The editorialboard of Intervention is pleasedto congratulate Mr. Ananda Galappatti on his receiving the 2008 Ramon Magsaysay Award for Emergent Leadership. Mr. Galappatti, a member of the editorial board of Intervention since its inception, was recognised by the Board of Trustees of the Ramon Magsaysay Award Foundation for ‘his spirited personal commitment to bringing appropriate and eiective psychosocial services to the victims of war trauma and natural disasters in Sri Lanka.’ The Ramon Magsaysay Awards were established in 1957 and are annually awarded to Asian individuals ororganisations in East, Southeast, andSouth Asia or achieving excellence in their respective fields. The award is given in six categories. More than two hundred and fifty individuals and organizations have been named Magsaysay award winners since 1958. Among them are some of Asia’s greatest humanitarians, community leaders, intellectuals, and artists. For further information please visit:

This paper describes how and why the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings were developed. A brief overview about the need for the guidelines, as well as the context and background, are included. Also, a discussion on the process of developing them with an eye towards identifying key issues and obstacles, and the strategies used to manage these issues and enable constructive collaboration, is provided. Also included are the processes of building positive networks and relations across agencies and sub-fields. Finally, there is a brief overview of how the Task Force worked and approached some of the issues that have been hotly contested in the field.

In this article, we place the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings' within the historical context of trauma healing and humanitarian intervention. The IASC taskforce has done important work by bringing to the fore the cultural and local experiences of suffering in humanitarian intervention. The guidelines' recognition of suffering and social repair as a holistic experience is a significant boon to applied understandings of populations in crisis. Our critique of the guidelines addresses some aspects of the practical application of mental health and psychosocial care. We highlight (1) the framing of ‘culture’, and (2) the institutional cultures and structural hierarchies of humanitarian intervention. The article concludes with recommendations for integrating a blend of mental health, psychosocial care, and humanitarian intervention into the humanitarian established order.

The use of the term ‘community approaches’ in psychosocial work often involves multiple meanings, all of which contrast with individual approaches to mental health. The importance of the context emphasizes the need to design and implement emergency programmes in ways that ‘make sense’ to local populations. This requires not only consideration of generational, gender, spiritual, and cultural practices within the community, but also reinforcing existing resilient resources in the face of adversity. In this commentary we describe several examples and sources that present ways of working in Latin American communities after disaster. We discuss the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings, with a specific focus on ‘Community Mobilization and Support’ and the four common functions it contains.

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.

Five dilemmas inherent in emergency response are presented and discussed from a public mental health perspective in reference to the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. These are: (1) Who should take the lead in the planning and implementation of the guidelines? (2) At what level are the guidelines to be used? 3) What evidence do we have for the usefulness of the guidelines? 4) What are the costs for the proposed interventions, and how are the activities to be financed? (5) What is the place of specific mental health and psychosocial support within the interventions?

In the Middle East mental health and psychosocial support systems are underdeveloped. Seven critical factors are identified that hinder the initiation of well functioning mental health and psychosocial intervention programmes: 1) shortage of national professional leadership; 2) absence of infrastructure to support mental health and psychosocial programmes; 3) stigma around mental disorders; 4) multiple models of intervention; 5) lack of funding; 6) competing interests of non governmental organizations (NGOs) and UN organizations; and 7) insufficient political will and instability. Some of these obstacles will be addressed by the availability of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, but there is also a need for focussed and planned action to address the other factors.

Both natural and human made disasters create distress in large populations. The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings set forth principles and a system for their employment, aimed at minimizing the psychological consequences of public health emergencies created by disasters. Guidelines cannot dictate which principle, or principles, of mental health and psychosocial support have the most relevance to the needs of a specific culture in a specific disaster. However, recent experience in the United States suggests that the core principles articulated in the guidelines are appropriate for use in industrialized and resource rich nations, and that approaches outlined within the guidelines are of practical use in these populations.

The author lauds the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings as a remarkable achievement, but in his view they have not sufficiently used scientific evidence. The author also deplores that the concepts of ‘trauma’ and ‘traumatic stress’ remain underplayed and makes a case for early psychological group interventions, as well as for more specific attention to childhood mental disorders in general.

Mental health and psychosocial surveys in emergency settings provide essential information on the psychological and social consequences of armed conflict and natural disasters. They also have programmatic implications. The Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support (MHPSS) in Emergency Settings fails to recognize the importance of data driven programmes. Outcome evaluations of mental health and psychosocial programs in emergency settings would provide crucial information for a best practices approach, which is currently lacking. Evidence based information will be more likely to convince all humanitarian players to follow the recommendations in the MHPSS guidelines.

The authors identify several factors that have limited the utility of epidemiological assessments in emergency settings, such as a narrow focus on post traumatic stress disorder (PTSD), an inattention to cultural variations in distress, and a failure to distinguish between normal distress reactions and actual disorder. Rather than rejecting epidemiology altogether, however, as the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support in Emergency Settings do, recommendations are made for ways to enhance the usefulness of large scale mental health and psychosocial assessments in settings of armed conflict and natural disaster.

The author reflects on the implications of guidelines that are a reflection of professional consensus. In the case of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, the author suggests that consensus represents (1) a political achievement promising improved inter-agency coordination; (2) a core knowledge base defining key principles and practices; and (3) a useful basis to structure further enquiry to gather a stronger evidence base for programming.

The authors respond to commentaries in this journal about the 2007 IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Overall, influential commentators coming from opposite academic traditions and knowledge bases appear to welcome these guidelines and value them. In this response, the authors focus on a few critical comments, which may be explained by divergent understandings about what is meant by minimum response and what priority activities may be part of that response.

In response to pressing needs, a mechanism for coordinating psychosocial activities evolved organically in the Jaffna peninsula of Sri Lanka following the Asian tsunami of 2004. The Mental Health Task Force attempted to coordinate both governmental and nongovernmental organizations, local and international, which were involved in psychosocial work. In time, the District Psychosocial Forum took over the role of coordination under the direction of the Regional Director of Health Services and District Psychiatrist. With the resurgence of the civil war, the forum has had to respond to the urgent psychosocial needs arising from the conflict situation. The Inter-Agency Standing Committee (IASC) delineates guidelines for coordinating psychosocial responses of agencies to emergencies due to natural disasters and war that was remarkably similar to the development functioning of the Mental Health Task Force and Psychosocial Forum and their experiences and the lessons learnt.

This article describes and analyzes the first comprehensive case study of the application of the IASC Guidelines on Mental Health and Psychosocial Support by Medicos del Mundo-Spain after the August 2007 earthquake in Peru. The methodology and core principles of the intervention are briefly summarized. The article explains strategies and key messages that were transmitted at each level. It proposes a multilevel approach that combines lobbying, sensitization, and training with key decision makers and grass roots work with leaders and community organizations. The experience in Peru provides important lessons for future implementation of the guidelines in other disasters.

Colombia is one of the first countries in the world to implement the IASC Guidelines for Mental Health and Psychosocial Support in Emergency Settings in the form of a ‘case study’. It was shown that the guidelines are in general terms applicable and adaptable to the Colombian context. The guidelines were a useful coordination tool for the stakeholders from three different communities in identifying their priority needs and planning according responses from a holistic mental health and psychosocial support (MHPSS) perspective. Reccomendations are made to improve implementation of the guidelines, as well as how to continue supporting the process at both national and local levels.

This case study describes the use of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings in Jordan. The fieldwork was carried out 17–27 August 2008 in Jordan and involved discussions with representatives of humanitarian organisations and UN agencies in Amman and Zarqa. This paper describes the ways in which the guidelines have been disseminated in Jordan and how they have ‘added value’ within the context of the Iraqi refugee crisis in Jordan. It also describes the factors that have hindered the full implementation of the guidelines.

This case study describes the use of the IASC Guidelines on Mental Health and Psychosocial Support in Kenya. The fieldwork was carried out 14–25 July 2008, and involved discussions with representatives of humanitarian organisations, UN agencies and government departments in Nairobi, Eldoret and Nakuru. It describes the ways in which the guidelines have been disseminated in Kenya, how they have ‘added value’ in that context, as well as the factors that have hindered the full implementation of the guidelines in Kenya.

This field report summarizes the general psychosocial training topics, describes two critical sessions and presents outcomes from a training of trainers conducted in Africa, with twenty-five psychosocial field practitioners from fifteen non-governmental organizations, on the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The training goals were to support a core group of resource persons for Africa on emergency psychosocial work, and offer a forum for explicit learning about and application of the recently published MHPSS guidelines in field work. Also included are highlights from the education and staff care sessions provided by the actual training facilitators. Finally, outcomes and feedback from participant evaluations are briefly presented.

The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings were helpful in organizing mental health and psychosocial support services for Burundians who were expelled from Tanzania. Key aspects of the guidelines were the restoration of social support for people in acute distress, the use of Psychological First Aid, and the provision of care for those with pre-existing mental health problems.

UNHCR has started to integrate the guidelines for mental health and psychosocial support into the overall activities. This report focuses on how this is being done in Ethiopia.

The purpose of this paper is to clarify the United Nations Population Fund's (UNFPA's) role and areas of work concerning mental health and psychosocial support in emergency settings for better inter-agency/sectoral coordination and collaboration. This paper will also discuss the implications of the guidelines for current operations and future ones.

This paper provides a brief overview of selected aspects of the World Bank's support in the area of mental and psychosocial health, with a focus on conflict affected countries, and reference to selected points in the Inter-Agency Standing Committee1 Guidelines on Mental Health and Psychosocial Support in Emergency Settings (Inter-Agency Standing Committee, 2007). Mental health and psychosocial wellbeing is at the very core of sustainable social and economic development, alleviation of poverty and peace. The guidelines represent an important step forward, enabling us to coordinate and strengthen our efforts, especially during emergencies in conflict and disaster affected countries.

The initiatives for Mental Health and Psychosocial Support by the International Federation of the Red Cross and Red Crescent Societies are presented, using the case of a cyclone in Bangladesh. The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings have proved useful, but need to be made operational through joint efforts by different actors, through dissemination to grass root rural levels, and through planning in the non emergency phase.

A major challenge for the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings is to make them accessible to community groups. People at the local level often have difficulty in reading and comprehending the guidelines. This article describes how pictorial aids, such as visual stimulus cards and ‘low verbal-high visual’ instruction materials, were used to assist communities groups to work with the guidelines. We describe how these materials have been developed in several post disaster settings in Latin America and South East Asia. The experiences with these documents suggest a promising practice for using the guidelines.

The humanitarian organization Médecins sans Frontiéres (MSF) supports the content of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The guidelines promote a systemic, comprehensive approach to psychosocial and mental health problems, and bring unity to a field that was much needed. However, these guidelines operate within the context of major reforms of the humanitarian aid sector. The potential implications of these reforms on independent humanitarian action are discussed.

One year after the official launch of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings, initiatives linked to their implementation have been undertaken in over 20 countries ranging from Iran and Nepal to Kenya and Peru. In this article we present an overview of the activities that are currently underway to implement the guidelines. This article provides an overview of different strategies that have been used and presents some of the strengths and challenges of these implementation strategies.