocial data in humanitarian contexts. I also serve as an NGO representative of the International Union of Psychological Science to the United Nations in New York. In the future, I hope to shed light on ways of helping communities recover from conflict, and to develop interventions that build on existing local structures and strengths. I also think that psychologists can play an important role in evaluating outcomes and increasing accountability of organizations involved in humanitarian and development work. Health, including mental health as an outcome in turn, can help guide policy and programming decisions. However, it is up to psychologists to demonstrate their expertise and to join the international community in taking on issues of global relevance. I always love to hear from people who would like to learn more or get involved in global psychology work. Do not hesitate to email me at: Inka Weissbecker. Ψ