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REFLECTIONS, COMMENTS, LETTERS
Year : 2008  |  Volume : 6  |  Issue : 3  |  Page : 232-235

A perspective from experiences in post conflict Timor Leste: the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings


1 Professor and Director of the Centre for Population Mental Health, University of New South Wales and Sydney South West Area Health Service, Sydney, Australia. He has worked for over 2 decades in research, training and service development amongst refugees, asylum seekers and post-conflict communities both in Australia and internationally. His current focus is on refugees from West Papua
2 Senior Fellow in the Centre for Population Mental Health Research, University of New South Wales, Sydney, Australia. She has had a long interest working in research and advocacy amongst asylum seekers and refugees, particularly focusing on populations from Timor Leste and West Papua

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Source of Support: None, Conflict of Interest: None


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In this paper, several lessons are shared based on experiences in post conflict Timor Leste. In order to provide care to patients with mental disorders in their home settings, a specialist community based clinical service was developed as an alternative to using the (already) heavily dysfunctional primary health care system. We found that mental disorder accounted for a disproportionate amount of the disability in the community. Symptoms of posttraumatic stress were widespread and often represented a normative survival reaction to threat to life. Treatment is only warranted for the minority whose traumatic stress reactions result in lasting, severe psychosocial dysfunction. Finally, we discuss the need to identify the community's own concepts of mental suffering and their expressions of these experiences.


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