INTERNATIONAL CONSULTATION ''MENTAL HEALTH OF REFUGEES AND DISPLACED POPULATIONS IN CONFLICT AND POST-CONFLICT SITUATIONS''

From Crisis Through Reconstruction
WHO Geneva, 23-25 October 2000

WHO convened the International Consultation on Mental Health of Refugees and Displaced Populations in Conflict and Post-Conflict Situations, in WHO Headquarters in Geneva, on 23-25 October 2000. Thirty-five experts in this field were invited from low and high-income countries, including several which are currently in conflict or post-conflict situations. United Nations agencies, NGOs, academic and research institutions were represented. On the first day of the consultation, the assembled experts were addressed among others by four leaders in the worldwide protection and care of refugees.

Dr Gro Harlem Brundtland, Director-General of the World Health Organization told the assembly of the International Consultation,

"... To address the mental health needs of large populations, we need definite strategies and plans. Ad hoc arrangements and improvisations in response to each emergency will no longer be acceptable. Specific management ability, strong field experiences and evidence-based approaches are required... WHO strongly recommends the establishment of community-based mental health care from emergency through reconstruction. Earliest integration of mental health within the public health care system available in camps and national services is the most efficient, and cost-effective strategy. The concerned communities must be mobilized and actively involved to decrease psychiatric morbidity and increase sustainability."

Ms Mary Robinson, United Nations High Commissioner for Human Rights, said in her address,

"... The number of refugees and displaced persons in the world shames us all. We should be actively seeking ways of alleviating their suffering. I believe that your deliberations relating to the... practical tools for rapid assessment (RAMH)... which will be adopted at the end of this Consultation will be significant steps forward."

Mr Frederick D. Barton, United Nations Deputy High Commissioner for Refugees, to summarize the challenges that lay ahead, said,

"... Like so much we try to do, the immensity of this challenge can seem daunting. The numbers are huge, the locations are multiple, the resources are scarce, the needs are immediate and varied, and our approaches are often compartmentalised and paternalistic. Our certainty is that our work will produce as many questions as answers. As we go about this work, it is vital that we remain focused on those we seek to help, renewing our commitment to their futures. If we do that, we will advance the grand cause of peace - and begin to make progress on these huge mental health problems in conflict-torn places."

Ms Erin Mooney, stressed on behalf of Dr Francis Deng, Representative of the United Nations Secretary-General on Internally Displaced Persons that,

"... displacement impacts upon mental health in three major ways. First, there is the trauma associated with the occurrence of displacement, which not only may be induced by but also often involves serious violations of human rights. Second, once uprooted, the displaced suffer a tremendous sense of loss and dislocation, and an uncertain future for them and their children. Adding further strain, displaced persons may find themselves in a discriminatory, even insecure environment, such that they continue to be in a very precarious situation even in their places of refuge."

The expert participants in the Consultation reviewed, amended and endorsed the Tool for Rapid Assessment of Mental Health Needs of Refugees, Displaced and Other Populations Affected by Conflict and Post-Conflict Situations, and Available Resources (RAMH). They also called to integrate it in the United Nations Office for Coordination of Humanitarian Assistance (OCHA) Emergency Operations.

RAPID ASSESSMENT OF
MENTAL HEALTH NEEDS OF REFUGEES, DISPLACED
AND OTHER POPULATIONS AFFECTED BY
CONFLICT AND POST-CONFLICT SITUATIONS
AND AVAILABLE RESOURCES

A TOOL FOR COMMUNITY-ORIENTED ASSESSMENT

VERSION FOR PILOT-TESTING

The creation of the tool became possible through the contributions of the
Governments of Finland, Greece, and Cyprus

AUTHORS:

Ms Mary PETEVI, WHO
Dr Jean Pierre REVEL, IFRC
Dr Gerard A. JACOBS, DMHI

Issued by the
World Health Organization

Developed in collaboration with the
International Federation of Red Cross and Red Crescent Societies
and the Disaster Mental Health Institute, The University of South Dakota, USA

Geneva, 2001