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Challenges of providing Mental Healthcare

19 Oct 2018

Language and cultural barriers, short amount of contact time between professionals and patients and the social stigma that often accompanies mental ill-health are some of the obstacles faced by our mental health teams in the field.



During humanitarian emergencies, we help people whose pain is felt far beyond physical wounds

To relieve their suffering, our teams have to deal with many obstacles and challenges.


Ionara Rabelo – MSF psychologist

In many of our projects, the first obstacle is language itself. We work with translators and there is a constant effort to find the right tone and words to use and to understand when one word fits better than another. Which tone of voice are they using to express sadness? Have I felt sad in the past few weeks? Have I ever felt like this before? Is my sorrow so deep that I do not want to live anymore? For me, getting to this level of detail is one of the biggest challenges. Another obstacle is our own background. We carry our western cultural background with us. To understand how people suffer in a country that has been at war for years – more than 60 or for four – I cannot use the idea of a “concrete” mental disorder, like anxiety, suffering or depression. We need to understand it as a normal reaction to an abnormal situation.

Julia Bartsch – MSF psychologist

We often work in places where people do not even know what psychological support is. They know they are suffering, but they do not know why. So part of our work is to help our patients understand that their suffering is related to the situation they are living in.


Ionara Rabelo

In a long-term project, we have the support of a full team to ensure our work goes smoothly. However, during a conflict, as we see near the Syrian border, where we meet patients sometimes only once, we can use individual or family approaches, but always focusing on what we can hear, how can we finish the session in a way that means the patient feels they have been heard and accepted? I need to say something that they will remember and find useful even a few days later when they are back on their journey.  


Leticia Nolasco – MSF psychologist

We never arrive in a project with something ready-made. We evaluate the situation and draw up a strategy based on what we find there. Before seeking out professional support, people look for support in their neighbours, family and friends. And from other local networks, such as resident associations and school groups. They feel very comfortable within their community. As we are here to talk about mental health, I would like to say, we spend so much time diagnosing conditions, when we should give much more focus to resilience itself. That is my opinion.


Our psychologists, psychiatrists and counsellors work in more than 50 countries caring for invisible wounds.