Promoting Mental Health and Resilience after a Disaster

Until recently, mental health programs during and after disasters were considered to be controversial. A disaster exposes many people to extreme stresses and injury and illness. Especially in resource-poor countries, a disaster also brings a range of problems that erode protections, increase social injustice and inequality and entail human rights violations. There is a growing international consensus on the need for a range of mental health and social interventions integrated with existing systems. The mental health and psychosocial response programs increasingly integrated into humanitarian assistance programs can be seen as an opportunity to model the introduction of mental health centrally and explicitly in the public heath framework of a country. Mental health is a state of wellbeing in which a person can use their own abilities and cope with the normal stresses of life. It is promoted by effective public health and social interventions. Mental health and physical health and behavior are closely interconnected. These connections are important after a disaster. Resilience refers to a person’s relative resistance to, or the overcoming of, stress or adversity. Mental health and resilience depend on interactions between personal and wider social factors, such as safety and access to education and work. Effective interventions to promote mental health and resilience after a disaster focus on self-efficacy and community participation. Interventions occur at several levels, and alongside help provided to those with mental illnesses. They include social policies such as rebuilding housing and opening schools. They also include activities closer to the person, such as livelihood support to women and girls. A challenge now is to evaluate and refine programs and good practice after a disaster: monitoring the effects on mental health of activities in nonhealth sectors; and monitoring the effects on broader health and function of activities designed primarily to promote mental health.