Question

Write a short description of a person, couple, or family in crisis. Include the age, gender, ethnicity/race, marital status, and any other relevant descriptive information for the individual/partners/family members. Describe the presenting problem and the crisis event. Explain why this situation is considered a crisis. Discuss how ethnicity, race, gender, age, class, sexual orientation, or other diversity characteristics may affect the individual/couple/family and the crisis intervention. Provide an overview of the social problem that may be helpful to know in planning the assessment and intervention. For example, if this is a child abuse case or substance abuse case, provide a summary of the scope, indicators, and consequences to the victim/survivor and to the family. Design a specific crisis intervention based on the content in the assigned course readings. Write a conclusion to your intervention plan. What do you anticipate the outcome to be? Include at least two actions you plan to take to avoid personal burnout in working with this case.

Answer

Introduction

Background

The humanitarian situation in nations impacted by crises is at an all-time high, which is unprecedented. They are motivated mainly by the prolonged concerns in Congo, South Sudan, Syria, and Yemen, to name a few examples. This requires comprehensive response plans, massive quantities of money for humanitarian services, and a staff capable of delivering these services. The humanitarian workers in the Congo are often depicted in popular media as passionate, brave, and selfless individuals devoted to doing good (Houldey, 2017). Humanitarian work, on the other hand, is neither glamorous nor straightforward for the most part. Indeed, being stationed in crisis zones is a dangerous occupation that may have long-term negative consequences for the physical and emotional health of those who engage in humanitarian relief (Huang, Xing & Gamle, 2016). People who work in the humanitarian sector are increasingly exposed to chronic stress, traumatic incidents, and other potentially hazardous circumstances.

More than two hundred and sixty-five people have been killed or kidnapped since 2013 when the number of attacks on humanitarian workers peaked (Stoddard et al., 2019). Long working hours, uncertainty about the situation in the country, travel difficulties and seeing the suffering of people who are a cause of concern are just a few of the stressors that humanitarian workers have to deal with every day (Welton-Mitchell, 2013). Their sense of belonging may be jeopardized because they have limited access to social support networks on-site and do not have a permanent home. Personal life goals such as being in a committed relationship and having children are severely restricted by the work demands (Brymer et al., 2006). Furthermore, sexual assault is a problem that affects both professionals and those who are harmed. Cases of misbehavior have been recorded more often among the ranks of humanitarian groups (Einbinder, 2018). Organizations working in crisis zones are characterized by a "masculine culture" or "cowboy culture," another type of gender-based discrimination in the humanitarian industry. Consequently, there is a gender component to the dangers of humanitarian work that must be considered (Blake, 2017).

There has been an increase in the amount of attention that has been given to the mental health of humanitarian workers during the last few years. Many humanitarian workers are now speaking out about mental health problems and expressing their urgent need for help, even if they do it in an anonymous way, which has been more frequent in recent years (Strohmeier, 2018). Due to the sexual assault of Megan Norbert by a fellow aid worker while on a humanitarian mission in South Sudan in 2015, there has been an upsurge in debate among humanitarian workers about gender problems, especially around sexual violence and harassment in the field (Inter-Agency Standing Committee, 2006). The problem has been recognized, and organizations are becoming more conscious that employee stress and poor mental health are issues that harm the capacity of the company to function successfully and efficiently (Welton-Mitchell, 2013). On the other hand, organizational staff support is still often seen as insufficient and understaffed, especially in the public sector, in general.

Problem Statement

Humanitarian health workers working in conflict zones are prone to trauma due to exposure to hostile and dangerous environments, with short and long-term psychological effects. Since 2001, thousands of attacks against humanitarian and health workers and their patients have been reported. At least 114 humanitarian health workers and patients have died in these attacks due to shootings, bombings, threats, removal of equipment, and militarization of medical facilities (Wang et al., 2013). Victims also suffer in other acts such as physical and sexual assault, kidnappings, and invasions. In addition to the risks related to the conflict itself, aid workers work long hours where they often have to make life and death decisions about victims beside that the crisis itself puts them in a very fragile situation at the moral and ethical level when often the needs of their patients are not met due to the scarcity of existing aid and resources (Stoddard, Harmer & Czwarno, 2017). Thus, it is essential to reflect on the critical incidents to which humanitarian health workers are exposed, considering their impact on mental health, quality of life, and the performance of their functions

Research Question

This study aims to answer the research question: Can post-mission/deployment among humanitarian aid workers' depression, stress, and PTSD be reduced?

Literature Review

The humanitarian concept is founded on "acknowledging the inherent dignity and worth of an essential humanity that all individuals share" (Slim, 2015, p. 8). While the origins of the humanitarian gesture, which is fundamentally about relieving the pain of others, may be traced back hundreds of years, the humanitarian system as we know it today is a relatively recent creation. Humanitarian aid is receiving a large amount of attention, and for a good reason: the world's population is in desperate need of help, including essential services such as food and shelter, as well as water, sanitation, and hygiene (WASH). Protracted conflicts in Syria, Yemen, and South Sudan are incredibly motivating factors in this movement (Sandvic, 2019). A wide range of employment activities, including logistics, project management, and translation, is performed by humanitarian workers worldwide to meet these requirements and deliver needed aid (Bryce, 2001). Direct assaults, such as murders and kidnappings, are among the most apparent and severe stresses, particularly at field duty stations. Direct assaults on humanitarian workers are often seen as traumatic incidents by those on the receiving end of them (Curling & Simmons, 2010). Furthermore, stresses were evaluated in several quantitative research on humanitarian workers' mental health, although this time via predetermined lists.

Anxiety disorders are a sort of mental health issue that affects the nervous system. Anxiety makes it harder to function normally during the day. The symptoms of anxiety include nervousness, panic, terror, and a fast pulse. Medication and cognitive behavioral therapy are two options for treatment. The healthcare provider may create a treatment plan that is tailored to your specific needs. On the other hand, post-traumatic stress disorder (PTSD) is a mental health condition that may develop when a scary incident occurs, either personally or via watching it. The most common symptoms of PTSD include uncontrolled thoughts about the incident, flashbacks, and nightmares. Most humanitarian workers who experience traumatic situations have temporary difficulties adapting and coping, but with time and adequate self-care, they will generally recover and move forward.

Mental illness may have severe implications for humanitarian workers' personal and professional lives if not properly treated. PTSD has long-term consequences for people's health and well-being, including higher marital instability and unemployment (Brunello et al., 2001). Workers who are "stressed out" are more likely to have an accident or sickness, miss more work, and seek medical attention more often. They are also less productive and efficient in their jobs (Antares Foundation, 2012). In addition to affecting individuals, workplace trauma may have ripple effects across a whole company (Dunkley, 2018, p. 62). Providing services to improve employee well-being and create a healthy, productive workforce is a critical part of avoiding and treating mental health issues among humanitarian workers, in addition to engaging in regular self-care.

One of the strategies for reducing post-deployment stress and PSTD is Psychological debriefing treatments. These interventions are intended to educate victims about typical reactions to trauma and encourage them to disclose their experiences and emotional responses to the incident. Debriefing is often provided in a single session within hours or days following an occurrence to anybody who has been exposed to it. CISD is the most popular kind of psychological debriefing, although various varieties of these single-session therapies have been studied. Individuals who are indirectly exposed to traumatic situations due to their employment, such as firemen or emergency medical staff, might benefit from CISD. Individuals acquainted with the organization and mental health experts conduct CISD in a single 3-4-hour session (Connorton, Perry, Hemenway & Miller, 2012). CISM also includes a family support component, in which family members of emergency workers are debriefed on the incident. There are also different protocols in place for sending individuals to get psychological therapy.

While working in crises, some humanitarian workers can manage their lives effectively and avoid developing symptoms of mental illness. Some people seem to flourish under these conditions (McKay, 2011). Individuals who have post-traumatic stress disorder (PTSD), depression, anxiety, burnout, or hazardous alcohol use may develop chronic mental health issues due to their physical problems and difficulties, in addition to physical problems and challenges. Psychological ill-health does strike humanitarian workers regularly. The prevalence rates of common mental health problems within this professional group are typically similar to or higher than those of reference groups cited in the literature (Eriksson et al., 2013). The gender dimensions of humanitarian work in general, and the mental health of humanitarian workers in particular, have, on the other hand, not been adequately addressed in this corpus of study or the broader literature on humanitarianism, which is a significant limitation (Strohmeier & Scholte, 2015).

Methodology

A qualitative analytical approach was used to perform this study. A descriptive study approach was necessary to determine the extent of dangers and difficulties faced by assistance workers to understand their mental health better. To begin, researchers used secondary materials to build a basic understanding of all the mental health hazards that may arise from working in humanitarian relief. Independent researchers and humanitarian assistance groups interested in learning more about their work's mental dangers and repercussions performed secondary research, which was used to supplement the primary analysis. They increased the findings of these studies with more in-depth descriptions of mental health issues and organizational standards from the Antares Foundation, CHS Alliance, and suggestions of the Inter-Agency Standing Committee. The most effective methods to fight mental health problems and risks must first be recognized to delve into the intricacies of international and national assistance workers' emotional well-being.

Secondary research papers were able to offer people and organizations applicable management theories for mental health problems. Organizations specializing in humanitarian management and mental health needs were also capable of providing essential resources for evaluating these management theories and making recommendations on how best to turn them into appropriate organizational policies. Humanitarian organizations' current mental health practices were studied using primary and secondary sources. An in-depth look at the working procedures of large humanitarian organizations such as the ICRC and MSF was gained via interviews with humanitarian and field experts. In contrast, we were unable to get in touch with any other humanitarian groups to conduct interviews. Therefore, data from their psychological support papers for employees was used to learn about their organizational procedures. Using a wide range of primary and secondary materials, an in-depth study of the research topic was conducted on international and national assistance workers.

Results and Analysis

The study found that the post-mission/deployment among humanitarian aid workers' depression can be reduced. An impartial evaluation of the prevalence of health issues among international humanitarian assistance workers - a specific category of aid workers' humanitarian missions is very stressful (Kahn, 2018). Besides organizational and environmental stressors, three-fourths of humanitarian workers reported assignment-related exposure to PTE. The number of field-related (environmental, cultural, and corporate) stressors reported by men and women was comparable, but the types of stressors differed. Female humanitarian assistance workers are more likely to come out for sexual assault and other unpleasant encounters (Sijbrandij et al., 2017). They are also more likely to witness sexual harassment and violence directed at their male counterparts.

The study also found that women were also more likely than males to report stress from interpersonal relationships. Due to a lack of technical assistance, management issues, and team composition. This may be because men and women communicate and handle conflict in different ways. Generally, men are more competitive (dominating) and less concerned with others than females when resolving disputes at work (Rahim and Katz, 2019). The fact that women are more likely to express emotions of helplessness and despair may be explained by this.

The capacity to self-manage and adapt in the face of emotional, physical, and social difficulties may be described as being healthy (Huber et al., 2011). Based on average sample scores with almost modest impact sizes, very few unfavorable pre-to-post-assignment health changes could be identified. After the assignment, people's mental health, social functioning, and overall well-being decreased. Improvement in any adverse health changes after humanitarian workers' return is an indication of their recovery. Secondly, humanitarians have reported better-than-expected health outcomes from before to after their assignments. Their levels of anxiousness have dropped considerably, in particular. This may result from the measurement's timeliness, a general feeling of pleasure with the task, or a combination of the two (Kim et al., 2017). Humanitarian work's intrinsic rewards and the possibility of a reunion with loved ones may have reduced anxiety experienced after assignment.

 The research showed that humanitarian workers' health is positively affected by these risk variables, contrary to previous studies that showed the opposite (Gritti, 2015). Predictive risk variables had only a modest post-assignment impact size. There may be a lack of power to detect small-magnitude effects because of attrition in the T3 trial, which is why there was no significance at follow-up. The results summarized above show that humanitarian workers, short-term emergency assistance workers, can remain healthy and cope with the high levels of stress they face on the job.

Discussion

Although the list above is biased toward the job description of UN aid workers, it is nevertheless representative of the challenges that all humanitarian workers face. The dangers to the mental health of humanitarian assistance workers working in the field are dual and complicated. Mental hazards are difficult to evaluate since everyone's predisposition to these risks is unique. The work in the region is, on the one hand, arduous, and no one is willing to put up with it. However, the rewards are substantial. Cardozo et al. (2012) observed the same trends in mental health risks as their predecessors, but they also revealed that those with a previous history of mental health hazards were at a higher risk of mental illness.

Humanitarian work is challenging because aid workers are under pressure to provide perfect outcomes in an unpredictable environment. The fact that aid workers' efforts are not always adequate to alleviate the problems in the communities in which they serve makes this a dangerous combination (Hom et al., 2017). Because aid workers interact with their communities daily, the paradigm of fieldwork allows them to see the effects of these deficiencies up close and personal. As a result, moderate stresses such as those described above may quickly become aggravated and escalate into something more serious. Stresses that occur daily may frequently build into chronic stressors that might develop into a mental health condition (Schnyder et al., 2016).

The growing prevalence of danger in different humanitarian contexts is the other side of the coin regarding the mental health concerns associated with humanitarian work. Unfortunately, 1998 was the first year in which more UN humanitarian workers were murdered than peacekeeping troops. In 2000, it was discovered that there were 375 recorded fatalities in the humanitarian sector, with 69 percent of them being caused by violence and 17 percent being caused by motor vehicles (De Jong et al., 2021). Researchers from New York University and other institutions have discovered a hitherto unreported level of violence against humanitarian assistance workers. When assistance workers are exposed to acute traumatic stresses, they may suffer a range of symptoms that can impact their physical and emotional well-being and adversely alter their actions, among other things (Connorton et al., 2012). Overtiredness, diarrhea, constipation, and headaches are some of the physical symptoms. Anxiety, frustration, and poor focus are some of the emotional symptoms. Besides, increased alcohol, caffeine, narcotics, cigarettes, and addictions are examples of harmful behavioral changes.

While individual coping strategies are essential in managing stresses and treating mental health problems, organizations are nonetheless accountable for the general well-being of their workers.  Humanitarian organizations must be willing to make resources and tools available to their employees (Young, Pakenham & Norwood, 2018). This is referred to as 'staff care' in many companies. The provision of mental health services within humanitarian organizations may fall within the jurisdiction of the human resources department and the legal department of the organization. MHPSS, also known as psychosocial and mental health support services, is a term that human resource departments often refer to as assistance. In the legal field, it is referred to as the "obligation of reasonable care"(Williamson 2017). Because its execution is complicated and requires the cooperation of many corporate sectors, organizations have given this practice of caring for their workers various titles.

Conclusion

The study concluded that reducing post-deployment depression, stress, and PTSD in humanitarian workers is possible. Helping workers with mental health support and treatment is complicated because of the variety of mental health disorders and dangers they face. Acute traumatic stresses and the everyday high-stress environment of the workplace may pose mental health concerns. However, assistance workers do not have to be exposed to these stresses regularly to develop a mental illness. Aid workers' coping strategies for dealing with acute traumatic stresses and their associated symptoms reveal whether or not they are at risk for developing mental health problems. Clinical depression, anxiety, burnout, and post-traumatic stress disorder (PTSD) are more prevalent among assistance workers who use negative coping strategies and have weak social support. Furthermore, relief workers who suffer from post-traumatic syndrome may not always need to have experienced direct trauma. They may also suffer from the same side effects as those exposed to secondary trauma due to their job in the community. Humanitarian assistance workers and organizations share responsibilities for finding a solution to the mental health problem.

Organizations should have holistic practices and policies that encourage a culture of well-being and request assistance among humanitarian aid workers before benefiting from the support. International assistance workers have different mental health needs than their national counterparts, and this study sought to explore how these disparities might be compensated for. However, it was also concerned with the long-term sustainability of humanitarian work. Humanitarian assistance workers have a strong will to keep going no matter what happens to them. Humanitarian assistance workers can face any circumstance and survive if they have all the resources and equipment they need, as well as an accessible and supportive social network.