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MHPSS & Protection

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by

Guillaume PEGON

on 1 August 2013

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Transcript of MHPSS & Protection

Objective: To support the most vulnerable people (including people with disabilities or injuries) seriously injured by war (Syrian crisis in Jordan, Lebanon, Syria, South Sudan, Ivory Coast, Mali) or natural disasters (Haiti, Pakistan...)

Approach: Mainstreaming of psychosocial & protection activities into functionnal rehabilitation project such as family mediation, speaker group discussion, life skills, safe place, PFA, referral... and some individual consultations (restarting phase)

Where:community, refugees camps, hospitals, rehabilitation centers
Psychosocial disabilities related to psychological stress due to migration, exile, natural catastrophe, conflict, poverty, lack of home and loss of family, social connections, employment, etc.

Psychiatric incapacities or mental disabilities related to chronic conditions and the treatment of serious mental disabilities (schizophrenia, depression, etc.).

Intellectual incapacities related to intellectual development problems due to genetic, chromosomal, biologic and environmental causes.
Violence based on gender: any harmful act committed against the will of someone and that is based on the socially prescribed differences between men and women

Violence based on age: any act of violence perpetrated against someone based on this person’s age. Violence against children and old people is the focus here

Violence based on disability: any act of violence perpetrated against someone in relation to his/her impairment
Emergency Settings
Objective: To support the most vulnerable people by working on their environments, which could be considered most of the time as the cause of mental health impairment/disability

Approach: Multisectorial (psychosocial/mental health, medical, social, educational, economic, legal services) based on the CBR guidelines (WHO)

Where:closed/deteriorated environments such as orphanages (Algeria, Maroco, Haiti), prisons (Madagascar, Togo), refugees camps (Dadaab), or a small community affected by war/genocide (Kenya, Burundi, Rwanda)
Development Settings
Specifics areas of intervention
-MHPSS-
Specific areas of intervention
- Protection -
Main modalities for intervention
Concepts & Interventions
Studies & Research
Networks
Policy paper & Methodological guidelines
Mental Health
Psychosocial support Protection against violence

Guillaume Pégon
History & Settings
Knowledge Management & Networks
History & Areas of intervention
Implementation of projects since 1990s in emergency, post-emergency and development scenarios

Objectives:
(1)To prevent and treat psychological distress, mental disorders of the most vulnerable people (persons with disabilities included), regardless of the context in which they emerge.
(2) To prevent the causes and mitigate the consequences of any types of gender, age, disability based violence

Approach: combination of clinical psychology, social anthropology, public health and community development

Consequences of violence
Psychological and psychosocial problems

Emotional disorders: anger, anxiety, anguish, fear, shame, self-hate; feelings of guilt, suicidal thoughts and behaviours, symptoms of depression, apathy
Cognitive disorders: syndromes of revivification (flashbacks, nightmares), amnesia, forgetfulness
Behavioural disorders: avoidance behaviour, hyper-vigilance, eating disorders, personal hygiene disorders, relational problems and sexual disorders
Mental disorders: post-traumatic stress, psychotic decompensation, serious depression


Physiological impairments and chronic diseases

Sexually transmitted infections (STI), including HIV and AIDS
Eating or sleeping disorders
Chronic pain or infection
Gastrointestinal problems
Social and economic problems

Blame on the survivor
Loss of role or functions in society
Stigmatisation, rejection and social isolation
Feminisation of poverty
Increased gender inequality
Loss of livelihood and economic dependence
Arrest, detention and/or punishment
Acute physical problems

Injuries (sometimes fatal), including of the fistula
State of shock
Illness
Miscarriage (high infant and maternal mortality rate)
Undesired pregnancy
Unsafe abortion
Menstruation and fertility disorders (or even sterility)
Complications during pregnancy
Gynaecological disorders
Sexual disorders
Infections
Modality 1 - Analysis and risk management of violence within the programs and missions

Modality 2 - Systems of governance

Modality 3 - Multisectorial services

Modality 4 - Self protection of individuals and communities
• Mental health in post-crisis and development contexts (2011). Policy paper on how to promote and develop projects to improve access to prevention and care, and the social participation for people living with mental health problems.

• Supporting persons living with trauma by rebuilding social and community links (Rwanda, 2009). Example of a community-based mental health approach after the rwandan genocide of the Tutsis, involved supporting the reference persons in the community, so that they can set up solidarity and care systems for vulnerable people and/or refer them to the appropriate care providers.

• A feeling of belonging: An exemple of a community mental health project in Rwanda (2012).
Documentary about the actions of Handicap International in Rwanda to reforge the links within the community.

• Interventions psychosociales en milieu carcéral (Madagascar, 2012). For helping to develop psychosocial interventions in prisons, this guide provides elements of understanding, thinking and practice to stakeholders working in prison: members of public sector and civil society, at national or international levels.

• Fostering and managing change in Algerian Nurseries (2011). Lessons learned on the algerian experience on support children deprived of family care.
• Conditions of life in prison and psychological distress (Madagascar, 2012).
This document presents the results of a quantitative study conducted in three prisons in Madagascar in 2011-2012. The objectives of this study were to measure the perception of prisoners on conditions of life in prison, to measure psychological distress, to determine the variables that influence psychological distress and perceptions of conditions of life in prison. In view of the results of the study, Handicap International has proposed a new model of psychosocial intervention. Developed through a stage system of complementary services, it promotes the application of a holistic approach focused on the needs of the prisoners.
IASC MHPSS Reference Group

Global Movement for Mental Health

Global Protection Cluster

Child Protection Working Group

GBV task group of the IAWG

ICRC Professional Standards Advisory Group




CONDEMNED
from Robin Hammond

• Sexual violence against children with disabilities in Burundi, Madagascar, Mozambique and Tanzania (2012).
Children with disabilities are vulnerable to sexual violence and do not have access holistic support services or justice. The objective of this research was to: gain insight into the vulnerability and resilience factors of children with disabilities who have experienced sexual violence; and start a movement at both national and international levels that facilitates discussion and promotes people to take action against sexual violence of children with disabilities. This report provides an overview of the research between the four countries, individual country analysis of the four countries and additionally recommendations for improving the situation for children with disabilities
• An assessment of the factors of risk and vulnerability of women and men with disabilities to sexual and gender-based violence (Rwanda, 2012).
This assessment testifies of cases of sexual and gender-based violence among people with disabilities, and explores the factors of risk and vulnerability of people with disabilities to sexual and gender-based violence.
• Community Mental Health and Gender Based Violence in West Districts of Rwanda (2012).
Action research: a territorial approach to the phenomena of violence and psychological distress on Rubavu Districts and Rutsiro. What factors of vulnerability and what local resources?
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