One of the aims of development work is to improve people’s living conditions, for example, by building schools or drinking-water systems. During a development project’s design phase, attention centers more on the project and its technical aspects than on the project’s beneficiaries. Yet, some situations affect people’s level of empowerment – their ability to achieve their potential; a traumatic experience, such as war or urban violence, doubles a person’s risk of alcoholism and triples their risk of drug addiction.
In such situations of violence or emergency, several questions arise: Is it possible to improve populations’ living conditions with basic services, such as drinking water, without providing for their psychological and social needs? How might we integrate “psychological first aid” where needed in development projects? Does adding such aid complicate projects? Is it needed to meet a project’s stated objectives? Can a region affected by hardship be put on a sustainable-development path without attending to the local population’s welfare?
Guillaume Pégon, a Technical Supervisor for Mental Health and Protection Technical Supervisor at Handicap International, answers our questions.
Why does Handicap International include psychosocial support in its development projects?
Handicap International is an independent and impartial organization for international solidarity that works to alleviate poverty, exclusion, conflicts and catastrophes. These situations can provoke more or less incapacitating mental health problems within populations. More frequently, the social context of these situations creates psychological distress and what we may call social pathologies: broken familial and personal ties, problems in relating to others, behavioral issues, unmet basic needs, security and protection hardships, and so forth.
Our assistance is relational in nature; it aims to give all parties mutual power.
Handicap International uses an ecological model to understand disabilities and describe the process of producing them. This model looks beyond the causes or personal factors that lead to a handicap, taking into account the way an environment hinders or facilitates life for someone with sensorial, physical, intellectual and/or psychological defects or disabilities. In doing so, we work on the effects rather than the causes of mental health problems in people’s daily lives, focusing on their community and social environment.
Each community can take care of its people with its own resources. We help communities reactivate the common ties that bind people to one another, or that previously bound them; for example, through mutual aid groups. Where trauma has broken ties in a variety of spheres, we use various cultural, social and economic mediations to strengthen social ties and people’s empowerment over their daily lives. This way of starting with an individual’s environment to affect his or her mental health is what we call “psychosocial” work. However, it would be more precise to call it an ecological approach to mental health.
Do you integrate this psychosocial dimension into all of Handicap International’s projects? If not, why not?
We only propose psychosocial activities when populations are at risk of or show signs of psychological distress. Handicap International is not trying to “psychologize” its development aid.
How does Handicap International help distressed populations?
Generally speaking, at first sight, project managers believe psychosocial activities to be complicated, unsustainable and not worth the effort. Furthermore, psychosocial and mental-health assistance touches the most intimate reaches of a human being. We mostly intervene in a context where the dominant norm for individuation is not a human being who becomes him- or herself – autonomous, accountable, emancipated, and capable – by him- or herself. The social norm is more that of a human being who becomes him- or herself because he or she wholeheartedly embraces moral, social and cultural codes. We try to start with the situations that cause problems for our partner populations, without idealizing their individualization process. We help our partners find solutions, seeking out locally available resources and bringing in as many local actors as we can. Sometimes our work resembles local development actions. Our assistance is relational in nature; it aims to give all parties mutual power. That is why we can speak of empowerment – for psychologically distressed people, for Handicap International, and for the local implementing organizations that help these populations. Once Handicap International establishes a relationship, the two other parties trust one another and can discuss more intimate concerns.
By taking on all kinds of problems – economic, cultural, political, familial, and so forth – and by proposing assistance that centers on using the community’s resources, we can sometimes win the trust of the most skeptical parties with this type of psychosocial assistance. We achieve this because even skeptics can see first hand what our assistance can do, especially in terms of empowerment. Then, because we work with the community’s resources, our approach affects the mental health of individuals in the community and their cultural, social and economic resources.