Crises and psychological damage: the role of psychosocial programmes
Most individuals manage to get over the shock of a major event. Others, who are more vulnerable, need help to recover psychologically. Without this help, they suffer and they weigh down their community through various forms of inaptitude or deviancy. Psychosocial programmes, which are adapted to individual cultural contexts, aim to help both individuals and the community. Though the need for programmes of this kind is now generally accepted, more detailed research is required into the methods involved, their specific objectives and how they can be evaluated.
In recent years, there has been greater acceptance of the need for a psychosocial component in humanitarian programmes and how these should be used. However, an area of uncertainty remains due to the many different forms which programmes of this kind can take.
A great deal of misunderstanding about the objectives and methods of psychosocial programmes comes from associations with Psychiatry and the treatment of Posttraumatic Stress Disorder (PTSD), the ancestor of psychosocial work.
People often fail to distinguish mental health and mental illness. Mental health is an all-embracing notion which does not simply refer to the absence of illness. The treatment of mental illness is carried out by a doctor and involves diagnosing and treating a recognised psychiatric condition .
The notion of humanitarian psychiatry appeared in the 1980s and it was not till much later that the idea of psychosocial programmes was developed. Today, mental health programmes in conflict and post-conflict contexts either have a medical/psychological dimension and focus on the individual or have a social/anthropological dimension and focus on the more collective notion of “social well-being”.
Though it is normal and universal to experience emotional disorder immediately after a major shock, it appears that most people deal with and overcome the effects relatively quickly. However, for a variety of reasons, a certain number of vulnerable individuals and groups find themselves in a situation where their ability to cope is seriously reduced. The consequences of the traumatism reduce their ability to adopt coping strategies and adapt to difficult post-crisis contexts.
If these individuals are not given some way of rebuilding themselves psychologically, in the face of all the challenges involved in contexts of this kind, their behaviour (violence, apathy, addiction, abandonment of parental duties, etc.) will have a negative effect on themselves and the rest of the community.
Therefore, even if they focus in part on the individual, psychosocial programmes are also aimed at all the relations between the members of a community so that they can face up to the difficulties, anti-social behaviour and delinquency which reduce their ability to recover both in the present and in the future. Over and above easing individual psychological pain, psychosocial programmes aim to support the capacity of a community. The difficulty is that, in contrast to vital needs, the consequences of psychological trauma are only apparent in the mid- to long-term.
 Numerous references are made to Evelyne Josse’s book: « Interventions humanitaires en santé mentale dans les violences de masse » (humanitarian mental health operations in mass violence contexts), published by DE BOECK, 2009.