When the tsunami hit Asia in 2004, some American psychologists rushed to help even though they had no prior experience in international emergencies, no knowledge of the culture and context, and no connection with local organizations or coordinating bodies. That wasn't a good idea, says psychologist Michael G. Wessells, PhD, a professor of clinical population and family health at Columbia University and a senior adviser on child protection for the Christian Children's Fund.
"That was a compassionate, well-intentioned impulse," says Wessells. "But experience has shown repeatedly that that kind of approach doesn't work and actually is at serious risk of causing harm."
Now there's a resource that Wessells can hand to psychologists and others who want to help survivors of natural disasters, wars and other emergencies. The Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings provide a framework that lays out what humanitarian organizations and individuals should do to protect and improve mental health and psychosocial well-being in the early phases of an emergency.
With the mission of improving humanitarian coordination, the IASC brings together the heads of both United Nations agencies and large consortia of nongovernmental organizations engaged in humanitarian work. The IASC Task Force on Mental Health and Psychosocial Support in Emergency Settings was co-chaired by the World Health Organization and InterAction, a consortium of 160 U.S.-based nongovernmental organizations. Wessells co-chaired the task force on behalf of InterAction.
Designed to guide people through the initial response to an emergency, the guidelines have several specific goals: They provide a framework for coordinating efforts, identify useful practices and flag potentially harmful ones, and clarify how different approaches to mental health and psychosocial support can work together.
At the heart of the document is a matrix offering guidelines for emergency preparedness, the minimum response (the first things to be done) to an emergency and the comprehensive response in several key areas. The document also offers "action sheets" for areas ranging from coordination, needs assessment, community mobilization, and human resources to health services, nutrition and shelter and site planning.
Psychologists hoping to help during emergencies, both international and domestic, need to familiarize themselves with the guidelines, says Wessells.
"The guidelines bring together expertise from practitioners around the world," he says, noting the extensive consultative process entailed in producing this consensus document. "We got feedback from hundreds of top academicians, practitioners and on-the-ground workers."
APA members and staff shared their input through APA's Office of International Affairs. And now APA is helping to get the word out. The network, for example, has already alerted its state coordinators about the new guidelines.
But mental health professionals aren't the guidelines' only audience, says Wessells.
"Perhaps the most innovative and far-reaching feature of the guidelines is the idea that mental health and psychosocial support aren't things done just by psychologists, psychiatrists and social workers," he explains. "They ought to be woven into the work of all sectors."
And that's true no matter how far removed someone is from what's traditionally considered mental health or psychosocial support work, adds Wessells.
Take the people who design refugee camps. Although they might feel they lack the necessary expertise, says Wessells, they need to be involved in promoting good psychological health.
"When you talk to people in camps for refugees or internally displaced people, they'll say things like, 'My biggest source of distress is the fact that my family and I have no privacy,'" he explains. "Or women in camps are too terrorized to go to the latrine, because the risk of gender-based violence is too high."
The guidelines also provide a crucial tool for training the next generation of disaster psychologists, says psychology professor Gerard A. Jacobs, PhD, director of the Disaster Mental Health Institute at the University of South Dakota in Vermillion. He and others have already incorporated the document into their classes.
Until the guidelines came along, says Jacobs, there was not much to offer students in the way of widely endorsed international standards in disaster psychology.
"Before, what we had to offer students were our own perspectives and opinions and a small body of literature," says Jacobs, who was one of the experts who shared feedback with the task force. "There were some guidelines before, but their guidance in terms of psychological support was little more than a statement saying that psychological support is something that people have a right to expect."
For more information, visit www.apa.org/international/pi/807iasc.html and www.apa.org/international/resources.html. To download the guidelines and related materials, go to www.humanitarianinfo.org/. The guidelines will soon be available in French, Spanish and Arabic.
Rebecca A. Clay is a writer in Washington, D.C.
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