WHO supports the Ministry of Health at central and district level in collaboration with key mental health stakeholders to provide mental health and psychosocial support services to the victims of the earthquake.

After the devastating earthquake on April 25, 2015, mental health needs in Nepal increased considerably. The alarming rate of suicidal ideas in 10 percent of earthquake-affected populations revealed through a rapid survey indicated the high mental health burden. As there is no mental health desk at the Government of Nepal’s Ministry of Health (MoH), the UN World Health Organization (WHO), as co-lead of the Health Cluster, is supporting the MoH to fill this gap. Immediately after the 2015 earthquake, there was an urgent need to coordinate among partners implementing mental health response activities to ensure adherence to WHO and Inter Agency Standing Committee (IASC) guidelines.

Delivering psychosocial services in coordination with the Protection Cluster was equally critical. Due to delays in reconstruction, people continue to live under difficult conditions exposing them to higher risk of mental health consequences. Mental health, one of the health issues ignored during disaster response and recovery, has drawn increased and unprecedented attention of planners and policymakers after the earthquake. It is important to utilize this momentum to ensure a responsive health system capable of ensuring essential mental health services during the aftermath of disasters, as well as normal.

PROJECT OVERVIEW

The MHPSS project objectives include support for:

1. The Government/Health Cluster in coordination of partners work on MHPSS;

2. Implementation of mental health response according to WHO and IASC Guidelines; and

3. Planning and implementation of mental health early recovery after the disaster.
 

PROJECT ACTIVITIES

The activities of the project during post-earthquake response were focused on coordination of the interventions based on WHO and IASC guidelines.

• Mental Health Sub-Cluster was activated to coordinate activities of partners during the response

• Mental Health Sub-Cluster meetings were held every week initially then every other week and every month subsequently

• Recording and mapping of activities carried out by the partners

• Training primary care doctors to provide basic mental health care based on mental health Gap Action Program Humanitarian Intervention Guide (mhGAP HIG) - a WHO training module to enable non specialists to provide basic mental health services during humanitarian situation

• Eye Movement Desensitization and Reprocessing (EMDR) - a form of psychotherapy for Post-Traumatic Stress Disorder and other psychological consequences after trauma - training to strengthen the skills of psychiatrists and psychologists to deal with psychological consequences of the disaster

After the response phase, the project activities focused on supporting MOH in planning and implementing early recovery of mental health services such as:

• MHPSS Stakeholders Analysis to develop a roster of the active organizations/individuals so that they can be utilized in delivering mental health service during humanitarian situation (ongoing).

• Review of the completed and existing community mental health programs in Nepal in order to derive lessons learned and distill recommendations for enhanced community mental health services (ongoing).

• Mental health management training to District Public Health Officers (ongoing).

• Preparatory workshop to introduce mhGAP during Bachelor of Medicine  training (planned for March 2017)

• Developing a system for identification of mental health disability among children (ongoing)

• Develop and pilot a system to improve (attempted) suicide data records (planned from March to June 2017 )

• EMDR-Part 2: training for psychiatrists and psychologists (planned for March/April 2017)

• Technical support to MoH on:

  • Revision of the National Mental Health Policy and Legislation

  • Revision of mental health chapter of the standard treatment protocol

  • Update the essential psychotropic medication list

  • Planning for the National Mental Health Survey

PLANNED RESULTS

• A referral list of the hospitals and organizations serving people having MH problems

• Developed a screening tool for community case detection with the partners

• Trained 114 doctors working in earthquake-affected districts on (mhGAP HIG)

• Trained 35 Psychiatrists and Psychologists on EMDR

• Provided 38 health workers in earthquake-affected districts with basic traumatology training

• Facilitated investigation and response to 4 different mass conversion outbreaks

• Developed a manual on mass conversion disorder to help health workers and teachers identify and respond to the situation

• Developed a curriculum on mental health program management for public health officers

• Revised mental health chapter of the standard treatment protocol

• Updated the essential psychotropic medication list

• Revising National Mental health Policy and Legislation