Mental health in humanitarian settings: Shifting focus to care systems

Research and Development Department, HealthNet TPO, Lizzy Ansinghstraat 163, 1072 RG Amsterdam, the Netherlands.
International Health (Impact Factor: 1.3). 03/2013; 5(1):9-10. DOI: 10.1093/inthealth/ihs005
Source: PubMed


Mental health in low- and middle income countries has received increasing attention. This attention has shifted focus, roughly moving from demonstrating the burden of mental health problems, to establishing an evidence base for interventions, to thinking about care delivery frameworks. This paper reviews these trends specifically for humanitarian settings and discusses lessons learned. Notably, that mental health assessments need to go beyond measuring the impact of traumatic events on circumscribed psychiatric disorders; that evidence for effectiveness of interventions is still too weak and its focus too limited; and that development of service delivery in the context of instable community and health systems should be an area of key priority.

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    • "On the other hand, critiques of community-based mental health care have highlighted conflict with health professionals, inappropriate incentives, infrequent visits, lack of training of care workers, unrealistic expectations, the lack of partnerships and the remaining dominance of large psychiatric hospitals (Eaton et al., 2011; Schenk & Michaelisb, 2010; Schneider, Hlope, & van Rensburg, 2008). Other recent research has alluded to the fact that community-based mental health can be addressed through community development (Christens, 2012) and an emphasis on human care (Jordans & Tola, 2013). Community-based health care was slow to get off the *Corresponding author. "
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