Hitendra Solanki, Mindfulness & Wellbeing Adviser for ACF-UK & The Start Network on the importance of being aware of mental health issues in humanitarian response.
So here is something to be mindful of for a moment.
World Mental Health Day 2015 took place on 10th October.
So I was just wondering. Were you personally aware it? Or did your organisation, perhaps, mark this global day and highlight mental health issues openly in the workplace?
Kudos to your organisation if it did! And if indeed it did, other than a nod to mark the day itself, perhaps via a perfunctory email, has it actually translated into anything pragmatic?
My guess is, that for many of us, we were unaware of this particular day.
However, if you were asked if you are aware of World Humanitarian Day, which took place on the 19th August this year, another guess is that you and your organisation, are probably a little more aware of this one.
However, both are inextricably linked nonetheless. The issue of mental health in relation to the work of humanitarian workers is a serious concern that affects all of us in the sector.
Workload and Stress
World Humanitarian Day, as described by the United Nations, has been designated, ‘to recognize those who face danger and adversity in order to help others’, and as an, ‘opportunity to celebrate the spirit that inspires humanitarian work around the globe’.
Sadly, for many of us, whilst we may celebrate this inspiring spirit that drives us, the effects of facing ‘danger and adversity in order to help others’, is taking its toll on the mental health and wellbeing of our personnel.
Whilst these may seemingly be contextual stressors, such as conflict, seeing people suffer, experiencing traumatic events etc, the worrying issue it seems is related not simply to such extreme stressors, but to the relentless everyday overwhelming nature of the work we do, and the mountainous workloads and lack of resources inherent in our organisations.
Whether we are in the field or a million miles away in London working at our desks in safety, it seems that workload is becoming a major cause of stress, anxiety, depression and burnout within our sector.
Research is beginning to reveal an alarming and chronic emergency that has crept up on us. For example, a survey amongst 180 aid workers across 60 countries by Larissa Fast & Dawn Wiest conducted in 2007, found that, ‘work stress was the most commonly cited experience across respondents’, with 57.8% indicating they had experienced it. This has also been echoed by UNHCR’s Mental Health & Psychosocial Report for Staff, published in 2013, which indicated that workload is the top stressor for their staff. Another often cited report, is the joint study by the Antares Foundation and the Center for Disease Control & Prevention (CDC) in 2012, exploring the emotional status of 1,032 national workers across Uganda, Jordan and Sri Lanka. This report revealed that, ‘between half and two thirds of the staff in all three countries showed clinically significant levels of depression, and about half in all three countries showed clinically significant signs of anxiety. Between one-fifth and one-quarter of the staff showed prominent signs of PTSD (post-traumatic stress disorder)’.
Let’s reflect on these figures. Almost two thirds of staff are affected by significant levels of stress, which is leading to increasingly serious levels of mental health deterioration. How can this be good for our wellbeing and of those we seek to help?
So we come back to the message behind World Mental Health Day once more. How does it relate to us in the Humanitarian Sector? And what are we doing to ensure the wellbeing and mental health of our own personnel?
Clearly, our sector needs to strengthen the support for our personnel to mitigate the negative impact of stress on mental health and wellbeing. Whilst we are enamoured with the idea of resilience in our interventions and dialogues with donors, it seems that our resilience as personnel is not prioritised as well as it could be.
Resilience needs to be supported and built on a model that invests in preparedness. A firefighter is provided with protective clothing, appropriate equipment, and training. In the same way, aid workers should be prepared and skilled to tackle the inevitable workloads and emotional ‘fire’ that accompanies our work in dealing with human suffering and the stresses such work exposes us to.
From the many aid workers I have spoken with, we seem great at treating our ‘burns’ as it were, yet there is very little support provided to improve the self-management of stress and prevent being ‘burned’ in the first place. Therefore a shift of emphasis to a preventative model is needed to ensure genuine resilience.
In this respect, the current three year mindfulness and wellbeing pilot, as part of the Start Network’s Transforming Surge Capacity project, is taking a robust approach to increasing resilience to stress and supporting self-awareness.
Mindfulness meditation is at the heart of the pilot, utilising an approach known as mindfulness-based stress reduction (MBSR). Developed by Jon Kabat-Zinn, a Professor of Medicine at the University of Massachusetts Medical School in the late 70s, MBSR, with practice, allows us to become clearly aware of what goes on in our own mind and body, in particular being aware of our thoughts, feelings and bodily sensations without self-criticism. This allows us to accept our experiences as they are, rather than how we want them to be, which may even include painful emotions.
In essence, over time, mindfulness practice allows us to respond skillfully to such emotions and thoughts, rather than simply reacting to them automatically via habits and conditioned responses. Following 35 years of research, it has been demonstrated that mindfulness-based stress reduction can positively and effectively increase wellbeing, whilst significantly reducing psychological distress. More importantly, the studies revealed that people become more resilient, happier, as well as productive.
The use of mindfulness has been effectively proven, is scientifically robust, and has shown itself to be effective in supporting wellbeing and mental health in many other sectors over the last three decades. Indeed, just this week, the all-parliamentary group on mindfulness met to discuss how mindfulness could be further integrated within society given its well documented benefits.
The Start Network’s Mindfulness & Wellbeing pilot has already started to make the journey to explore and build a scientifically credible evidence base in how it can practically support and build resilience for personnel within our sector. In August and September 2015, four six-day training sessions were held in the Philippines, which included staff from Start Network agencies in Tacloban who had personally experienced loss and trauma following the devastation caused by Typhoon Yolanda. The feedback and evaluations from these have been extremely positive and promising.
Additionally, the CHS Alliance will shortly be publishing a paper on the need to prioritise wellbeing within our organisations, and why a shift of emphasis towards the preventative side is critically required to ensure this support. Mindfulness may be a genuinely effective component of such a shift.
World Humanitarian & Mental Health Day?
Having a special day combining these two existing ‘world days’ is of course unlikely and unnecessary.
However, the themes regarding mental health, and in recognising our work as humanitarians, are intimately linked, and are indeed necessary, if we are to make a real and genuine shift to a more supportive and preventative approach for us in the humanitarian sector.
This will require that our organisations do more than just a simple promotion of World Mental Health Day and World Humanitarian Day.
Rather it needs our organisations' leaders, policies, and practices to come to a point where we can genuinely ensure that for all of us, as humanitarians, our mental health is supported, not just on special days, but on each and every day itself.
Mental health and humanitarian aid workers: a shift of emphasis from treatment to prevention