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Delivering Mental Health and Psychosocial Support - The essential role of the social service workforce in supporting refugees and migrants
Blog by Nicole Brown, Communications and Advocacy Manager, Global Social Service Workforce Alliance
Over the past eight months of the COVID-19 pandemic, with many people facing lockdowns and drastic changes in interactions outside the home, the mental health impact across all ages and groups of people has become more apparent and alarming. For asylum seekers, refugees and migrants, who already face distressing and unknown situations, there are additional risks and uncertainties that are exacerbating stressors and anxiety. Many countries rushed to send asylum seekers or migrant workers back to their home countries. This vulnerable group of children and families has extra reason to fear COVID-19 as a result of being on the move and lacking permanent shelter and residency, preventing them from being able to comfortably shelter in place, maintain social distance, receive preventative treatments or access other health services. These fears, combined with so many others, are creating longer-term negative impacts on the mental health and psychosocial well-being of these children and families.
Estimates based on research in 2019 shows that more than one in five people (22·1%) in post-conflict settings has depression, anxiety disorder, post-traumatic stress disorder, bipolar disorder, or schizophrenia. COVID-19 is likely to exacerbate these already high rates of mental health disorders among this particularly vulnerable population.
The first director of the World Health Organization (WHO) stated that, “without mental health, there is no health.” Mental well-being is closely connected to overall well-being. There is also increasing acknowledgement of the important role mental health plays in achieving global development goals, as illustrated by the inclusion of mental health in the Sustainable Development Goals. With an estimated 271.6 million migrants worldwide, meeting these mental health needs is a significant challenge.
Yet, despite these worrying statistics and downward trends in mental health, there is reason for hope. Social service workers are on the frontlines of assessing needs and delivering services to hard-to-reach and vulnerable groups. During the COVID-19 pandemic, they haven’t shied away from this challenging role, rather they have shown that, now more than ever, they should be considered an essential workforce.
Social service workers are trained and qualified to meet mental health and psychosocial support needs in development and humanitarian settings. During this pandemic, they have drawn on their training and experience in responding to other disasters, outbreaks and crises. In a survey conducted by the Global Social Service Workforce Alliance on social service workforce response during COVID-19, 54% of respondents indicated they are providing MHPSS services.
In addition to directly addressing MHPSS needs, social service workers address a myriad of other stressors in order to prevent mental health problems. In refugee settings, they play an essential role in a range of activities including: reunification and family tracing; fostering community acceptance, social integration and social inclusion; making referrals to other services and health providers; ensuring access to social protection; distribution of necessary supplies and materials, and so much more. They are also the connectors and facilitators who unite and coordinate input from other sectors, disciplines and borders. Examples of the essential coordinating roles they perform include:
- In Tanzania a team of government social workers were trained by REPSSI, prior to COVID-19, on responding to emergencies and delivery of psychosocial support (PSS) services. These workers were then in place at the onset of COVID-19 to provide counselling services to those affected by PSS issues as a result of losing loved ones to COVID-19 or supporting those who were in quarantine centers.
- With 170,263 children affected by COVID-19 school closures in Bhutan, the Ministry of Education activated the Education Emergency Operation Centre under which a mental health and psychosocial support (MHPSS) sub desk was created. To ensure the provision of MHPSS to children, parents and caregivers in need, UNICEF supported 147 school counsellors from 20 districts to be trained on how to provide psychosocial support remotely to parents and caregivers and face to face structured psychosocial support to children once the schools reopen.
- In Ireland, social workers were rapidly devising new services and ways to support individuals and families. They developed liaison services for families where loved ones living in mental health residential settings may be separated from other family members and used telehealth platforms as one way of continuing services, as reported by the Irish Association of Social Workers to the International Federation of Social Workers.
- In Madagascar, UNICEF, in collaboration with the Ministry of Population, developed a technical guidance note in Malagasy on how social service workforce volunteers could assist in providing psychosocial support for people affected or in contact with COVID-19. It included detailed guidance on the provision of psychosocial support in health care, institutional and home settings. The guidance has been shared across all 22 regions of Madagascar in hard copy. An audio training based on the guidance is being developed and dispatched across solar reusable radio, to overcome the limited internet and smartphone access.
Social service workers have long been advocates and champions for the prevention, promotion and provision of mental health and psychosocial support services (MHPSS). Recognizing and advocating for the essential role that the social service workforce plays in developing and providing these services, in the current pandemic and beyond, will enable the workforce to continue and expand its work. This will enable a wider range of children, families and vulnerable individuals to benefit from the unique range of services the workforce can provide.
 The Lancet. (2019). New WHO Prevalence Estimates of Mental Disorders in Conflict Settings: A systematic review and meta-analysis. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30934-1/fulltext
 Dr Brock Chisholm, the first Director-General of the World Health Organization (WHO), was a psychiatrist and shepherded the notion that mental and physical health were intimately linked. He famously stated that “without mental health there can be no true physical health.”
 An online survey was conducted in April 2020, with 215 responses from 33 countries. These findings helped to inform the technical note on Safety and Wellbeing for the Social Service Workforce during COVID-19 Response: Recommended Actions.