HealthNet TPO’s psychosocial programmes focus on community awareness, training of community workers, health facility staff and psychosocial assistants to either provide counselling or make sure clients are seen by qualified health staff. The psychosocial and community awareness programmes also develop capacity of local community members to self organize and cooperate with civil society organisations to prevent not only mental problems, but also address other social problems that may cause longer term harm.
Evolution within HealthNet TPO programmes
Our psychosocial programmes do not focus on the treatment of individuals alone (e.g. of torture victims), as various evaluation and monitoring studies by HealthNet TPO have shown this approach does not improve the overall health status of a population. As a result of these studies, HealthNet TPO recommends that a big part of psychosocial support programmes need to focus on awareness building to help prevent mental illnesses. Moreover, we do not only develop capacities of health facilities and among health and education workforce (doctors, nurses, teachers), but more actively involve communities, local organisations and networks. Other important assets in psychosocial programmes are: working with families on family violence, mediating in reuniting children (ex-child soldiers or street children) with their families and addressing family violence as an expression of violence in the wider community with local womens’ organisations. For people with more severe complaints referral mechanisms need to be set up.
Our experience has led to various recommendations influencing our current interventions:
HealthNet TPO has developed a specific aid programme to help traumatized children in areas disrupted by war and disasters (see the Child Thematic Programme). Local health workers are being trained in an intensive programme to recognize and treat children with psychosocial problems (Classroom Based Intervention). This child programme has been implemented in five project countries: Burundi, Sudan, Nepal and through local partner organizations in Sri Lanka (Shantiham) and Indonesia (Church World Services). Within three years, the child programme should reach 130.000 children. See the Care Package for more detailed information on these interventions.
New trends in our psychosocial support programmes
At present the approach, as described above, is under further development to include a family intervention modality, especially aimed at vulnerable families and at testing a research-informed procedure for intervention in low-resource settings. This work will then link with family interventions in Afghanistan and in DR Congo at a later stage.
Psychosocial programmes are often dependant on relief and rehabilitation funding; unfortunately sometimes without a perspective on longer term integration in the existing (primary) health systems. HealthNet TPO addresses this issue gradually by working on health financing, and integrating psychosocial activities within this approach.
Psychosocial support is also given to (ex)asylum seekers in the Netherlands within the Methodology Development for Special Refugee Reception programme and the pilot project for Sustainable Return Asylum Seekers. Sharing our elaborated knowledge on this subject is done by organizing various courses like the Practice Oriented Course for Mental Health & Psychosocial Support in (post)Conflict Areas.
Psychosocial interventions are part of an overall approach to reach people in need and offering much needed psychosocial support to people in post-conflict settings. Outreach, health education, referral and selected community interventions are thus part of the integrated health care delivery system approach.