It has been five years since the IASC Guidelines on Mental Health and Psychosocial Support (MHPSS) in Emergency Setting were launched. The Guidelines were welcomed by MHPSS practitioners to create a common framework not only for action, but also for systematic collection of empirical data on what works and what does not (evidence base).

The central question in this discussion is:

After five years, how have the initial needs and challenges of the IASC guidelines been met and what are the most important lessons learned and challenges that still lay ahead of us?

1. The cultural and local experiences of suffering in humanitarian intervention were praised (Abramowitz & Kleinman 2008), but Rose mentioned the dilemma of “…sustainability of the integrated mental health/primary care model, post emergency in a country with poorly developed primary health infrastructure, and no history of community psychiatry” (Rose 2011:220). To what extend at the field level have the guidelines also been adapted into local contexts and have informed local policy development on MHPSS?
2. Another issue raised by Rose was “…whether it was wise to invest in community mental health services, rather than reinforcing already established central ones” (Rose 2011:220). Many humanitarian aid workers believed, and often still do, that actions related to MHPSS are second or third tier interventions that come only after meeting the basic needs for security, health, food, water/sanitation, and shelter: has this changed?
3. How has the community mobilization aspect that is arguably the most transformative component of the guidelines, evolved within the implementation of the guidelines?

The complete discussion, and the IASC Guidelines Collection Reference List with all the references and other reading material are available under resources