IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings

Elizabeth K. Carll, PhD

Following several years of intensive consultation and review, the Interagency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial support in Emergency Settings were launched at the United Nations in November 2007. The launch was interesting and interactive, providing an update for the non-government organizations (NGOs) and U.N. staff. The Guidelines are perhaps the most reviewed document of its kind with hundreds of organizations representing civil society, the private sector, and governments providing input and recommendations. The IASC was established in 1992 by the United Nations to facilitate coordination of response to humanitarian emergencies.

The IASC Task Force on Mental Health and Psychosocial Support in Emergency Settings is a collaborative effort of U.N. agencies and civil society and is co-chaired by Mark van Ommeren, PhD, representing World Health Organization (WHO) and Mike Wessells, PhD, representing InterAction, a consortium of 160 U.S.-based NGOs.

An extensive and long term review process was essential in order to achieve global support for the adoption of the comprehensive guidelines which are to provide a minimum framework of action for the many agencies and responders often involved in the aftermath of large-scale disasters. Having comprehensive guidelines in place is important as often weak coordination of services in the wake of disasters led to further problems down the road.

Interdisciplinary consultations were held in many venues with multiple agencies. ISTSS members Yael Danieli, PhD, Elizabeth Carll, PhD, and Dean Kilpatrick, PhD participated in the 2005 New York City consultations.

Aptly described by several of the speakers at the UN launch, the Guidelines are a compilation of effective strategies and dos and don'ts, such as preventing the “parachuting” in of foreign NGOs who may provide services they think appropriate, but which are not necessarily appropriate to the culture and community. An example cited by the speakers described how in the wake of the Tsunami, short term interventions appropriate to Western culture were not sensitive to Eastern culture and community strengths and often did not provide sustainability after these responders left.

The basic focus of the IASC Guidelines is the need to strengthen coordination of necessary services in the wake of disaster, such as mental health and psychosocial services, as these overlapping services are often under separate auspices. In addition, the Guidelines can be used to advocate for services for particular populations or needs, such as children, based on the included action sheets. The Guidelines provide a consensus of action which is also important in order to have governments buy into the responsibility to support and fund disaster intervention. Also emphasized is the importance of integrating mental health and psychosocial services into all of the aspects of disaster response, as opposed to separate stand alone interventions.

Included in the Guidelines is a matrix which details actions for various actors during different stages of a disaster and is complemented with a set of action sheets describing how to implement minimum responses identified in the matrices. In addition to the minimum responses listed for each of the domains or functions, a list of comprehensive responses is also indicated for the stabilized and early reconstruction phases. References for additional key resources are also provided. However, the guidelines are not intended to be a cookbook approach, rather to be combined with conducting local situation analyses tailored to the most appropriate interventions for particular communities.

Examples of weaving mental health services through the 11 domains are described and highlight the complex and comprehensive nature of disaster response. The 11 domains include coordination; assessment, monitoring and evaluation; protection and human rights standards; human resources; community mobilization and support; health services; education; dissemination of information; food security and nutrition; shelter and site planning; and water and sanitation.

The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings provide a key step in the development of a consensual document to support effective collaborative intervention in the wake of disaster.

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Elizabeth Carll, PhD is a licensed psychologist in Long Island, New York, editor of Trauma Psychology - Issues in Violence Disaster, Health, and Illness, Two Volumes, 2007, Praeger. She is a representative to the United Nations and a member of the ISTSS team along with Joyce Braak, PhD  and lead representative Yael Danieli, PhD.