Brief Notes on Mental Health & Psychosocial Support after 2011 Batticaloa Floods

Dr. T. Gadambanathan & Ananda Galappatti

The following is a brief response to queries we have received about what considerations should be made during the recovery phase of the flood disaster with regards the possible mental health and psychosocial impacts on affected people.  As individuals and families return to their communities and homes from temporary camps, the relief effort is due to transition towards meeting the needs of restoring shelters, resuscitating livelihoods and repairing infrastructure.  In terms of Mental Health and Psychosocial Support (MHPSS) needs, we note the important differences between the recent flood disaster and either the 2004 Tsunami or prolonged armed conflict in Sri Lanka.  The experience of the recent floods has not produced the same severity nor complexity of impacts on either psychological (ie. primary trauma) or social dimensions of the affected people’s lives.  Therefore, we suggest an approach to assisting recovery that is primarily built on a) integration MHPSS considerations into mainstream relief and recovery programmes, and b) linking with existing MHPSS services in the district wherever targeted or more specialised services are required.

Some Guiding Principles for Integration of MHPSS Considerations into Flood Recovery

The way that support is provided to meet the material and practical needs of individuals, families and communities affected by the floods can have positive or negative implications for their levels of distress and difficulty – both at individual and group levels.  Recent eruptions of anger and commotion around relief distribution illustrate dramatically some of these impacts.   Sensitive approaches can go a long way to addressing material needs that are causing worry to affected people, as well as avoid creating new problems.

  1. Ensure clarity of information about relief, possible compensation, available services and recovery processes.  Ensure predictability, reliability and transparency in relation to these.
  2. Do No Harm – prevent relief and other forms of assistance from causing conflict, competition or disruption within affected communities; avoid creating unrealistic expectations; prevent creating long term dependencies.
  3. Involve affected communities in prioritisation, planning and implementation of recovery programmes.  Ensure that relief provision is based on up-to-date needs assessment, and responds to community or family priorities.  Actively coordinate with others providing assistance to the same community.  Reinforce the sense of control and competence of people in the community and within families, rather than helplessness.
  4. Support the resumption of normal community structures and activities (ie. schools, religious practices, village committees, etc), and minimal disruption of these by external programmes.

Whilst most people will not require specialised or targeted MHPSS interventions, there may be a few whose pre-existing vulnerabilities may have been worsened by what has happened to them during and after the flood.  Being sensitive to the existence of people who may be in need of special assistance, and connecting them to existing services is a valuable action that can be taken by non-MHPSS service providers and volunteers.

  1. Pay attention to pre-flood vulnerabilities (serious mental illness, disability, extreme poverty, complex family or social problems) that may prevent some individuals and families from making an independent recovery from losses due to the floods.  Identify support needs and create sustainable responses to these problems, many of which may persist in the medium to long term.
  2. Identify local resources for mental health and psychosocial support (possibly at a Divisional Secretariat / MOH or lower level) to whom difficult cases or issues may be referred, or from whom assistance may be sought for responding to vulnerable individuals or groups. In remote areas where these services do not yet exist, the opportunity should be used to extend available services to meet MHPSS needs for the medium and long-term.
  3. Specialised or targeted MHPSS interventions should be based on systematic needs assessments, and should seek to integrate with the existing systems for care.

Useful Contacts / Sources:

  • Mental Health Unit, Batticaloa Teaching Hospital (Hotline: 065-2225656)
  • Mental Health Unit, Valaichenai Base Hospital (Hotline: 065-3657613)
  • Office of Regional Director for Health Services, Batticaloa (065-2224465)
  • IASC Guidelines on MHPSS in Emergencies (see especially practical guidance on cross sectoral considerations to support wellbeing)
  • www.psychosocialnetwork.net (an online global network with resources and practitioners in the field of MHPSS)

Dr. Gambanathan is the District Psychiatrist, Batticaloa. Ananda Galappatti is a medical anthropologist and a practitioner in the field of mental health and psychosocial support (MHPSS) in situations of conflict, disaster and other adverse social conditions.