Mental Health, Psychosocial Support for Women in the Wake of Crisis

Photo By: UNAMID, Albert Gonzalez Farran (CC)

Natural disasters, armed conflict, and other humanitarian catastrophes affect millions of people around the world. They can result in emergency situations marked by extensive mortality and morbidity rates, mass displacement of people, malnutrition, disease, and the destruction of political, economic, and health care infrastructures. In 2015 alone, about 150 major natural disasters affected millions of people worldwide. These humanitarian crises can have a lasting impact mental health, which is crucial to the overall well-being, functioning, and resilience of individuals, societies, and countries seeking renewal after crises.

For example, for the past two decades, the Democratic Republic of Congo (DRC) has been embroiled in violent conflicts. Those conflicts coupled with ongoing political instability have caused the deaths of somewhere between 3.5 million and 5.4 million people and have prompted the mass displacement of people into neighboring Rwanda and Uganda. Armed conflict in the DRC has displaced over 3 million Congolese as pseudo-governing bodies fight to gain control of eastern DRC. The proliferation of armed groups and targeted violence against women and girls tears at the fabric of the community while fracturing families and diminishing lives. Nearly 40% of women in eastern DRC have experienced sexual violence and the risk of victimization persists during flight and in camps where women and girls seek protection.

Up to 80% of internally displaced people and refugees are women and children. Women and children are more vulnerable to direct physical harm, exploitation, and sexual violence during acute emergencies and therefore require special consideration during humanitarian crises. Women and children are often disproportionately represented in refugee and internally displaced communities due to their disparate social and legal status in many jurisdictions, lack of access to capital, and other legal means to protect themselves when crises emerge. 

In communities where there are underlying social and economic inequalities based on gender, sexual violence is also more likely to occur.  During times of crisis, like the situation in the DRC, there is an exacerbated strain on mental health of the affected population. According to UNICEF, sexual violence can have numerous social and psychological consequences that not only affect survivors, but also their children, families, and the larger community. Survivors of sexual violence are often ostracized and face discrimination. Psychological consequences range from trauma and withdrawal, to self-blame, and feelings of isolation. A range of mental disorders, including depression, PTSD, suicidal ideation and other forms of self-harm are also common among survivors. Guilt, anger, anxiety and other similar emotions can influence future health-related decisions as well.  

Addressing these inequalities not only helps prevent sexual violence and its negative consequences, it also improves the well-being of the community as a whole.

Bridging the Gap

Women bear the brunt of the acute care responsibilities in societies where humanitarian crises commonly occur and they play a critical role in helping to mend the wounds in societies torn apart by war, famine, or natural disaster. Humanitarian crises can provide unique opportunities to build better mental health systems for those in need and nongovernmental organizations (NGOs) lead the way in providing these services during acute emergencies. The International Rescue Committee (IRC) is one organization that is helping to bridge the service gap for survivors of physical, sexual, and psychological trauma during emergencies.

The IRC’s Women’s Protection & Empowerment (WPE) program has been working with partners to respond to emergencies in areas of displacement or conflict, including internally displaced person (IDP) camps in DRC by providing case management and emotional support as well as free emergency post-rape counseling and care within 72 hours of disclosure. IRC staff train and support local providers to deliver essential medical and psychosocial services, including cognitive behavioral therapy for survivors of sexual violence.  The WPE program also provides a platform for Village Savings and Loans Associations (VSLAs), formed by women using IRC’s EA$E4 approach that allows opportunities for women to access credit, save money, and learn new business and vocational skills, while providing a way for engaging couples on equitable gender dynamics within the household.

There are considerable challenges associated with providing mental health services during emergencies, but with challenge also comes unique opportunities. With a strong emphasis on evidence-based programming, IRC is taking the lead in responding to, and preventing, violence against women and girls during humanitarian crises. NGOs play a critical role in building local capacity, training staff, and forging community ownership. Replicable and sustainable models of psychosocial rehabilitation based on well-founded scientific evidence are needed to address the complex challenges women and girls face during complex humanitarian emergencies.