Addressing Psychological Effects of Armed Conflicts and Violence

General observation
Swedish Red Cross has conducted a variety of activities implementing the pledge, not least with regard to continued mobilization within the Movement and awareness raising. Swedish Red Cross has been a leading organization in this work together with the Danish Red Cross, ICRC and the ICRC. The subject is now included in the agenda of the 2017 Council of Delegates of the RCRC Movement and a resolution is being prepared. More than 15 National Societeis are now actively involved to support this initiative within the Movement.

Below we have described some of the Swedish Red Cross’ activities.

Research projects in mental health
In collaboration between the Swedish Red Cross University College (SRCUC) and the Swedish Red Cross (SRC), several research projects linked to mental health, torture and trauma are ongoing. In 2016, the articles Prevalence of torture and other war-related traumatic events in forced migrants – a systematic review and Refugee trauma measurement – a review of existing checklists were published, as well as the research report Newly resettled refugees and asylum seekers in Sweden” (see attached documents). Results from the last study show that mental ill health is common among newly resettled refugees from Syria and asylum-seekers from Syria, Eritrea and Somalia. Mental ill health is more prevalent among asylum-seekers, individuals with poor social support, post migratory stress and victims of torture. More than 30% of persons participating in the study mention that they have been exposed to torture. These results suggest a need for interventions that can lessen the burden of mental ill health, and promote mental well-being in these vul­nerable groups. Mental ill health constitutes an important barrier in the establishment process in a new country. Interventions aimed at pro­moting mental health can, apart from alleviat­ing the suffering for the individual, also have positive socio-economic consequences. In 2018, the SRCUC will expand the study and give priority to additional research on asylum seekers. The aim is to reach out to some 500 asylum seekers with broadly the same questionnaire that was distributed to asylum seekers and newly arrived last year. In addition, follow up studies will be done with those participants that were reached in 2016.

Research on mental health, torture and trauma has so far led to a number of positive outcomes. Together, the SRCUC and the SRC has been able to increase knowledge in this field, something that has been raised through a more sharp advocacy work towards concerned authorities, highlighting needs for specialized treatment but also needs for better integration structures and psychosocial support. The SRC has received increased funding from concerned authorities and research has been one way to raise needs. In addition, research is used internally to improve our own work with treatment and rehabilitation for traumatized refugees.

WS Mental health and Psychosocial effects of Armed Conflict and Violence
In December 2017 SRC hosted a International WS “Mental health and Psychosocial effects of Armed Conflict and Violence” with partners within the Red Cross and Red Crescent Movement. Apart from the Red Cross and Red Crescent representatives, also representatives from Ahfad University for Women and the Arab Resource Collective (ARC) participated (see attached file WS report) Participants presented and discussed the situation and responses globally, regionally and in the different countries. Every presentation bared witness of the critical needs related to mental health and psychosocial wellbeing due to contexts affected by armed conflicts and violence – in addition to basic needs for structural and organizational commitments related to mental health in every community and country. Armed conflicts and violence, as well as other types of emergencies, mean increased stress for individuals, groups and communities. It furthermore weakens ordinary structures providing basic services and health care. At times, ordinary structures have been challenged for decades.

Four areas currently in need for further development were identified during the workshop. Apart from the difficulties to match the great needs for MHPSS, the importance of integrating MHPSS in all programs to make sure international minimum standards are reached. Furthermore, the need to care and to provide PSS for volunteers and staff needs to become a part of operations. Tools for monitoring, evaluation and learning need to be developed and implemented systematically to facilitate improvements and quality assurance. Finally, there is a need for policy development in support of MHPSS in armed conflicts and violence.

https://drive.google.com/drive/folders/0B9coPPfJrdzAdW41aXNNR25JZVU

Together with affected persons and communities, support and further develop activities and methods to address the psychological effects;

Domestic activities
During 2016 SRC has increased HR resources within MHPSS national programs resulting in more activities carried out i.e. new PSS program targeting newly arrived migrants aiming at improving PSS wellbeing New working methods have been tested together with participants i.e. developing support groups activities in regional initiative “Hej Värmland” Partnerships with Save the Children and Church of Sweden have been established resulting in joint effort to support local capacity building with new PSS training curriculum. New, Innovative way of communicate with target group through media network “Al kompis” have been tested with good result. (see attached file “SRC Kite project”). A preliminary study “PS support to RC volunteers” was conducted in 2015. The result indicates high perceived meaningfulness of voluntary assignment in SRC. Volunteers feel they make a difference and reported strong cohesion in many volunteer groups. Furthermore the report also highlighted signs of burnout, stress and compassion fatigue especially in programs working with vulnerable groups such as migrants. A need to improve the PS support for all SRC volunteers has been identified.

Our SRC Treatment Centers for persons affected by war and torture have further developed MHPSS program for patients and their families. Examples of this is: expanded psychosocial support activities for children; the development of specialized treatment for children and youth; the development of a mobile treatment team providing treatment to asylum seekers in site in asylum reception centers (i.e. not in our permanent structures), and; the development of more psychoeducational and other group activities where we reach more persons in need that are waiting for treatment. In addition, efforts have been made to increase training on mental health, trauma, torture, and the right to healthcare, for instance through the development of online training films that have been used extensively for staff working in the primary healthcare system (films developed together with Sveriges Kommuner och Landsting)

International activities
During the past years SRC have increased our MHPSS work together with our PNS:s and today we have developed MHPS components in eight countries including contextualized tools and trainings in three different languages (Arabic, French and English) ( See attached file “Report ToT in PFA- Sudan”, ” LRC Program overview”) Furthermore, PSS has been identified as one of the main needs of volunteers in the conflict and emergencies, as the ViCE study has already illustrated ( see attached file “Vice Study”)

In order to prepare a more effective and efficient response to MHPSS needs, and to contribute to the overall development of this thematic and operational area within SRC, SRC established an MHPSS Working Group (WG) to ensure coordination and cooperation between international and national department. The MHPS WG have quarterly meeting.