Médecins Sans Frontières (MSF) started mental health and psychosocial interventions in 1990 with a community-based programme in Gaza (Palestine). Since the early 1990s, MSF has implemented psychosocial or mental health interventions in over 40 countries worldwide. The interventions covered various aspects of mental health in different contexts such as acute emergencies, the effects of (acute) trauma, primary healthcare, adaptation and chronic stress-related complaints, psychosocial support to improve outcomes in nutrition, TB and HIV programmes, and psychiatric care in institutions.
Since MSF is an emergency medical humanitarian organisation, the bulk of our programming is in acute or chronic settings of mass conflict. These are characterised by events that involve thousands of people who have experienced, witnessed or heard of traumatic events. Often there is significant material damage, destruction of the social fabric and community function.
These guidelines focus on manmade rather than natural disasters, but our experiences in India, El Salvador and Pakistan (earthquake interventions), and following the 2004 tsunami, cyclone Nargis in 2008 and the Haiti earthquake in 2010, showed that the principles described also work well in contexts of natural disasters.