This study explored the socio-economic and psychological effects of terrorist bomb blasts on the lives of survivors, using a qualitative research method. Results have shown that, although several years may have elapsed since the event, respondents were yet to recover from its effects. Those who survived still carry the scars to constantly remind them of the horrific ordeal. They are tormented by psychological issues which, for them, are often more difficult to deal with compared to the trouble and pain caused by physical injuries sustained. Most of the participants have experienced frequent stress related psychological symptoms, as well as other associated symptoms such as sadness, depression, anxiety, irritability, lack of concentration in daily activities, nightmares and flashbacks of events. Additionally, there has been serious long term socio-economic effects of terrorist bomb blasts on the survivors, such as unemployment, uncertainty over the education of their children and declining health status. Furthermore, as well as dwindling social-economic status, inadequate government support and lack of follow-up in terms of rehabilitation are among the most pressing problems faced by this group of survivors, which needs to be urgently and properly addressed.

This personal reflection describes the experience of a Swiss/Belgian psychologist who has been working as a mental health programme coordinator in Palestine for Médecins du Monde France for 2.5 years. His reflection (which does not necessarily reflect the view of Médecins du Monde France) touches on the importance of rethinking psychosocial interventions for individuals and communities facing continuous critical events. The author also reflects on his background, his motivation and challenges, as well the impact of the current situation on Médecins du Monde, in terms of both international and national staff.

This article aims to promote the integration of mental health and psychosocial support into livelihood programmes, presenting existing research within behavioural economics, humanitarian and economic fields that support the need and effectiveness of such integration. It presents examples of mental health and psychosocial support integration into livelihood programmes put in place by a grass roots organisation in the USA and the largest development institution in the world, the World Bank Group, respectively. While these initiatives took place within organisational, socio-economic and political environments that significantly differ from those where most humanitarian programmes take place, a series of best practices, processes and approaches that could be considered within humanitarian settings are highlighted in the conclusions.

The field of mental health and psychosocial support (MHPSS) in emergencies has been slow to engage with the growing global policy consensus around disaster risk reduction (DRR) as embodied by the Hyogo Framework for Action and its successor, the Sendai Framework for Disaster Risk Reduction. However, there are encouraging recent efforts to harness the synergies that exist between the fields of DRR and MHPSS. As these linkages between the fields of MHPSS and DRR are still in an early stage of development, our attempt to outline a preliminary basis for how the objectives of the two fields may be combined in practice, and conceptually, might help move this process forward. It is in the interest of the MHPSS field to invest further in ways and means of integrating with the fast growing, dynamic and increasingly influential field of DRR. In turn, the field of MHPSS has much to offer by way of perspectives and approaches that can amplify the impact of DRR activities on the quality of life of people who are at risk of experiencing hazards or disasters. We believe this paper will demonstrate this and encourage others in the MHPSS field to seek greater dialogue and integration between the two fields.

This article examines the efforts of the International Organization for Migration to mainstream mental health and psychosocial considerations into camp coordination and camp management, through capacity building and provision of direct psychosocial support. It focusses on the activities carried out by the International Organization for Migration in South Sudan, in the Protection of Civilians Areas, and in the north east of Nigeria, with the aim to identify relevant challenges and best practices.

A multi-layered approach to mental health and psychosocial support in emergencies includes the integration of psychosocial approaches into sectors with primary aims other than the enhancement of mental health and psychosocial support. This paper shares the experiences of Church of Sweden’s psychosocial team in supporting its partner organisations (within the ACT Alliance) to integrate a community based psychosocial approach into programmes in sectors including: education, child protection, livelihoods, water and sanitation, and food security. Case studies are used to describe how mental health and psychosocial support core principles can assist organisations to integrate psychosocial approaches into a variety of programmes, and to demonstrate that this is more about working in a different way than about taking on additional tasks. The challenges associated with supporting organisations to integrate psychosocial approaches into their programmes are also outlined, and the need for research to evaluate the effectiveness of this type of approach is acknowledged.

In the Central African Republic, a political crisis started in 2013 that greatly affected the population. They were exposed to traumatogenic factors causing the emergence of symptoms of posttraumatic stress disorder in large segments of the population. The situation of high food insecurity, combined with high levels of psychological distress, have significantly limited the population's coping strategies. Within this context, the nongovernmental organisation, Action Contre la Faim, implemented a programme aimed at addressing both immediate and underlying causes of malnutrition, integrating psychosocial and food security approaches. In order to improve the access to food, 900 pregnant and lactating women received monthly food coupons that were exchangeable in the local market. Of these, 199 women who had been identified as the most psychologically vulnerable benefited from specific support: individual counselling or therapeutic groups. Through this multi-sectoral approach, the women’s average individual dietary diversity score increased and households improved their food consumption score. Further, these women improved their psychological wellbeing and were able to regain some degree of hope and to develop coping skills. They regained confidence and felt stronger and more prepared to face the future, showing that this multi-sectoral approach strengthened family resilience.

According to humanitarian minimal standards, humanitarian programmes should maximise participation of affected populations within their response. Participation has been a key point in proposals, evaluators are aware of it and every aid worker has heard of it. In theory, it is a perfectly implemented, well understood and a well respected construct. In the field of mental health and psychosocial support, participation is core principle number two. Based on personal observations, this paper will delve deeper into the concept of participation within mental health and psychosocial support and the importance of its implementation. Further, and perhaps more importantly, it will reflect on the fact that even though this concept is so imbedded into concepts of humanitarian aid, there is a huge implementation gap. As a result, this paper also calls for action to fill this implementation gap and improve humanitarian aid through the principle of participation.

This article describes the approach, implementation and evaluation of a pilot mental health and psychosocial support case management programme that was developed by the United Nations High Commissioner for Refugees in Syria. The aim was to provide a description of the programme approach, its implementation and outputs. The programme integrates different forms of case management approaches based on a multi-layered, stepped care model. Earlier results of mixed method monitoring and evaluation revealed improvement in wellbeing among programme participants. The step-wise approach indicates, in addition to the positive mental health outcome results, a functional case management system.

The largest number of Syrian refugees in the world are currently hosted in Turkey, with the great majority of them residing in urban settings. This paper presents the findings of The Humanitarian Emergency Settings Perceived Needs (HESPER) Scale survey conducted with the population of urban Syrian refugees in the town of Kilis in south-central Turkey in 2013. The high level and variety of perceived needs and daily stressors shows the magnitude and hardship in the urban Syrian refugee community in Kilis. Issues such as: income/livelihood; clothes, shoes, bedding or blankets; the way aid is provided; being displaced from home; a place to live in; distress; education for your children; and physical health were considered as priorities by most of the HESPER survey participants. A subsequent in-depth participatory assessment in the town of Kilis in February 2014 was useful for better understanding of the expressed needs of the urban Syrian refugee population, designing mental health and psychosocial support interventions and providing recommendations to humanitarian actors.

This study examined the implementation of the Enhancing Resiliency Amongst Students Experiencing Stress intervention, which is a teacher mediated, evidence based school intervention, targeting youth who have been exposed to ongoing conflict. Our hypothesis was that posttraumatic symptom levels can be reduced when youth have higher levels of ego resilience and that this can be achieved through a teacher mediated, school intervention. We found that ego resilience is negatively related to posttraumatic symptom levels, while anxiety levels and impairment in functioning are positively related. However, in contradiction to our hypotheses, we also found that the school intervention was not sufficient to contribute significantly between the pre and post measures and resulted in higher levels of posttraumatic symptom levels, anxiety levels and impairment in functioning. These findings are explained within the context of the harsh environment in which the students and their families live. Additionally, our findings indicate that implementing a school intervention within the context of continuous exposure to traumatic events may require a more holistic approach.

The signing of the truce on 23 June 2016 and the finalisation of peace negotiations on 24 August 2016 marked the end of more than 50 years of continuous armed conflict in Colombia, South America and the transition to ‘post conflict’ status. According to annual reports from the Internal Displacement Monitoring Centre based in Geneva, Switzerland, Colombia has ranked first or second in numbers of internally displaced persons every year for the past 12 years, making forced migration a defining characteristic of the country. This is based on the personal reflections of a mother and daughter (ER and AdPGR) who were displaced from rural Colombia and resettled in the nation’s urban capital of Bogoá. They survived the rigors and hardships of displacement and became capable counsellors on a global mental health project, bringing evidence based interventions to a highly traumatised population of internally displaced women in Bogotá. Their account speaks to the lived experiences of more than six million Colombian internally displaced ‘victims of the armed conflict’. Particularly notable is the description of myriad trauma exposures prior to the moment of displacement. This field report demonstrates how personal accounts are a useful tool for educating clinicians working with these populations.

Families in Ethiopia, with few opportunities to generate income, sometimes send a young family member to work abroad. In many cases, the family sells property to raise the necessary funds, and therefore, expect that much of the income earned will be sent home. However, young migrants are often vulnerable to exploitation and abuse and may want to return home, or need to return after violence breaks out in their country of migration. Yet, returning home raises a number of challenges, not least those involved in returning empty-handed. In this personal reflection, I discuss working with the International Organization for Migration assisting young returnees to Ethiopia, explore the psychosocial issues affecting those who migrate and return, and put forward suggestions as to how their psychosocial wellbeing can be strengthened.