An Overview of International Medical Corps
The International Medical Corps (IMC) is a Non-Profit world relief and humanitarian organization that provides a variety of services in countries around the world. With 25,000 local partners and 4,500 medical professionals, IMC provides services from emergency response to economic development, infrastructure development to primary physical and mental health care, and more (International Medical Corps, ND). The following is an overview IMC including a brief description of the history and mission of IMC and a succinct review of the type and location of IMC projects around the world. Also included is a review of IMC philosophy of providing mental health services, a description of the mental health program IMC piloted in Sri Lanka and implications and challenges of providing mental health in that region. Finally, I provide my commentary on the efficacy IMC’s approach to mental health treatment and what I see as exemplary and needing improvement in its efforts around the world.
Brief History and Mission
IMC was established 1984 by Dr. Robert Simon in an effort to change the face of international relief work. The inspiration to start IMC started with Dr. Simon’s work with the people of Afghanistan after conflicts with the former Soviet Union in the 1970’s. Since 1984, ICM has expanded its operations to 70 countries providing both long-term relief and emergency response. Most recently, IMC provided disaster relief for Tsunami victims in Japan and those devastated by the 2012 Typhoon in the Philippines. (International Medical Corps, 2013a)
IMC’s overarching mission is to relieve suffering, increase the quality of life, and save lives around the world. The IMC accomplishes this through by wa...
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... Sri Lanka in disasters. International Review of Psychiatry, 18(6), 593–597. doi:10.1080/09540260601129206.
Mendis, N. (1990). A model for the care of people with psychosocial disabilities in Sri Lanka. Psychosocial Rehabilitation Journal, 14(1), 45–52. doi:10.1037/h0099456
Public Radio International (2009). International Medical Corps: A Thousand Words. Retrieved from http://www.youtube.com/watch?v=xJErgHsraiM&feature=youtube_gdata_player.
Samarasekara, N., Davies, M. L. M., & Siribaddana, S. (2012). The stigma of mental illness in Sri Lanka: the perspectives of community mental health workers. Stigma Research and Action, 2(2). doi:10.5463/sra.v1i3.48.
Weissbecker, I. (2013). What is Unique About International Medical Corps’ Approach to Mental Health and Psychosocial Support. Retrieved March 31, 2014, from http://internationalmedicalcorps.org/document.doc?id=236.
The traditional approach to the care of the mentally ill during the last 200 years was custodial, rather than therapeutic. This approach to “Psychiatric Care Delivery System” was introduced in India from Britain . Mental hospitals were established in isolated areas, often on the outskirts with the object of segregating the patient as troublesome and dangerous to their neighbors. The overriding concern was to protect the citizens without regard for appropriate care and cure of the ailing patients. As a consequence of this objective of the mental hospitals, the quality of care in such hospitals had been very poor. The inmates were subjected to indignity and humiliation for an indefinite period, and once admitted never recovered, or rehabilitated back in their family, but doomed to the inevitable end. The stigma of mental illness thus prevailed.
An Imperfect Offering is a powerful personal memoir from a James Orbinski, a Canadian who has spent most of his adult life in front-line humanitarian work in the world's worst conflict zones. Despite its dark chapters, it is also a hopeful story about the emergence of Médecins Sans Frontières (MSF) as a new and independent agent of civil society, and the possibilities of making the world a better place. In “An Imperfect Offering”, James Orbinski tells the story of people who have been harmed by war, and humanitarian workers who have come to heal them when possible. He engages in deep reflection on the nature of humanitarian response and the many threats to this most human activity. He has sharp criticism for governments who act to cause suffering or to prevent its relief. He asks, “How am I able to be in relation to the suffering of others?” His life as a doctor, and a humanitarian worker illustrates this answer. Accordingly, the books main thesis is that humanitarianism is about the struggle to create space to be fully human. However, he illustrates how this struggle is becoming increasingly difficult with the imperfect offering of politics, which has resulted in the blurring of boundaries between humanitarian assistance and the political objectives of military intervention.
Mental healthcare has a long and murky past in the United States. In the early 1900s, patients could live in institutions for many years. The treatments and conditions were, at times, inhumane. Legislation in the 1980s and 1990s created programs to protect this vulnerable population from abuse and discrimination. In the last 20 years, mental health advocacy groups and legislators have made gains in bringing attention to the disparity between physical and mental health programs. However, diagnosis and treatment of mental illnesses continues to be less than optimal. Mental health disparities continue to exist in all areas of the world.
U.S. Public Health Service.(1999). The Surgeon General’s Report on Mental Health. Retrieved June,5,2000, from http://www.surgeongeneral.gov/library/mentalhealth/home.html
As such, it is relevant to review previous methods of needs assessments utilized with refugee populations. In many states, mental health screenings are not formally conducted during the resettlement process. In North Carolina, providers and resettlement agencies have been reluctant to administer mental health screenings because there are few - if any - mental health services available to refugees if a need were to be identified. Time constraints, costs, lack of available interpreters, and an inability to follow-up with newly arrived individuals also contribute to the scarcity of available screenings (Pathways to Wellness, 2011). A number of mental health screening tools have been developed to assess the magnitude of this gap in services for refugees but none have proved comprehensive yet brief enough to ascertain the immediate mental health needs of refugees (The New Mexico Refugee Symptoms Checklist-121; The Hopkins Symptom Checklist-25; The Posttraumatic Symptom Scale-Self Report). Most recently, however, the Pathways to Wellness Project (2011) developed the Refugee Health Screener – 15 (RHS-15) for refugee resettlement agencies and has conducted multiple studies to ensure its reliability and validity. Due to the brevity, cost-effectiveness, and reliability of this measure, the
The social problem we have chosen to address is the mental health status of refugees. Refugees are exposed to a significant amount of trauma due to fear, war, persecution, torture, and relocating. The mental health illnesses that can affect refugees due to exposure to traumas include post-traumatic stress disorder, depression, and anxiety. Research indicated that refugees relocating from war-torn countries are particularly vulnerable to mental health concerns because many have experienced early traumas and face further post-traumas after relocation (Cummings, et al., 2011). However, despite the prevalence of mental health issues concerning refugees, mental health needs often go unrecognized and untreated.
States obtain many services that fall under mental health care, and that treat the mentally ill population. These range from acute and long-term hospital treatment, to supportive housing. Other effective services utilized include crisis intervention teams, case management, Assertive Community Treatment programs, clinic services, and access to psychiatric medications (Honberg at al. 6). These services support the growing population of people living in the...
The Secretariat. (2011). Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level . ().
...ices and psychiatric treatment requires tailoring to the individual or community needs. Shouldn’t we facilitate other supportive modalities to fill in for the lack of validity and efficacy of the current diagnostic and therapeutic approaches? The United States is home to many immigrant groups and is a beacon for people seeking protection. As health providers in the United States, we have the privilege of working with diverse populations including asylees and refugees, offering and participating in the global health services on our soil, and trying to appropriately heal and address the well-being of people entrapped between cultures and systems. The United States welcomes thousands of refugees each year. This welcome can be extended and supported by expanding our cultural understanding and addressing of mental illnesses and psychosocial factors affecting their health.
Mental health patients are stigmatized, even in the most developed nations. Even in these developed nations there is often a lack in proper access and education for underprivileged populations. One way the burden of mental health issues can be measured in Disability Adjusted Life Years (DALY); one DALY is thought of as one year lost of “healthy” life. (WHO, 2016) The sum of these DALYs are described by the World Health Organization as being “The gap in the current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability.” (WHO, 2016)
Mental illness is a preventable and treatable illness that is experienced by a large number of people worldwide, but disproportionately affects people of color and individuals in poverty. Mental illness does not just affect those who are diagnosed with a mental illness but it also has an impact on those around the individual, including family and friends. However, the impact does not stop there; it affects all of society economically and potentially socially. An estimated 450 million people suffer from mental illness worldwide; as well as one in four people will experience one or more mental illnesses in their lifetime (World Health Organization, 2007). This means that a quarter (25%) of people in the world will have experienced mental illness at some point in their lives but may have recovered from their mental illness. In addition to that, the United States of America has the highest lifetime rate of mental health issues of any of the 17 industrialized countries, according to an epidemiological study done by the World Health Organization (WHO) (2007). Additional data shows that the United States has the second highest poverty rate out of 21 wealthy countries as well as having significantly high rates of income and wealth inequality, which is shown to be one of the highest risk factors for mental health problems (Shea & Shern, 2011, p. 5).
In the article Issues and Controversies says, "Throughout most of human history, people with mental illness were ostracized, isolated, and persecuted." ( Infobase,1) This belief system can give causation of mental illness in different cultures and such influences in a community will always be in a negative manner. Various societies struggle with the notion of mental health. The standards of every culture believe to be considered normal, natural, or healthy. These views lead to disagreements about the causes, diagnosis, and the treatment of the disorders. Many people with mental problems are discriminated against because of their mental disorder. Mental illness and stigma refers to the view of the person with mental illness as having undesirable traits. Stigma leads to negative behavior, stereotyping, and discriminatory behavior towards the person with mental health issues. This stigma causes the affected person to experience denial or shame of their condition. Perceived stigma can result in the patient being scared to seek help. Stigma can be divided into two perspectives, public and self stigma. Upadhyay says, "Public stigma occurs when the general
Over the last two decades, there have been numerous research studies that link mental health as the foundation for all health, social, organizational and educational recovery (Ormston, 2014; McLaren, Belling, Paul, Ford, Kramer, Weaver, Singh, 2013). The American society and the global world continues to witness catastrophic human induced incidences that often times point to the increasing need to pay attention to the declining state of a global mental health community. Evidence links the interconnectedness of the mind and body and attributes health and social problems direct linkage to inattention to mental health (Rubin, 2014). Despite medical, social and technological advances, we continue to lack understanding of the complexities of the human mind which has further alienated our understanding of ourselves.
World Health Organisation (2003). Advocacy for Mental Health. Retrieved on 3rd November 2013, from http://www.who.int/mental_health/resources/en/Advocacy.pdf
The role of the ICRC since its inception has gradually shifted from just being a body tasked with providing relief in times of humanitarian strife to one of a body of immense si...