MSF teams have offered trauma-related care in over 40 areas around the world, including; Chechnya, Sudan (Darfur), Iraq, Congo and Kashmir.
MSF provides emergency medical aid in catastrophes all over the world — armed conflicts, natural disasters, famines and epidemics. MSF doctors and nurses are often seen treating physical ailments: bandaging the war-wounded, rehydrating a cholera patient, performing an emergency cesarean section. But for more than 20 years, MSF has also been caring for patients’ mental health.
In 1998, MSF formally recognised the need to implement mental health and psychosocial interventions as part of our emergency work. For people who have lived through terrible events, the psychological consequences can be severe. Depression and anxiety can immobilize them, at just the time when they need to take action for themselves and their families. Mental health care is also part of services for HIV/AIDS, tuberculosis, nutrition, sexual violence and during disease outbreaks and disasters.
MSF’s mental healthcare aims primarily to reduce people’s symptoms and improve their ability to function. Often this work is done by local counsellors specially trained by MSF. MSF psychologists or psychiatrists provide technical support and clinical supervision. When appropriate, MSF’s counselling services may reinforce or complement mental healthcare approaches that already exist in the local community.
At the same time, specialized clinicians treat severe mental illness. But severe illness accounts for a minority of the cases that MSF sees.
Needs are high, and MSF continues to expand its mental health programs. Last year, MSF’s mental health teams performed more than 100,000 consultations worldwide. People sought help for many reasons — the agonizing loss of a child in an earthquake, the trauma of sexual violence, getting caught up in a violent conflict. MSF mental health workers listened to their stories, and helped them find ways to cope and move on with their lives.
Treating severely disturbed people remains a challenge for MSF teams, given the complexity of managing psychiatric drugs and medication. Increasing teams’ capacity to treat these illnesses remains a priority for MSF. Setting up mental health care programmes in emergency situations is not straightforward, especially when violence and trauma is ongoing and no ‘cure’ is therefore possible. Sometimes it is difficult to guarantee continuity of care in unstable and dangerous settings.
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