• What is mental health?
Mental health is a state of mental well-being in which people cope well with the many stresses of life, can realize their own potential, can function productively and fruitfully, and are able to contribute to their communities.
• Mental health conditions
– There are nearly 1 billion people living with mental disorders
– Mental, neurological and substance use (MNS) disorders account for 10% of total disease
burden (DALYs) and 25% of years lined with disability in 2019.
– Global economy loses more than US $1 trillion annually to depression & anxiety
– 1 out of every 100 deaths globally due to suicide
– People with severe mental disorders die 10 to 20 years earlier than the general population
– More than 3 out of 4 people with mental disorders in LMIC do not receive care for their condition
– Gender: depression tends to be more common among women than men; substance use
more common among men
– Age: more behaviour problems in adolescents, and dementia only common in older adults
• Mental health in emergencies
– Almost all people in humanitarian emergencies will experience psychological distress, which for most will improve over time
– One in 11 (9%) in humanitarian emergencies will have a moderate or severe mental disorder.
• One person in five (22%) in humanitarian emergencies will have any mental disorder
– People with severe mental disorders are especially vulnerable during emergencies and need access to mental health care and other basic needs
– COVID caused 25% increase in anxiety and depression in 2020
– Higher rates in communities with higher rates of COVID-19
– Higher rates among women & young people
IASC Guidelines: Inclusive framework: mental health and psychosocial
support is a composite term that covers the following two aspects.
• protecting or promoting psychosocial well-being and/or
• preventing or treating mental health conditions
- 1 – Integrating MHPSS services within Primary health care centers (PHCs) & secondary health care centers (SHCs) in NW Syria, ( mhGAP IG-HIG & PSWS )
- 2 – Stand-alone specialized mental health services (Azaz Mental health hospital -Substance use centers)
During the last 8 years of implementing the mental health programs in Syria, PAC has worked with health cluster and MHTWG to conduct several programs and tools. All the tools applied in NWS that are endorsed by the MHTWG developed in participation of PAC.
Currently, PAC is managing the central mental health program in NWS to serve:
– Chronic unstable MH patients with no families from both genders.
– Chronic stable MH patients with no families from both genders.
– Sever MH patients from both genders.
– SUD patients management and support.
– Community-based MH screening, PSS, and Referral services
– Community re-engagement for SUD and Chronic MH patients through vocational therapy
– Pilot project to provide Spiritual health for MH patients.
– Suicide prevention awareness services and hotline
– Substance use support hot line.
– PSS support for caregivers of MH and PWD patients to improve their well-being and work with their relatives.
– Technical assessments and research.
– PSS services for pregnant and lactating women to improve their own feeding and baby care integrated with primary health care services and nutritional CMAM and IYCF services.
- 1 – Admission to PAC`s mental health hospital for acute and chronic Mental health Patients.
- 2 – Admission to PAC`s substance use centers for substance use cases.
- 3 – MHPSS consultation conducted by psychiatrists
- 4 – MHPSS consultation conducted by mhGAP-trained doctors
- 5 – Clinical management for Substance uses cases within outpatient department and substance use centers.
- 6 – Motivational interviews conducted by psychologists for substance use cases.
- 7 – Mental health group awareness-raising sessions, including distributing MHPSS messages as posters in public places.
- 8 – PSS activities for children.
- 9 – Problems management plus program.
- 10 – Psychoeducation.
- 11 – Create internal and external referral pathways.
- 12 – Global events such as World Mental Health Day…. etc.
- 13 – MHPSS case management.
- 14 – PFA
- 15 – detection and referral for MHPSS cases.
- 16 – Case management for suicidal cases.
- 17 – hotline number for suicide.
- 18 – hotline for substance use.
- 19 – Conducting capacity-building training on MHPSS topics for internal and external interested MHPSS practitioners ( mhGAP – clinical management for Substance use cases- suicide prevention-parental depression– MHPSS case management – PM+- SH+- Self /staff care).
Samples of the specialized activities & approached have been conducted by PAC’s MHPSS team in NW Syria:
- 1 – Psychiatric Inpatient Hospitalization (new admission criteria, discharge, and remote follow-up approach for the complex cases within PAC`s Mental health hospital and facilities).
- 2 – Clinical management of substance use disorders and community rehabilitation and re-engagement.
- 3 – Action plan for mhGAP-HIG Training & Supervision Rollout to General Healthcare Providers
- 4 – Suicide Prevention (Assessment & Management)
- 5 – Checklist for Integrating Mental Health into Primary Health Care (PHC)
• MHPSS Manager:
– Co-lead for Suicide Prevention Task Force for NW Syria.
– MHPSS TWG Coordinator at Protection Cluster and CP Sub Cluster.
– LEADERSHIP IN MENTAL HEALTH COURSE The American University in Cairo in collaboration with WHO EMRO
– TOT on mhGAP HIG (WHO- IMC – UNHCR)
– PRACTICAL APPLICATIONS OF INTERAGENCY MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT COORDINATION AND OPERATIONS (WHO)
– MASTER TOT TRAINING ON PERINATAL DEPRESSION (THINKING HEALTHY) FOR NORTHWEST SYRIA(WHO)
– SELF HELP PLUS TOT TRAINING World Health Organization (WHO)
– DETECTION & REFERRAL ON SUBSTANCE USE TOT World Health Organization (WHO)
– TRAINING ON STAFF-CARE AND PEER SUPPORT – GROUPS. Sigmund Freud university Berlin
– TOT ON SUICIDE PREVENTION AND SUPERVISION World Health Organization (WHO)
– TRAINING OF TRAINERS ON SELF CARE FOR HUMANITARIAN AID WORKERS World Health Organization (WHO)
– TOT REMOTE PFA (PSYCHOSOCIAL FIRST AID) COVID-19 TRAINING UNHCR.
– EXECUTIVE PROFESSIONAL CERTIFICATE PROGRAMME IN PSYCHOSOCIAL SUPPORT AND CONFLICT TRANSFORMATION.
– MENTAL HEALTH AND COUNSELING (TRAINING PROGRAM) International Blue Crescent (IBC).
– MASTER OF HIGH STUDIES IN SOCIOLOGY DEPARTMENT AND COUNSELING University of Aleppo / Faculty of Arts and Humanities/Sociology Department and counseling.
• Psychiatrist:
TOT trainer on (substance use -mhGAP- suicide prevention – Self-staff care) Department and counseling.
• mhGAP trained doctor :
MH GAP practitioners
• Psychologist :
TOT suicide prevention PM+, SH+
• Psychiatric nurse :
1-Training on Clinical management of substance use disorders and community rehabilitation and re-engagement
2- Psychiatric Inpatient Hospitalization (new admission criteria, discharge, and remote follow-up approach for the complex cases within PAC`s Mental health
