Mental Health and Psychosocial Support Programme

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Mental Health and Psychosocial Support
Programme

• WHO
• Lebanon

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Size of the problemProjected prevalence rates

• baseline data from World Mental Health Survey
  2000 (published in Lancet 2006 by Karam et al)
• Projected data after disaster interpretation of
  world literature
• Observed rates will vary with
• Case definition and assessment method
• Community and sociocultural context
• extent of previous and current disaster exposure
  of different communities
• local ways of coping and supporting
• willingness to endorse questions in surveys

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Summary Table of WHO Projections
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• Concerns in the post War scenario
• Current security or/and political situation
• Displacement (even if it was short. We have to
  mention that as soon as the ceasefire took place
  people started returning to their villages
  although there were still security concerns)
• Unemployment
• Lack of justice and of state control, lack of
  basic services, and the instability of the
  situation.

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Activities To Date

• National Plan
• Capacity Building
• School Mental health programme
• Public education and awareness raising

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Guiding Principles of the Plan (Adapted from
IASC guidelines)

• Human Rights (respecting right of protection and
  care, non-discriminatory care, access to all
  groups)
• Participation and Inclusiveness (community and
  stake holders involvement in planning
  implementation)
• Promoting Resiliency (most people with signs of
  distress will recover but with appropriate
  support)
• Normalization of daily life (reestablish family
  community connections, provide opportunities to
  resume activities of daily living)
• Community-based (strengthen the ability of the
  community institutions, leaders and members to
  support and help one another)
• Capacity building (training and support to
  community members, religious structures,
  educational, health and social services)
• Do No Harm (identify minimize risks and
  unintended negative impacts of the program)
• Intersectoral Collaboration (collaborate with all
  stakeholders in all sectors)
• Foster Public Mental Health Education And
  Awareness.
• Development Of Mental Health Services In A
  Sustainable And Integrated manner.

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Aims And Objectives of the Plan

• AIM
• Promoting the mental and psychosocial well being
  of the children, women, and men of Lebanon with
  the aim to improve their quality of life.

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Short Term Objectives

• Develop the capacity of Primary Health Care
  professionals to identify, manage and refer
  common psychological and mental health problems.
• Provide psychological first aid focusing on
  people in distress, which may be especially
  likely among vulnerable groups like women ,
  children, elderly and disabled.
• Identify individuals with serious mental illness
  and ensure provision of appropriate mental health
  services including essential psychotropic
  medication and basic psychosocial support.
• Promote positive mental health and psychosocial
  well being through Public education and awareness
  raising of the communities through involvement of
  the communal institutions.

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Proposed Long Term Objectives

• Proposed Long Term Objectives (These attainment
  of these objectives need the development of a
  separate plan and programme under the umbrella of
  a national mental health policy)
• Develop a comprehensive national plan and
  program for mental and psychological health in
  the context of an overarching policy focusing
  on
• Capacity building through training of all cadres
  of health care professionals
• Integrate the services into the general health
  system in the country .
• Coordinate and Collaborate with existing mental
  health centers to develop Mental Health Services
  accessible for the mentally ill in the country.

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• Promote mental health and prevent mental ill
  health with collaborative action across sectors
  like Education, NGOs, social and religious
  groups and community stakeholders.
• Promote indigenous research and build in
  evaluation component to ensure evidence based
  planning and implementation of the mental health
  programmes.
• Develop and organize specialized mental health
  services including rehabilitation services for
  the mentally ill.
• Develop Mental Health Legislation.

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Rationale for Mental health Integration In PHC

• The unique positioning of the primary health care
  network
• To support primary care services who are already
  overwhelmed with high levels of consultation by
  people with common mental disorders, usually
  presenting as somatic complaints.
• To obtain care for people with mental disorder
  who have no access to specialist care (in some
  areas of the country there may not be a
  specialist doctor or nurse easily accessible )
• To ensure that the physical health care needs of
  people with mental illness are not neglected (
  Physical and mental illness frequently coexist.
  People with severe mental illness have relatively
  high standardised mortality ratios from cardiac
  disease, respiratory disease, malignancy and, in
  low income countries, infectious disease.

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• To address accompanying social needs Many
  psychiatric disorders are connected with family
  problems and social difficulties and are only
  understandable when viewed against this
  background. Primary care teams with their
  continuing contact with the local population are
  well placed to have such detailed knowledge
• To provide continuity of care Primary care teams
  are well placed to provide long term follow up
  and support without frequent changes of personnel
• To take account of the patients perspective Many
  patients with mental disorders do not consider
  themselves in need of psychiatric care and there
  is less stigma if the patient is seen in primary
  care

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Building up the Capacity of PHC personnel
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School Mental Health Programme

• In the immediate term( 2006)
• Training school teachers in all public and
  private schools on the identification, dealing
  with, and referring psychological /behavioural
  problems and mental health disorders seen in
  schools. (material ready)
• A system of linking the schools with the health
  systems for referral also needs to be established
  to respond to the emerging needs identified.
• Public education about mental health coping
  mechanisms after the crisis.
• In the short term (year 2006-2007)
• Evaluation of the effectiveness of different
  mental health interventions in schools, with
  pilot testing in selected schools, aiming at
  identifying the best approach to integrate mental
  health into the context of the Lebanese education
  system.
• In the long term (starting 2007-2008),
• Efficient integration of the mental health
  component into the school health program,
  including a curriculum for schools, a curriculum
  for teachers, and setting up referral mechanisms.

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Public Education And Awareness Raising Plan

• In the immediate term( 2006)
• Preparation and printing of Brochures and
  posters--- ready by 20th October.
• In the short term (year 2006-2007)
• Distribution to all the Media, Health , Community
  organizations and Educational outlets including
  Pharmacies
• In the long term (starting 2007-2008),
• Efficient integration of the mental health
  component into the National Health education
  strategy for NCDs

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Tyre Mental Health and psychosocial Support
coordination

• Who is doing what and where.
• Coordination and collaboration among partners.
• Saturday 21.10.2006, 11.00 am