Maintaining our mental health is a process that may require support, especially in times of disaster. As a humanitarian aid organization working to ensure that people affected by disasters have access to services, a project we have been carrying out with local governments for the last two years to make mental health sustainable is very valuable in this respect. MHPSS Team Leader Ayşe Eriş shares our strategy development experience in Şanlıurfa.
Mental health is a concept that we use a lot but is difficult to define. We know its importance, but what exactly do we mean by mental health? According to the World Health Organization, mental health is not only the absence of mental illness, but also a continuous and dynamic state of health in which people are strong in coping with stress, find channels to realize their potential and integrate with society. And of course everyone in the world deserves to have mental health.
Access to Mental Health
As a rights-based humanitarian aid organization, protecting the mental health of the people we support is an important part of our work. Being able to do this together with local governments is also valuable in terms of the spread and permanence of our work. Because data shows that there is a need for systematic and sustainable solutions on this issue. According to a study conducted in Türkiye in 2020, there are only 3 mental health and illness specialists and 5 psychologists for every 100 thousand people. If we look at the total of all personnel working in this field, there are approximately 16 employees for every 100 thousand people. This number is 43 on average in European countries.
Needs Assessment in Şanlıurfa
In order to support the improvement of these conditions, we, as Support to Life Association, are the implementing partner of a project on access to mental health in cooperation with the German Federal Ministry for Economic Cooperation and Development (BMZ), in cooperation with the Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH (GIZ) and Şanlıurfa Municipality Department of Women and Family Services. In June 2023, we conducted a mental health needs assessment with 630 women beneficaires from 32 Women Support Centers in 13 districts of Şanlıurfa. Although the results were not very far from the general results in Türkiye, they enlightened us in many other areas.
The common needs of 630 women in our in-depth survey can be summarized as follows:
- Women are not sufficiently informed about mental health and psychosocial support services.
- Women cannot find the psychological support mechanisms they need.
- Women are afraid to access these mechanisms due to social pressure and fear of stigmatization.
- Women want to receive psychological support services in their mother tongue.
- Women find the services too costly and therefore cannot receive services.
- Women especially need a safe space where they can leave their children in order to receive mental health support.
Location is also an important factor in accessing services. Among the 15% of 630 women who were able to receive psychosocial support, only 7 out of 95 women live in rural areas. We can say that access to mental health in rural areas is quite limited compared to urban areas.
Strategy Towards Accessible Services
This needs assessment on mental health and psychosocial support has been the basis for us to work with Şanlıurfa Municipality to design activities that aim for structural and sustainable improvement in this area. Municipalities of course have an important role in providing sustainable mental health services. In order to define this role and make it even more effective, we developed the Şanlıurfa Metropolitan Municipality Mental Health and Psychosocial Support Strategy as part of our project. In this strategy study, which we conducted under the guidance of the Municipality's Women and Family Services Department, we used the Pyramid of Mental Health and Psychosocial Support developed by the Inter-Agency Standing Committee (IASC) as a reference.
The Mental Health and Psychosocial Support Model proposed by this strategy aims to provide local communities and refugees with access to support services in this field and to increase their psychosocial well-being. It also focuses on increasing the inclusiveness and diversity of services and strengthening the capacities of service providers. This model, designed with the filtered results of a long study, has already started to be implemented by Şanlıurfa Metropolitan Municipality, Department of Women and Family Services.
Within this strategic model, which we designed in collaboration with stakeholders, we offer trainings to municipal unit managers and daycare teachers in different areas. We organize trainings on psychological first aid, working with vulnerable groups and trauma survivors, child safety and child protection, prevention of sexual exploitation and abuse, cognitive behavioral counseling skills, referral and interview techniques, parent/caregiver support practical program, secondary traumatization and mental self-care.
Özlem, a kindergarten teacher and one of the participants of the applied program that we support parents and caregivers, describes the impact of the training as follows:
“Children and their parents were very disconnected when they came to the daycare center. We strengthen the communication between parents and children with our information sessions. We also provide information to protect the well-being of parents. With the trainings we receive from the Support to Life Association, our professional competence increases and we mediate visible improvements in parents' communication with their children.”
Rafah, a beneficiary who participated in the mental self-care sessions, said that she realized the importance of well-being: “Children don't only need to eat, drink and care. They also need attention and love. It is very important to understand their language. Sometimes we don't even have time for ourselves in the daily hustle and bustle. However, as long as we are well, our children will be well. I thought about this for the first time during Support to Life's training.”
In the same session, Unit Manager Sema emphasized the importance of protecting mental health in disaster areas:
“We were affected by the disaster both directly and indirectly through the support we provided. Our lack of knowledge about mental self-care actually had a negative impact on our work. Knowing what secondary trauma is and even defining the situation we experienced made us feel very comfortable.”
It is important for all of us to provide accurate, effective and timely psychological and psychosocial support for women without harming anyone, without discrimination, and by supporting their knowledge and skills. With this perspective, we continue our interdisciplinary training programs for municipal staff and provide mentoring and supervision support. The next steps are to improve the skills of Women's Support Center staff to identify mental health risks, to establish an inter-departmental referral system, and to create a service map that includes actors inside and outside the municipality. Because everyone deserves to feel good and reach their potential.
Ayşe Eriş / MHPSS Team Leader
Şanlıurfa
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