Written by Jonathan Kyle
CBOs serving all over the world often face extremely traumatic stresses, and face enormous hurdles when rebuilding their lives. However, mental health support has not always been prioritized in emergency response. We sat down with Rhett Cruz, senior mental health and psychosocial support counselor at Medair, to try to understand why this is, and whether things are changing.
Mental health support is rarely at the forefront of humanitarian responses. Why do you think so?
Helping work is often understood as having to do with needs that you can identify and respond to immediately.
For example, a house that needs rebuilding, or a community that needs safe drinking water. From these, you can get very tangible and accurate results. Mental health support varies, because the outcome is not entirely clear. It takes time, and sometimes years of work, to finally see a person or community recover, and return to mental health again.
Moreover, mental health was and still is surrounded by preconceived notions, including the so-called Western countries. It might be taboo to even start a conversation about it. We tend to shy away from mental health issues and try to pretend they don’t exist. This affects aid organizations as well.
But progress is being made. The pandemic has increased awareness and conversations about mental health. Lockdowns, isolation, loneliness… Many people realize, perhaps for the first time, how mental health affects them, even in small ways.
Why do you think mental health is just as important as physical health?
You cannot separate the two, because both affect the other. If you suffer from depression, anxiety or trauma, your daily functioning is affected and your immune system may be negatively affected. Likewise, if you suffer from a physical condition or develop a sudden illness – such as a disability, cancer, etc. – your mental health will likely be affected, because you will have to learn how to re-adapt to life in a new way, which can be a heavy mental burden. As it is often said, there is no health without mental health.
What does mental health support add to the humanitarian response?
We all need a safe home, clean water and nutritious food. These things are necessary. But even when we have it, we can still get frustrated or depressed. Helping people requires more than providing safe shelter and food, especially when they are exposed to traumatic events. I remember a colleague who once told me about a man he met in Kosovo. This guy said to him, “It’s great that you came to rebuild our homes. But who is going to help us rebuild our minds?” To me, that really says it all. You can rebuild a brick community, but without addressing the mental health issues they face, you haven’t fully addressed their needs.
You advise humanitarian workers who work in different countries on mental health issues. Does your approach change by country or crisis?
Like any other part of the humanitarian response, mental health and psychosocial projects need to adapt to culture and context. We should not assume that everyone in the world reacts in the same way that we do. Every context and every community can be very different, and we have to keep that in mind.
For example, how do people feel more comfortable expressing themselves? How do they deal with loss or grief? What kind of resilience system did they build to deal with their experiences and trauma? These are some of the questions we need to ask. It starts with listening to people, not assuming we already have the answers.
Medair focuses on emergency response. However, mental health affects people over and over again in a lifetime. How can we ensure the sustainability of mental health support?
Honestly, I’m not sure we can. However, what we can do is make sure that people are better prepared to face life’s challenges. When you build someone’s new home, you also can’t be sure that it will be sustainable – it may be destroyed in future conflicts, for example. But if the people in the community were also trained to be builders, they would be equipped to rebuild that house. In the same way, if people have integrated tools and mechanisms for dealing with mental health challenges, they can also mentally rebuild themselves. Their circumstances may not change but with the right tools, their ability to adapt and respond to them, will change. Simply put, our goal is to help people develop a blueprint for rebuilding their lives.
What are some specific ways to do this?
A major priority for us is working with local organizations and communities. We aim to work within existing structures, whether it is the state health ministry or civic organisations, to ensure that tools are instilled within the community, beyond our temporary intervention.
Another component of ensuring sustainability is peer support groups, where people who face similar challenges come together in their communities. The truth is that a lot of mental health support doesn’t necessarily need to be done by professionals. Families, friends, and neighbors can do a lot of it – which is why these peer groups are so important. They help create a strong support system. People know who they can turn to in difficult times.
Of course, this is still a lot of work in progress. More must be done. But I am convinced that these steps, among others, are moving us in the right direction.
Rhett Cruz currently works as a Principal Mental Health and Psychosocial Support Consultant at Medair, based in the Netherlands. She joined Medair in 2006.
Medair is an international humanitarian NGO that provides emergency relief and recovery services to families made vulnerable by natural disasters, conflict and other crises. This content was produced through resources collected by Medair’s field and headquarters staff. The opinions expressed here are those of Medair only and should not be taken in any way to reflect the official opinion of any other organization.