This field report reviews some of the challenges encountered in providing support to local international, nongovernmental organisations staff in Gaza, shortly following the cessation of conflict in July and August of 2014. Methodology and the content of group sessions are described. The paper concludes with highlights from the evaluation, reflections on what was learned, and some recommendations on the provision of further staff support in the future.

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As the Syrian refugee crisis continues unabated, Greece remains one of the first ports of sanctuary. While the country is still gripped by one of the worst financial and societal crises of the past 40 years, little attention or funding was available to provide mental health and psychosocial support to migrants or refugees. In 2007, Nikolaos Gkionakis, along with other colleagues, founded the Babel Day Centre to provide mental health care and psychosocial support for migrants and refugees. When the current crisis began, he was perfectly placed as one of the trainers for a project training border security, police, volunteers and aid workers in psychological first aid and self care for carers in Greece. This personal reflection gives context and background to the crisis, discusses the Babel Day Centre, and highlights and details the psychological first aid project, which was supported by both the War Trauma Foundation and the United Nations High Commission for Refugees.

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This paper describes lessons learned from a classroom based intervention, which was implemented in the post conflict area of Poso, Indonesia. These lessons are drawn from qualitative research and a randomised controlled trial in the area, as well as data from our own programme monitoring and evaluation. We describe these lessons learned from a socio-ecological perspective, making recommendations to strengthen the classroom based intervention’s connection with critical mental health and psychosocial issues relevant at individual, family and wider community levels. Lessons learned include: the need for further adaptations to address local somatic expressions of psychological distress; consideration of changes at the cognitive level; a need for gender specific activities; engaging families in school based interventions; and addressing the damage to the wider social fabric, including at peer level. The engagement of trained paraprofessional health care is also discussed as an essential consideration.

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Ibado Mahamoud Hilole, a Somalian woman, fled to Ethiopia after her son was killed in Mogadishu in 2010. Since then, she has lived in a refugee camp situated on the border where Somalia, Kenya and Ethiopia meet. In this personal reflection, she describes how her life has been affected by the violence in her country, how she survived periods of despair, and yet was able to find the courage to become a peer counsellor for other refugees. After training, she is now able to provide a listening ear, as well as giving practical support and advice.

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In response to a disaster in high income countries, disaster mental health professionals typically have, at most, one encounter with a survivor of the event. After providing the initial psychosocial interventions, the individual is either referred to follow-up mental health resources or has access to the mental health delivery system. When disasters occur in low and middle income countries, access to follow-up and treatment for mental health issues may be unavailable or limited in capacity. Underdeveloped and poorly resourced primary and secondary care services, a deteriorating health care infrastructure and the limited availability of health care professionals are all barriers that contribute to limiting access to mental health care for survivors of a disaster. This paper will discuss implementing Single Session Therapy as a framework of practice for providing mental health interventions, post disaster, when it is not possible to provide either continuity of mental health treatment or follow-up for survivors.

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Following armed conflict in the North Waziristan Agency, a mental health and psychosocial support initiative was launched for internally displaced persons in Bannu, Pakistan. This was convened by volunteer mental health professionals, in collaboration with a variety of agencies (provincial government, military, humanitarian agencies) in a security compromised region. As part of the initiative, monthly camps were held for a period of six months. Mental health needs were assessed. A multidisciplinary team (psychiatrists, psychologists, psychiatric nurses and psychosocial workers) offered mental health care to 680 people who attended the camps, of which 28% were under the age of 18 years old. Twenty-one percent returned for follow-up, while others were followed-up in the community by psychosocial teams. Estimates of common mental disorders were found. Both pharmacological and psychological treatments were offered, according to existing guidelines. Active efforts were made to conduct holistic assessments and avoid a pure biomedical approach. This also provided an opportunity for training non specialist staff and led to formal (World Health Organization) mental health gap action plan training for primary care staff.

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This paper presents a model of a capacity building intervention, which encompasses twophases: reception and familiarity (a process of getting to know people to beyond their problems) and community mobilisation. This intervention was conducted with 65 participants from Chincha (Peru) urban and rural areas after the earthquake of 15 August 2007, highlighting a community intervention that was based on the content and methodology generated during the sessions. It is grounded in the recognition of local capacities and putting collective action into practice, through workshops and art to enhance culture and identity and empower participants. The 65 participants were able to mobilise their communities to design and create 17 murals and signboards. The main achievements of this model of intervention were the progressive withdrawal of external professionals involved, the development of personal skills of community leaders (e.g. self efficacy, organisation), and the systematic increase of leadership and community participation.

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