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International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2015

Open Access 01-12-2015 | Case study

Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective

Authors: JoAnne E Epping-Jordan, Mark van Ommeren, Hazem Nayef Ashour, Albert Maramis, Anita Marini, Andrew Mohanraj, Aqila Noori, Humayun Rizwan, Khalid Saeed, Derrick Silove, T Suveendran, Liliana Urbina, Peter Ventevogel, Shekhar Saxena

Published in: International Journal of Mental Health Systems | Issue 1/2015

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Abstract

Background

Major gaps remain – especially in low- and middle-income countries – in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations’ mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development.

Case description

Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste.

Discussion and evaluation

These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders.

Conclusions

Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.
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Metadata
Title
Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective
Authors
JoAnne E Epping-Jordan
Mark van Ommeren
Hazem Nayef Ashour
Albert Maramis
Anita Marini
Andrew Mohanraj
Aqila Noori
Humayun Rizwan
Khalid Saeed
Derrick Silove
T Suveendran
Liliana Urbina
Peter Ventevogel
Shekhar Saxena
Publication date
01-12-2015
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2015
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-015-0007-9

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