AJ Jones (DEP 2017-18) writes:
“I’ve
had many discussions with fellow aid workers who really feel this humanitarian
response has not been very humanitarian to them” – Participant F
This
needs to change. But most organisations have been slow to respond to their
staffs’ mental health needs despite the fact that everything we do for our
beneficiaries is planned, monitored and evaluated through a psychosocial lens.
Why is this, and why are we failing to care for our aid workers’ mental health?
To
answer this I conducted an exploratory study into the mental health culture
within some aid organisations by interviewing a range of aid staff. The study’s
participants either worked, or had worked, for agencies in conflict and
non-conflict settings all over the world, in a field or office-based role.
Their responsibilities ranged from delivery level volunteer to country
director. My research found that unhelpful donor and management attitudes were
significant contributors in creating a poor mental health culture in most
organisations, and that this culture acted as a powerful barrier to staff
seeking help.
The problems with
poor donor and management attitudes
“One of the hindering points for having staff
mental health services… is that they [the donors and management] focus on the beneficiaries overlooking the
needs of the staff” – Participant A
In
most aid agencies I observed a poor mental health culture. Specifically, I
found that managers and donors had little-to-no understanding, or awareness, of
mental health issues and their impacts on staff, and in most agencies I found a
complete absence of any support or services for aid workers at all, especially
among national staff and volunteers. Moreover, I found that most staff felt
replaceable and this generated fears of discrimination in their roles or
careers if they divulged a mental health issue. And in some aid agencies I
found a worrying lack of mental health awareness in general, alongside the
absence of any published information or studies about aid worker mental health
to help inform and raise awareness.
Poor
donor and management attitudes towards mental health were largely to blame for
creating this culture. Many donors and managers either did not know enough
about aid worker mental health to tackle it effectively, or had not considered
it an area that needs addressing, or were not incentivised or interested in
confronting it – this was especially the case in the Middle East where mental
health is still widely perceived as a Western construct.
But it’s not all
bad…
“My employers are very understanding… we have
a very good director… he knows how to put our needs first” – Participant A
I was
pleasantly surprised to see a positive culture in some organisations, and where
staff mental health care is taken seriously it can have positive effects. When
managers were supportive, understanding and proactive in addressing staff
mental health care I observed positive outcomes. This ranged from informal and
formal team bonding, to beliefs that aid work can be a positive experience, to reports
of personal growth and recovery after suffering from a mental health illness.
Some consequences of this positive culture were that services and support were
made available, which staff could, and did, access; employees were more productive
and loyal; and staff felt valued and rewarded for their hard work. This should,
logically speaking, improve the organisation’s performance.
However,
a positive mental health culture appears to be the exception rather than the
rule, and this needs to change. If we want the aid we deliver is to be as
effective as possible then we need to be doing more to address aid workers’
mental health. This starts with rigorous research informing positive action.
There is an urgent
need for further research
First,
we need to better understand why some donors and managers hold these attitudes
towards staff mental health care. Second, we need to understand in what ways staff
mental health care initiatives impact on overall organisational performance.
Third, we need to conduct a larger longitudinal study. This research would
provide valuable academic contributions to the wider debate on aid staff mental
health, and raise awareness across all levels to help deconstruct poor mental
health cultures across the sector.
We cannot continue
as we are
It is no
longer enough for organisations to have policies and services in place to react
to disorders as they emerge; donors and managers need to create and maintain a
proactive mental health environment in which mental health issues are
understood and taken seriously by everyone, and help seeking is encouraged.
This means fundamentally changing how some donors and managers understand and
respond to staff mental health care, and this needs to happen soon. We cannot
continue as we are, otherwise our beneficiaries, the aid we deliver, and the
people who deliver it will all suffer a great deal more.
