Empowerment in crisis: uniting for inclusive mental health care

In emergencies, people with disabilities are often still left behind – not only physically – but with their mental health too.

They are exposed to multiple risks, which often impact their mental health or exacerbate existing conditions. These can result in psychological distress, abandonment, neglect and abuse.

Until recently, there have been few options for addressing this major gap within the Mental Health and Psychosocial Support (MHPSS) community and actors working in emergency settings, who did not have specific guidance on supporting people during a crisis . Within countries, there is little connection between the disability movement and the emergency preparedness and response actors, including those working in MHPSS.

But there’s good news. This year the Inter-Agency Standing Committee (IASC) MHPSS Reference Group (the major collaboration of UN and other agencies that have been hugely influential in setting global standards on MHPSS), have published guidance on inclusive MHPSS to address this. The Information note on Disability and Inclusion in MHPSS provides principles and practical guidance on how to ensure that people with all kinds of disabilities are included in all aspects of emergency response.

Historically, people with mental health conditions and psychosocial disabilities have been particularly neglected. During COVID-19, they were 5 times more likely to die than their peers, even in high income countries, and those in institutions are particularly at risk if, for example, staff are unable to come to work or flee conflict or natural disasters.

The Information Note was developed in a collaborative process with CBM Global, UNICEF and other agencies in the Inclusive MHPSS thematic group at IASC. It was also co-produced with organisations of people with disabilities (OPDs) and with the Reference Group on Inclusion of Persons with Disabilities in Humanitarian Action.

The Information Note has now been turned into an accompanying training package by CBM Global and the World Blind Union. This is targeted at both MHPSS actors and those working in disability inclusion in areas prone to humanitarian crises. It has been piloted in Philippines and Nepal, with a pilot happening in Ukraine due in June 2024.

It was designed with key parameters to make it practical and versatile:

• it can be deployed very quickly, even during emergencies
• it only takes 2-3 days to deliver the training
• it provides a core set of skills for all MHPSS actors (not only specialists) to do inclusion better.

Uniquely – and reflecting coproduction of the info note – training is always delivered with local OPDs, with a joint preparation day a key element. This promotes building of relationships between MHPSS actors and OPDs, and enables a good understanding of local contexts and needs and priorities of people with disabilities, due to the local knowledge of OPDs and these relationships, help in planning and executing a rapid response during any future emergency.

The ambition of IASC is that all major MHPSS agencies have their frontline staff undergo this training – and many agencies have already shown commitment to this. The opportunity is there for a fundamental shift towards inclusive practice in this work where we meet people at the highest risk of being left behind, and we now have the tools to address this.

In the UK, mental health has had a low profile within the FCDO, but MHPSS is biggest investment the UK has in its foreign engagement. Therefore, the development of this package is an important opportunity for FCDO to align its MHPSS work with the Disability Inclusion and Rights Strategy, and to demonstrate its support for inclusive approaches to humanitarian action.

Bond members who work in MHPSS, or are interested in inclusive approaches to MHPSS and wider humanitarian action are welcome to explore the links below and contact CBM Global for further information.

If you’d like to know more, please feel free to contact Matthew and Julian.