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Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians
Syria report UNHCR
A Review for Mental Health and Psychosocial Support Staff Working with Syrians Affected by Armed Conflict 2015
This report aims to provide information on the sociocultural background of the Syrian population as well as cultural aspects of mental health and psychosocial wellbeing relevant to care and support. it is based on an extensive review of the available literature on mental health and psychosocial support (MHPSS), within the context of the current armed conflict in Syria.
The document is primarily meant to inform mental health and psychosocial support (MHPSS) staff, such as: psychologists, psychosocial counsellors, social workers, psychiatrists, psychiatric nurses, and others who are involved providing individual or group counselling, psychotherapy and/or psychiatric treatment for Syrians. Other humanitarian professionals, such as general health providers working with Syrians or staff involved in public health, community-based protection, community mobilisation, child protection, sexual and gender based violence (SGBV), may find this document useful, although it is not primarily written for them.
The specific information in this review complements more generic guidance, such as the Inter-Agency Standing Committee (IASC) Guidelines for Mental Health and Psychosocial Support in Emergency Settings and UNHCR’s Operational Guidance for Mental Health and Psychosocial Support Programming in Refugee Operations. Together with these guidelines, this report can inform the design and delivery of interventions to promote mental health and psychosocial wellbeing of Syrians affected by armed conflict and displacement, both within Syria and in countries hosting refugees from Syria.
Suggested citation: Hassan, G, Kirmayer, LJ, Mekki- Berrada A., Quosh, C., el Chammay, R., Deville-Stoetzel, J.B., Youssef, A., Jefee-Bahloul, H., Barkeel-Oteo, A., Coutts, A., Song, S. & Ventevogel, P. Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians: A Review for Mental Health and Psychosocial Support staff working with Syrians Affected by Armed Conflict. Geneva: UNHCR, 2015
Photo credit: ©2014 Turjoy Chowdhury, Courtesy of Photoshare


Webinar Recording: Role of Psychiatrists in Humanitarian Settings
August 19, 2015

Role of Psychiatrists in Humanitarian Settings (Recording )

Wednesday, 2nd of September, 2015, 15:00 UTC

Humanitarian emergencies have devastating psychological and social effects on individuals, families, communities and societies; increasing the risk of mental health and psychosocial concerns in affected populations. In response to these effects, psychiatrists working within the government or aid agencies are expected to provide a different profile of services that assimilates new concepts related to community support and capacity building activities.

mhpss.net through the webinar ‘Role of Psychiatrists in Humanitarian Settings’ is trying to explore the various aspects of this role through presentations and discussion with a group of psychiatrists who have been working in different contexts and with different agencies.

Watch the recording of the webinar at this link. (Duration Approx. 120 minutes) We apologize for the fact that Internet access difficulties have affected the recording of the introduction at the start of the webinar.

The webinar will start with presentations by Dr. Fahmy Hanna (World Health Organization), and Dr. Peter Ventovogel (UNHCR), followed by feedback and field reflections from Dr. Asmaa Moustafa (Egypt), Dr. Fuad Almossa (Turkey), Dr. Peter Hughes (United Kingdom), and Dr. Sherese Ali (Canada). The webinar will be moderated by Dr. Mohamed Elshazly, Global Host for MENA Region at mhpss.net.

Feel free to share this recording among your networks.

More information on our speakers:

Webinar-fahmyDr. Fahmy Hanna, a qualified medical doctor and psychiatrist from Egypt, he received his post graduate certificates and trainings in Egypt, UK, India and Italy. Dr. Hanna has more than a decade of experience in mental health services and its development in low and middle income settings. He most recently has served at the WHO office in Damascus /Syria as a Technical officer on mental health during the current crisis in the country; He previously worked at the WHO office in Libya from 2011 to 2014 as a mental health advisor providing technical support for designing and implementing a successful scale up program for mental health and psychosocial services during the conflict and in the post conflict phase. He also served at WHO EMRO office as Technical officer on mental health and substance abuse during 2010-2011 with a focus in his work on mental health of Displaced Iraqis in the region. Dr Hanna, during his career, had visited and provided technical consultations for a wide range of programs on mental health and health of special groups with different donor agencies, Academic institutes ,UN and NGOs in many countries including Egypt, Palestine, Lebanon, Sri Lanka, Iran, Tunisia, Saudi Arabia and Jordan. Before this, he also served in several strategic positions at the Mental Health Department at Ministry of health in Egypt and supported the development and implementation of the national mental health information system and the national advocacy campaign for people with mental disabilities in Egypt .

Webinar-peterDr. Peter Ventevogel, M.D., is a psychiatrist and a medical anthropologist. Since 2013 he works with UNHCR, the refugee agency of the United Nations and is currently the Senior Mental Health Officer based in Geneva. From 2008-2013 he was the editor-in-chief of ‘Intervention, Journal for Mental Health and Psychosocial Support in Conflict Affected Areas’, published by the War Trauma Foundation. He worked with the NGO HealthNet TPO in mental health projects in Afghanistan (2002 – 2005) and Burundi (2005-2008) and as their Technical Advisor Mental Health in the head office in Amsterdam (2008-2011). In 2011 and 2012 he also worked as psychiatrist with Arq Foundation, the national trauma expert centre in the Netherlands. Peter regularly did consultancies for the World Health Organization and the UNHCR in Egypt, Jordan, Libya, Pakistan, Sudan and Syria. He has been course director of several academic short courses such as the course ‘Culture, Psychology & Psychiatry’ (Amsterdam Masters of Medical Anthropology), the ‘Practice Oriented Course Mental Health & Psychosocial Support in Post Conflict Setting’ (HealthNet TPO, the Netherlands) and the annual course Mental Health in Complex Emergencies (Fordham University New York).

webinar-asmaDr. Asmaa Moustafa is a graduate of Medical school of Ain Shams university, Cairo, Egypt in 2001, has started working in Abassia Mental Hospital in 2003 and specialized in Child Psychiatry in 2004, Abassia ‘s Child Unit was serving a huge catchment area (Cairo mainly but were serving children from other governorates), she was working among a multidisciplinary team of psychiatrists, psychologists, social workers helping children with different emotional and behavioral problems, in 2011 she worked in PSTIC (Psychosocial Training Institute in Cairo) offering training and supervision of psychosocial workers whose work was among refugee children (schools, those who were working with single mothers, and those who were offering recreational activities for children), she was facilitating referral of children to needed medical and psychiatric services if needed. Currently she is working in Nadim Centre for treatment and rehabilitation of victims of torture whose clients include a percentage of refugees.

Webinar-fuadDr. Fuad Almossa, MSc Psychiatry. Formerly working as a psychiatrist with International Medical Corps, Turkey; in this role, he had been providing training to primary health care (PHC) staff to identify and manage those with mental or psychosocial problems, with the goal of integrating mental health into general health care. He is also providing training and supervision to community based psychosocial workers who are providing psychosocial/non-pharmacological interventions to persons in need. Dr. Almossa has more than seven years of experience in clinical mental health services, training and MHPSS services in emergencies, and worked with many INGOs in Yemen (2007) and KSA (2009). His academic credentials include a Master degree in psychiatry from Syrian Board of specialties. Dr. Almossa is currently a PHD candidate in psychophysiology department, Gaziantep University, Turkey, and working on a research on (Evidence Based Psychosocial interventions in the promotion of mental health in Emergency Settings)

Webinar- Dr. PeterDr. Peter Hughes, Consultant Psychiatrist/ Hon Senior Lecturer Springfield University Hospital, London. Chair of Volunteering and International Psychiatry special Interest Group at Royal College of Psychiatrists. Lead for Kings Sierra leone mental health link and Somaliland Kings THET link. Extensive field experience in global mental health including complex humanitarian emergency.

Main interest area -training health workers.


Webinar-Dr.ShereseDr. Sherese Ali (MD FRCPC, Consultant Neuropsychiatrist, Dip. American Board of Psychiatry and Neurology, Dip. Academy of Psychosomatic Medicine), has worked as a humanitarian doctor since 2010, serving the role of MHPSS manager and coordinator in Ethiopia, Haiti, Sudan, Iraq, Turkey, Northern Syria, Damascus and Somaliland. She has served as consultant mhGAP and ToT trainer for the WHO EMR. She has experience in post-disaster relief and development and mental health emergency response in areas of armed conflict. She has served on the expert committee for the evolving WHO Convention of the Right for Persons with Disabilities. Dr. Ali has published articles in this field based on the experiences in Haiti and Sudan and has contributed to the mhGAP adaptation guides for Sudan and Iraq.

Dr. Ali completed medical training at the University of Calgary, Alberta, Canada and did subspecialty training in Neuropsychiatry and Consultation Liaison Psychiatry at the Maudsley Institute, London, England and Harvard Medical School, Boston, MA, USA.  Her areas of academic focus are in the field of epilepsy, rheumatology and brain injury and she has published several book chapters and peer-reviewed journal articles on these topics.

Our Host:

webinar- mohamedMohamed Elshazly, is Regional Host for Middle East and North Africa at mhpss.net. Mohamed is a qualified medical doctor and psychiatrist from Egypt with more than a decade of experience in clinical mental health services, training and MHPSS services in emergencies. He is working now as Regional MHPSS Advisor- Middle East, at International Medical Corps.

New edition of WHO’s Mental Health Atlas series (2014)
August 4, 2015

The new edition of WHO’s Mental Health Atlas series (2014) has recently been published.  It is considered to be the most comprehensive and widely used source of information on the global mental health situation. You can access the Mental Health Atlas here: http://www.who.int/mental_health/evidence/atlas/mental_health_atlas_2014/en/

The Mental Health Atlas assumes new importance as a repository of mental health information in WHO Member States because it will provide much of the baseline data against which progress towards the objectives and targets of the global Comprehensive Mental Health Action Plan 2013-2020 will be measured.

Shekhar Saxena, Dan Chisholm and Fahmy Hanna, from the WHO Department of Mental Health and Substance Abuse, highlight some key messages from the latest Atlas in the series (Mental Health Atlas 2014) in the following podcast from the Mental Health Innovation Network: http://mhinnovation.net/global-mental-health-how-are-we-doing


The “4Ws” in Lebanon: Who’s doing What, Where and Until When in MHPSS (2015)
August 3, 2015
4ws lebanon

The “4Ws” in Lebanon: Who’s doing What, Where and Until When in MHPSS (2015)

This report is the second mapping exercise of the “4Ws” in Lebanon, the first of which was published in the December 2013 UNHCR commissioned report, Assessment of Mental Health and Psychosocial Support Services for Syrian Refugees in Lebanon.

In the present report (Click here) the 2014 results will be compared to those of the previous year to display the changes in service delivery.

State of the World’s Fathers – Report now available for downloading
July 27, 2015

MEN CARE LOGOState of the World’s Fathers is the world’s first report to provide a global view of the state of men’s contributions to parenting and caregiving. Presented by MenCare  you can download the report at http://sowf.men-care.org/

While the full report is available in English, there are Executive Summaries available in Spanish and Portuguese.


Webinar Recording Available Now! Please share the link…
July 9, 2015
Slider image

Monitoring and Evaluation in MHPSS Programming in Humanitarian Emergencies.

Conducted : Wednesday 15th of July- 4 pm UTC

Please click here to watch a recording of the webinar (Duration: Approximately 80 minutes).

This webinar will provide guidance and tools for monitoring & evaluation (including assessment and learning) at all stages of mental health and psychosocial support (MHPSS) programming in humanitarian settings. The webinar will include an overview of an M&E framework, and will deal with the process from an initial needs assessment required for MHPSS program design to the practicalities and challenges faced in implementation.  It will also explore the need for overarching evaluation and research to improve our programs and identify best practices for future work.  The speakers are both MHPSS practitioners who bring considerable field experience from emergency settings to bear on these topics.


Zeinab -photo

Zeinab Hijazi - MHPSS and Protection consultant

Zeinab currently provides direct support to the International Medical Corps’ MHPSS programs in Syria, providing guidance and oversight in the development, monitoring, evaluation and running of culturally appropriate mental health and psychosocial activities. This includes provision of mental health care, psychosocial support, and protection activities targeting various vulnerable groups, including children among IDP and vulnerable host populations. Zeinab has over 9 years of experience supporting International Medical Corps’ MHPSS programs in the Middle East and North Africa region.

In recent months, Zeinab completed various consultancies with UNICEF (New York) co-leading a global review of evidence and practice of MHPSS for children in Emergencies. She also completed a mission in March 2015 with the World Health Organization in Iraq, contributing to and informing mental health policy and services through a situational analysis and assessment.

Zeinab has a Masters Degree (MSc) in Mental Health Policy and Services and is currently pursuing her doctoral degree in clinical psychology.


Sarah Harrison- MHPSS coordinator with International Medical Corps, TurkeySarah

Sarah is currently the MHPSS coordinator with IMCs ERT Turkey. Sarah started working for IMC in Turkey in September 2013.  Her previous positions include MHPSS Officer for UNHCR Damascus within their MHPSS Program for Iraqi refugees and then subsequently Syrian IDPS (this was the first program of its kind for UNHCR globally) from May 2012-August 2013.  Sarah also helped create the Operational Guidance Note on MHPSS for UNHCR – which is now a guiding policy document for the UN Agency. Previous positions have also included the IASC MHPSS RG Co-Chair for 2 years (2010 – 2012), Global MHPSS Advisor for ActionAid and then the same position with ACT Alliance.  She has supported, co-ordinated, advocated for, and managed MHPSS programs in humanitarian emergencies and protracted (refugee) settings since 2007.

Moderator : Mohamed Elshazly, Global Host for mhpss.net (Middle East and North Africa Region)


Yemen 2015 Crisis Response Group now open
July 3, 2015

A new group has been opened in order to respond to the Level 3 emergency declared in Yemen by the UN Humanitarian Coordinator as of July 2015. Read more here.

Click on the following link to join Yemen 2015 Crisis Response group:



Nepal Earthquake 2015: Desk Review of MHPSS-Related Information
June 22, 2015
Desk review Nepal-slider

A comprehensive “Desk Review of Existing Information with Relevance to Mental Health & Psychosocial Support” has been compiled on behalf of the Inter Agency Standing Committee (IASC) Reference Group for MHPSS in Emergency Settings, and was last updated on 18 June 2015.

This document describes a desk review started after the April 25 and May 12 earthquakes in Nepal. The main aim of the desk review was to summarize existing information with regard to mental health and psychosocial wellbeing in Nepal. It is hoped this desk review will help people responding to the earthquakes to take into account information on the socio-cultural context in Nepal, and to avoid collecting information in needs assessments that is already available. Conducting a desk review after major emergencies is part of the 2007 ‘Inter-Agency Standing Committee Guidelines for Mental Health and Psychosocial Support in Emergencies’.

The desk review was undertaken by a group of more than one hundred collaborators working on behalf of the Inter-Agency Standing Committee for Mental Health and Psychosocial Support in Emergencies. Faculty and (post)graduate students at several universities used the same methods to search the academic and grey literature from multiple disciplines; screen the results from searches; and summarize relevant documents. A version for peer review was completed and shared on 22 May 2015 and a final version made available in early June.

Searches identified 563 documents and 242 documents were included in writing this desk review. Documents included both information from (program) reports on websites as well as research published in peer-reviewed journals. The peer-reviewed literature on mental health and psychosocial wellbeing has focused primarily on mental health for populations affected by political violence in Nepal, including populations affected by armed conflict, torture survivors, and displaced populations (internally displaced populations, refugees from Tibet and Bhutan).

Download the desk review here.


Training Course: Mental Health in Complex Emergencies offered by the IIHA

 Mental Health in Complex Emergencies (MHCE 11)

September 20-30, 2015 | Addis Ababa, Ethiopia

 Course Description

The Mental Health in Complex Emergencies (MHCE) course is an intensive multidisciplinary ten-day training course for mental health workers and humanitarian program staff who wish to gain insight and competency in establishing mental health or psychosocial programs in (post) conflict areas or in complex disaster settings. It will provide practical orientation and training to equip participants to establish and organize comprehensive programming in mental health and psychosocial support, and strengthen adjunct skills for use in complex humanitarian emergencies and relief situations. Such skills include needs assessments, monitoring and evaluation, understanding the humanitarian context, security and self-care. In the last 3 days of the course students will choose between a workshop on learning clinical or on research skills relevant to a humanitarian setting. More detailed information about course structure and learning objectives is available in the course brochure and on the website.

Course Highlights

  •  Interactive and practice-driven teaching
  •  A choice of specialised workshops in the final three days
  •  Faculty combines academic excellence with extensive field experience
  •  Diverse and international group of students
  • Active alumni network

Qualifications: This is a multidisciplinary training program for participants from a variety of backgrounds. Applicants should have a background in either mental health or social work or have a relevant professional background that allows for future engagement in mental health or psychosocial program in complex emergencies. Participants must be fluent in English. Preference is given to applicants with more than two years of experience in the field. Participants are required to have a university degree.

Course location: This residential course will be held at Asham Resort hotel on the shores of beautiful Lake Bishoftu in Debre Zeit, approximately one hour from Addis. All students and faculty will stay at the hotel together, allowing for more informal gatherings and sharing of experiences outside formal teaching time.

Tuition fees: For those who wish to receive academic credit, the cost is: $1750. Upon successful completion of the program participants are eligible to receive two academic credits from Fordham University’s Graduate School of Arts and Sciences. Students seeking academic credit will be required to submit a research paper (1,400-1,600 words) due one month after the conclusion of the course in accordance with the guidelines provided by the Course Directors. For those who do not wish to receive formal academic credit, the cost of tuition has been reduced to $1350 Dollars. These participants will receive a certificate of attendance. 33 W. 60th St., Suite 804 | New York, NY 10023 | www.fordham.edu/iiha | [email protected] | +1 212-636-6294

Accommodation: Accommodation including all meals has been reserved at the hotel: $1050 for 10 days.

Specialist workshop fee for previous MHCE alumni: People who have done the MHCE basic course in the past can apply separately for the 3-day workshops on (28-30 Sept): $1000 for accommodation and tuition

Scholarships: The Center for International Humanitarian Cooperation (CIHC), partner organization of the IIHA, offers a limited number of scholarships for tuition fees. To be eligible, you must be a citizen of a developing nation and be currently working within the humanitarian field.

Applications: Applications are accepted on a rolling basis. If you are interested in attending this program, please contact the International Programs Coordinator, Alexandra DeBlock at [email protected] for further instructions.

Deadlines: Once an application has been submitted and accepted, the full course fee covering both accommodation and tuition of $2400 (or $2800 if wishing for academic credit) should be paid to Fordham as soon as possible. Accommodation reservations cannot be held after the August 20, 2015. Any applicants accepted after that date will have to apply directly to the hotel for accommodation.

About the organizers:

The Institute of International Humanitarian Affairs (IIHA) was created at Fordham University in December 2001 to forge partnerships with relief organizations, offer rigorous academic and training courses at the graduate and undergraduate level, host symposia, and publish books relating to humanitarian affairs. Recognizing the need for a universally accepted basic standard of training for all humanitarian workers, the IIHA holds numerous training courses to accommodate the needs and schedules of humanitarian aid workers around the world.

The Center for International Humanitarian Cooperation (CIHC) was founded in 1992 to promote healing and peace in countries shattered by war, regional conflicts and ethnic violence.

HealthNet TPO is a Dutch aid agency that works on health and well-being in areas disrupted by war or disasters. By working together with local communities we use ‘health’ as a means to bring people together and to restore mutual trust.

International Medical Corps (IMC) is a global, humanitarian, non-profit organization dedicated to saving lives and relieving suffering through health care training and relief and development programs in over 30 countries. Mental health and psychosocial support services and activities are a cornerstone of our integrated and comprehensive programming.

Website: www.internationalmedicalcorps.org and https://internationalmedicalcorps.org/programs/mental-health


UNHCR is the United Nations Refugee Agency, mandated to lead and co-ordinate international action to protect refugees and resolve refugee problems worldwide. In 2013 UNHCR published the ‘Operational Guidance for MHPSS Programming in Refugee Operations’ that formally recognizes the importance of MHPSS as an integral part of its mandate.

WHO/UNHCR Issue New Guide on Mental Health in Humanitarian Emergencies

Joint News Release
5 May 2015


WHO/UNHCR Issue New Guide on Mental Health in Humanitarian Emergencies

5 MAY 2015 | GENEVA – Worldwide close to 80 million people are currently impacted by humanitarian emergencies arising from natural disasters and armed conflicts, such as those in the Central African Republic,  South Sudan, Syrian Arab Republic, Yemen, and more recently, Nepal. The World Health Organization (WHO) estimates 5% to 10% of these people suffer from a mental health condition such as depression as a result of the emergency.

People with mental health disorders rarely have access to specialized health workers trained in assessing and managing their conditions. WHO and the United Nations High Commissioner for Refugees (UNHCR) have therefore produced a mental health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG), so non-specialist health workers can better identify, assess and manage mental health needs.

The new guide provides practical, first-line management recommendations for mental, neurological and substance use conditions. Contents include modules on assessing and managing conditions such as acute stress, grief, moderate-severe depressive disorder, post-traumatic stress disorder, epilepsy, and harmful use of alcohol and drugs.

Mental health in humanitarian emergencies

Most people, adults and children, experience grief and acute distress. But emergencies also trigger conditions such as depressive disorder, post-traumatic stress disorder or prolonged grief disorder, that can severely undermine a person’s daily functioning. People with severe pre-existing conditions such as psychosis, an intellectual disability or epilepsy are even more vulnerable.

Managing these conditions presents many challenges to health workers. In natural disasters, like the recent earthquake in Nepal, people have been displaced, facilities have been damaged, and supplies of medications are limited. Health workers are often in short supply and under enormous pressure to see as many people as possible in the shortest amount of time. And there are only very rarely specialist facilities available to take referrals. The new guide will give the available health responders the ability to begin to address these needs.

New guide enables general health workers to give mental health care

WHO and UNHCR hope all humanitarian partners will use the new guide to help reduce suffering and increase the ability of adults and children with mental health needs to cope in humanitarian emergencies.

The new guide will be used in Syria, where the four-year conflict has displaced more than 7.6 million people within the country and left an additional 4 million seeking refuge in neighbouring countries. WHO started training Syrian non-specialist health workers in 2012. Since then over 500 health workers have been trained. The new guide will help accelerate and scale-up access to mental health care in Syria and other emergency settings.

The mhGAP is a WHO programme that seeks to address the lack of care for people suffering from mental, neurological and substance use conditions. In 2010, it published the mhGAP intervention guide, a widely-used evidence-based manual for the management of these conditions in non-specialized health settings, particularly in low- and middle-income countries. The new mhGAP humanitarian intervention guide is an adaptation of the original guide, which has been tried and tested in the field. It is written specifically for practitioners working in humanitarian emergencies.

Related link
- Download the guide