Toward integrated emergency health services: Alternative strategies for the future

Background/Purpose: Complex humanitarian emergencies (conflicts and/or natural disasters) do not recognize borders. The connection between conflict and trauma on psychosocial development and wellbeing has long been established as emergencies expose and exacerbate existing individual and societal vulnerabilities. Methods: An extensive literature search, including non-governmental organizations' “grey” literature, was performed. Articles were analyzed for key contributions, available programs, and mental health measurement indicators. Results/Outcomes: Analysis reveals that emergency mental health services are not integrated into the relief response (ad hoc) and/or are insufficient. Provision of early mental health interventions reduces the burden on a country's health facilities and the overall relief response. In order to achieve integrated physical and mental health services (a key WHO goal) alternative strategies are proposed. Conclusions: Setting up a referral network among relief organizations stimulates collaboration and sharing of best practices. The recent publication of the Inter-Agency Standing Committee (IASC) Guidelines offers concrete strategies for ensuring that emergency care is effective, inclusive, and culturally appropriate. Training relief workers in the use of psychological first aid and mental health needs assessments provides opportunities to raise awareness about these guidelines. The training sessions reinforces cooperation established by the referral network. With greater appreciation of the necessity to integrate emergency mental health services, relief workers become advocates for change within their own organizations, and together, within the political arena. With concrete guidelines to assist in articulating specific funding priorities and measurement indicators to ensure accountability and credibility, advocating for change will be more meaningful and persuasive.