Guidelines and recommendations by international organizations on MHPSS
Introduction
The war in Ukraine has had a profound impact on the mental and psychological wellbeing of individuals, families and communities affected by the conflict. The intense military escalation has resulted in disruption in access to healthcare services in addition to other important sectors in the region (1). Recognizing the urgent need for mental health and psychosocial support (MHPSS) interventions, various international organizations have developed comprehensive guidelines and recommendations to address the complex mental health challenges arising from the conflict.
Recommendation and Guidelines from international agencies and NGOs.
Various international agencies and non-governmental organisations (NGOs) have proposed recommendations and guidelines on how to tackle the humanitarian crisis and to support Ukrainians both within and outside of the country. Outlined below is a list of some of the key recommendations and guidelines.
The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) highlighted the importance of intensifying MHPSS for those affected by conflict and the region's health workers. Read more (1)
A report aiming to inform policy by The World Bank Group emphasized the need to strengthen mental health financing, build human resource capacity, and improve coordination and communication regarding information sharing among donors involved in mental health programming and reform in Ukraine. Read more (2)
A 2022 rapid situational analysis by the International Medical Corps (IMC) highlighted measures to strengthen the MHPSS humanitarian response in Poland. Read more (3)
In its 2022 strategic response for Ukraine, the World Health Organisation (WHO) provided a guide to developing specific action plans for MHPSS services to meet the needs of conflict-affected populations. Read more (4)
In a public health situation analysis for refugee-hosting countries, the WHO also emphasized the need to provide widespread MHPSS for those affected by the conflict. Read more (5)
The Interagency standing committee (IASC) outlined critical considerations for responding to MHPSS needs of people affected by conflict in Ukraine. Read more (6)
The United Nations High Commissioner for Refugees (UNHCR), as part of a participatory assessment with IDPs, proposed recommendations on possible actions to address their needs. Read more (7)
A joint agenda by UNICEF and UNHCR for children fleeing Ukraine calls for action in nine key areas, including providing basic needs such as psychosocial support. Read more (8)
UNHCR has published a situation regional response plan for Ukraine, outlining the response plan and recommendations for several countries hosting refugees from Ukraine, including Poland, Moldova, Romania, Hungary, and Slovakia. Read more (9)
Older people are a particularly vulnerable group and are disproportionately impacted by the crisis, partly due to their advanced age and poor physical condition. HelpAge International outlined several key recommendations for older people affected by the crisis. Read more (10)
HelpAge International also recommends that all humanitarian actors in Ukraine ensure that older people who have fled to other areas of the country can access complete essential services, including mental health support and social services. Read more (11)
Recommendations emerging from research.
Rapid but extensive research has been conducted in response to the crisis and several key recommendations have emerged from studies.
The International Alert, the Global Initiative on Psychiatry, and the London School of Hygiene and Tropical Medicine, in a study on the crisis in Ukraine, highlighted key important areas for relevant policies and programmes such as:
· IDPs are considered one of the target groups for mental healthcare provision by the relevant agencies in Ukraine.
· Scale up of trauma-informed responses and provision of adequate mental health care for IDPs based on a bio-psychosocial approach. Read more (12)
A pilot study by Anna E. Goloktionova & Monica Mukerjee showed that Problem Management Plus (PM+) effectively reduces MHPSS symptoms and can be feasible to implement in eastern Ukraine. They, therefore, recommend that PM+ be integrated into MHPSS interventions. Read more (13)
Recommendations from a study aimed at addressing the challenges arising from military conflict in Ukraine highlighted the importance of integrating internally displaced persons (IDPs) into their host communities and providing psychological support to war veterans. Furthermore, they underlined the need for improvement in the method and practice of providing psychological assistance to war veterans and IDPs. Read more (14)
When Russia annexed Crimea in 2014, international institutions developed preliminary response plans detailing recommendations for an effective response to the looming humanitarian crisis. Read more (15)
A study on the needs assessment of older people by HelpAge International found that family separation is one of the most traumatizing experiences for many older refugees. Therefore, they call for supporting family reunification for older people. Read more (16)
References
1. United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Flash Appeal Ukraine [Internet]. OCHA. 2022 [cited 2023 Feb 8]. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/Needs%20of%20older%20people%20in%20Eastern%20Ukraine%20-%204-03-22.pdf https://app.mhpss.net/?get=405/ukraine-flash-appeal-2022.pdf
2. World Bank Group. Mental Health in Transition: Assessment and Guidance for Strengthening Integration of Mental Health into Primary Health Care and Community-Based Service Platforms in Ukraine [Internet]. World Bank Group. 2017 [cited 2023 Feb 8]. Available from: https://app.mhpss.net/?get=405/wbg-imc-2017-ukraine-mental-health-assessment.pdf
3. International Medical Corps (IOM). Rapid Mental Health and Psychosocial Support Situational Analysis [Internet]. IOM. 2022 [cited 2023 Feb 8]. Available from: https://app.mhpss.net/resource/rapid-mental-health-and-psychosocial-support-situational-analysis
4. World Health Organisation (WHO). Ukraine crisis strategic response plan for June – December 2022 [Internet]. WHO. 2022 [cited 2023 Feb 8]. Available from: https://www.who.int/europe/publications/i/item/WHO-EURO-2022-5778-45543-65230
5. World Health Organisation (WHO). Ukraine crisis. Public health situation analysis: refugee-hosting countries, 17 March 2022. [Internet]. WHO. 2022 [cited 2023 Feb 8]. Available from: https://www.who.int/europe/publications/i/item/WHO-EURO-2022-5169-44932-63918
6. MHPSS Reference Group. Responding to Mental Health and Psychosocial Support (MHPSS) needs in Ukraine and affected countries: Key considerations when offering help remotely/online [Internet]. MHPSS Reference Group. [cited 2023 Feb 8]. Available from: https://app.mhpss.net/?get=405/english_responding-to-mental-health-and-psychosocial-support-mhpss-needs-in-ukraine-and-affected-countries_-key-considerations-when-offering-help-remotely_online.docx.pdf
7. United Nations High Commissioner for Refugees (UNHCR). Ukraine Participatory Assessments Summary Report [Internet]. UNHCR. 2015. [cited 2023 Feb 8]. Available from: https://www.unhcr.org/uk/news/ukraine-participatory-assessments-summary-report
8. UNHCR & UNICEF. Ukraine emergency: children fleeing Ukraine - the advocacy agenda for action [Internet]. 2022. [cited 2023 Feb 8]. Available from: https://app.mhpss.net/?get=405/engukraineparentinga4colourinhousepdf.pdfhttps://app.mhpss.net/?get=405/engukraineparentinga4colourinhousepdf.pdf
9. United Nations High Commissioner for Refugees (UNHCR). Ukraine Situation Regional Refugee Response Plan [Internet]. UNHCR. 2022. [cited 2023 Feb 8]. Available from: https://app.mhpss.net/?get=405/ukraine-situation-rrp-plan-and-flash-appeal-march-december-2022_1.pdf
10. HelpAge International. Older voices in humanitarian crises: Calling for change [Internet]. 2016. [cited 2023 Feb 8]. HelpAge International. Available from: https://reliefweb.int/report/world/older-voices-humanitarian-crises-calling-change
11. HelpAge International. No Time for Business as Usual [Internet]. 2016. [cited 2023 Feb 8]. HelpAge International. Available from: https://helpage.org/silo/files/no-time-for-business-as-usualhelpage-international.pdf
12. International Alert. Hidden burdens of conflict: Issues of mental health and access to services among internally displaced persons in Ukraine [Internet]. 2017. [cited 2023 Feb 8]. HelpAge International. Available from: https://www.international-alert.org/publications/hidden-burdens-of-conflict/
13. Goloktionova AE, Mukerjee M. Bringing Problem Management Plus to Ukraine: Reflections on the past and ways forward. Intervention. 2021 Jan 1;19(1):131. Available from: https://app.mhpss.net/?get=405/intervention191131-7366914_202749.pdf
14. Yablonska TM. The psychology aimed at addressing challenges arising during the recent military conflict in Ukraine. psychoprevention. 2017:37. Available from: https://jbc.bj.uj.edu.pl/Content/461843/NDIGOC020207_2017_001.pdf#page=37
15. United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Preliminary Response Plan: Situation in Ukraine [Internet]. OCHA. 2014 [cited 2023 Feb 8]. Available from: https://app.mhpss.net/?get=245/ENG_Ukraine-Preliminary-Reponse-plan-final-18.08.14.pdf
16. HelpAge International. Moldova: Needs Assessment of Older Ukrainian Refugee [Internet]. 2022. [cited 2023 Feb 8]. HelpAge International. Available from: https://reliefweb.int/report/moldova/moldova-needs-assessment-older-ukrainian-refugees-14-september-2022
