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MENTAL HEALTH AND

PSYCHOSOCIAL
SUPPORT IN SOUTH
SUDAN
Orso Muneghina,
Senior Programme Advisor

Some quick facts

Independent from July 2011


Civil conflict 1955-1972 and from 1983-2005
Internal conflict erupted again in December 2013
11.6 million people: some 2.5 million are IDPs
N.1 in the Most Fragile State Index. Common indicators
of the MFSI include:
a state whose central government is so weak or ineffective, that it has little
practical control over much of its territory;
non-provision of public services;
widespread corruption and criminality;
refugees and involuntary movement of populations and sharp economic decline

Key Challenges for MH and PS


Table 1 : WHO projections of MH disorders in adult populations affected by emergencies
Before the emergency ( 12
month prevalence)

After the emergency ( 12


month prevalence)

What does this mean for


South Sudan ( n.people
affected)

Severe disorders ( e.g.


psychoses, severe depression,
severe anxiety disorders)

2-3%

3-4%

348.000 464.000

Mild or moderate mental


disorders ( mild depression
and anxiety, including mild
and moderate PTSD)

10%

15-20%

1.740.000 2.320.000

Normal distress ( no disorder)

No estimate

Large percentage

IASC Pyramid: Intervention levels


Degree of severity and
intervention needed

Specialized
services
Focused non-specialized
support

Community and Family Support

Basic Services and Security

% of people affected

Treatment gap in South Sudan


Treatment gap = prevalence of disorders vs Shortage of
(qualified) ( human) resources and services
Only 2 psychiatrists in the country
over 2.5 mil. people displaced (UNHCR)
No mental health nurses
Only 1 (teaching) MH hospital in the whole country
No courses in psychiatry, psychology or social work
Psychiatric cases treated in prisons
Lack of access to services ( HNTPO recent research)
Lack of psychotropic medicines

Our strategy of intervention


A 3 tier-strategy comprising:
1) short-term emergency response with a focus on
stabilization and mental health support and recovery;
2) a transition phase which lays the groundwork for longer
term MHPSS work;
3) a long-term strategy where integrated services are
offered at community and health facility levels ( longterm vision)

Where we work on MHPSS

SSJR (emergency response)


We are establishing Mental Health and Psychosocial Support
(MHPSS) Networks in 4 counties that could be sustained over the
long term.
These networks comprise a variety of different actors already
servicing host communities and displaced people.
As a result, community workers/volunteers are trained and able to:

Map and assess local formal and informal resources


Increase access by identifying priority conditions (such as depression, suicide, but also
community problems),
Provide supportive interventions for those in need ( PFA/basic counselling)
(re) Activate family and community support (ex. Community based Centres/self-help groups)
Know when and how to refer cases for focused and more specialized support
Provide ongoing and follow up support for (re) integration at home and community level (
case management)
We are also training health workers at the PHC level on MH awareness to gain a better
understanding of MH issues and provide further support when needed.

NEPAL example

Ongoing and plans for the future


( medium-long term strategy)

Keep advocating for increase attention on MH policy and


Reform ( through the MH platform )
Provide guidance to local partners and international
actors on setting up MHPSS interventions (UNICEF)
Provide evidence through research for advocacy and
further programme implementation
Integrate MH into PHC : MHGap guidelines for the
training and scaling up of MH
Activate partnerships with local Universities to build local
capacity in social work and mental health care