Chronically Ill in an Emergency: Why Mental Health Matters

In humanitarian settings, mental ill-health is powerfully inter-connected with other non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, diabetes and chronic respiratory diseases. Integrating mental health and psychosocial support (MHPSS) with NCD prevention and care might therefore be useful, both to be more effective, and to require fewer resources. There is, however, a lack of widely accepted guidelines that take this into account, and this course is intended to draw attention to that issue. Attention to NCDs focused initially on four major disease categories (cardiovascular disease, diabetes, chronic respiratory disease and cancer) and four groups of associated risk factors (unhealthy diets, physical inactivity, tobacco use, and harmful use of alcohol). Recently, mental ill-health has been considered as the fifth NCD and environmental determinant as the fifth risk factor for NCDs – known as ‘5-by-5’ conditions. The course has a threefold aim: i) to explore evidence of interaction between mental ill-health and other NCDs and the role of psychosocial support in humanitarian response; ii) to explore what is being done and where; what level the determinants of health are being addressed at and the integration of mental health and psychosocial support or MHPSS and NCD prevention and care in humanitarian response; and iii) to identify and explore challenges, opportunities and lessons learned for integrating MHPSS and NCD prevention and care in humanitarian response. The MOOC will be led by a course leader from the University of Copenhagen in close collaboration with academic teachers, the Danish Red Cross and IFRC Reference Centre for Psychosocial Support, Copenhagen, Denmark.

• Overview of MHPSS and NCD Prevention and Care in Humanitarian Response
• This module will provide you with an overview of MHPSS and NCD prevention and care in humanitarian response. We will start by discussing the World Health Organization (WHO) definition of health and the burden and risk factors associated with mental ill-health and other NCDs globally and in humanitarian settings. Then we will discuss the shift from the 4x4 approach (four major NCDs plus four modifiable risk factors) to the 5x5 approach (including mental ill-health and environmental risk factors). Consequently, we will explore factors that worsen mental ill-health in humanitarian responses as well as the role of psychosocial support in improving mental health and well-being. Finally, we will discuss the nature and role of agency in recovery from mental ill-health and other NCDs.
• What is Being Done in Integrating MHPSS and NCD Prevention and Care
• In this module, we will focus on exploring what is being done and at what level to address comorbidity of mental ill-health and other NCDs in in primary health care in humanitarian settings. We will also seek the answer to what is the role of policy measures and community-based programmes to promote mental and physical well-being as well as ensuring continued access to care. Finally, yet importantly, we will discuss various approaches for integrating MHPSS and NCD prevention and care in humanitarian response, including a case from Kenya.
• Lessons Learned from Integrating MHPSS and NCD Prevention and Care
• Diverse challenges posed by humanitarian response include varied demographics of the populations affected, the range of mental ill-health and other NCDs, and ethical dilemmas regarding prioritization of MHPSS and NCD prevention and care. In this module, we will discuss these challenges, as well as the opportunities and lessons learned for delivering MHPSS and NCD prevention and care in humanitarian response. We will also look at the impact of COVID-19 to keep MHPSS and NCD prevention and care.