This blog has been written by Dr Jessica Hawkins and Dr Rubina Jasani relating to the postgraduate module, ‘Mental Health and Psychosocial Support in Humanitarian Crises’  available on the MA Humanitarianism and Conflict Response and MSc International Disaster Management programmes.

This academic year, we decided to embark on an ambitious endeavour to introduce a new postgraduate module titled Mental Health and Psychosocial Support in Humanitarian Crises. Ambitious, because it is an under-researched area in humanitarian studies, but also because studying mental health in a non-psychology setting presents a host of challenges for lecturer and student alike. It is not a hidden fact that mental health at Universities is reaching crisis point for staff and students alike. According to YouGov, one in four students experience symptoms of depression and anxiety whilst at University. When you combine this with students who, on a day-to-day basis read, research and write about some of the worst crises affecting humanity, past and present, one would almost think that tackling the topic of mental health in humanitarianism would be a step too far. Our other modules cover some of the most horrific instances of violence and conflict; some engage with the persistent global inequalities which mean our fellow human beings suffer unnecessarily when disasters strike and some modules consider the responses to these crises and analyse the pathways for peace, in adversity. You wouldn’t exactly describe us as the “happiest” of academic departments. In addition, some of our PGTs have worked in the aid industry. An industry, which according to recent research by Fiona Dunkley (2018:3) is ‘inherently stressful’ and exhibits a workforce with poor mental health provision, surrounded by a veil of stigma. Introducing a module on mental health in humanitarian crises was therefore extremely “ambitious” from our perspective; but absolutely necessary as we try to confront the silence of mental health in all aspects of life, but in particular in an industry which lacks funding for psychosocial support, whether for staff, volunteers or recipients of aid. The structure of the class had a focus on PTSD with guest lecturers from a variety of industries, including NHS psychologists working with refugees and asylum seekers, academic psychologists, aid workers dealing with mental health first aid in the Middle East, a theatre performance by an asylum-seeker and refugee women’s group based at the Octagon Theatre, Bolton and lectures from Rubina and Jessica on the history of PTSD, the politics of trauma, tensions between the global and local and the mental health of aid workers. This blog continues by responding to some of the comments we received from our students at the end of this pilot year for the module.

Repeating the definitions of PTSD

One of the comments we received from students is that in every class, they received a definition of PTSD. Some said this was repetitive. We argue that this is ultimately crucial. A common issue with humanitarian response for psychosocial support is the Westernisation of diagnosis and treatment. Mental health is perceived and understood very differently in different societies, however, as many students wrote in their final essays, the western norms have permeated humanitarian responses and in some instances create more issues than they help to solve. Therefore, it is essential that students receive the definitions from the different guest lecturers so that they can engage critically with these definitions and understand the challenges to intervention when these definitions are operationalized.

Although most of our students will not be providers of mental health first aid or psychosocial support in the “field” when they move on to humanitarian jobs, it is important that they recognise the complexities around the diagnosis and think critically about what models of intervention might work best.

Studying trauma in humanitarian crises is depressing

Figure 1 – First Aid Responder providing humanitarian aid. Talia Frenkel, American Red Cross

Here, we have to face facts. Working in the aid industry has a certain element of do-gooder altruistic intention (figure 1); however, this shine wears off very quickly. The day-to-day reality is that long hours, working away from home, deprived of social networks and facing humanitarian crises on a number of levels with very little reward is hard work, even for those of us based in the UK. The feel good factor of helping others does not last long. For us, studying mental health in these situations is essential because we can learn to cope better. As humanitarians, we need to learn to respond to our own mental health needs so that we can seek treatment (in whatever form that may be – exercise, medical treatment etc.) in a more timely manner. Further, if we as humanitarians have better mental health, we can be better responders and become more sensitive to those around us, whether colleagues or recipients of aid.

We’re not psychologists, shouldn’t we leave mental health to them?

This is a good point. But a psychological approach is limiting and is based on a Eurocentric reading of trauma and hence has limitations. Throughout the course, Rubina and Jessica emphasised that they were approaching the content of this module from an interdisciplinary perspective. Although some of our guest lecturers were trained psychologists or psychiatrists, they engaged with the subject critically through their own practice. Just as we do not train students how to be trauma surgeons or transport logisticians we were clear to point out that we were not training students to perform mental health first aid or psychosocial support. Instead, we wanted students to understand that this is a major humanitarian issue and even when you know trauma exists, there are no quick fix solutions especially in contexts of acute structural inequalities and complex colonial histories. While we recognise that campaigning for more funding to support mental health provision in crises and for organisations to support the mental health needs of their workers and volunteers is important, we also want our students to understand that what comes after disasters is also linked to larger political histories and structural factors and hence how does one then deal with these things just through Psychology. For one of their assessments, we tasked students to design a mental health strategy presentation to be presented to their choice of organisation, aimed at their choice of recipient. The resulting podcast videos were the highest quality assessments we had ever seen at postgraduate level. Some could have been sent out straight away to the corresponding organisation; they were that good. As a result, we are convinced that through this course, we have provided students with the skills to critically assess mental health support in humanitarian crises and make suggestions on how this could be improved.

Final thoughts?

Without doubt, running this module and taking it as a student has been challenging. It was challenging for both of us too. Together we have learnt so much about our own wellbeing and how to make ourselves more resilient to the horrors of humanitarian crises. Yet, it has also been an accomplishment for Rubina and Jessica to know that within this year’s cohort of postgraduate students we have brought mental health on to the agenda, something which we hope they will take forward in whatever capacity they continue their careers in humanitarianism.

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