The global mental health (GMH) professionals respond to various humanitarian crises. Settings determine the specific role of the GMH provider, priorities of interventions, and the best practices. This and next chapters review ground assumptions and principles for the interventional strategies as they apply to the disaster response and support for refugees at the places of resettlement and in the refugee camps. The disaster’s impact on MH varies based on whether it is a natural disaster, terrorist attack, or epidemic. However, the overall disaster response assumes that most people will be able to cope with some support. In addition to the expected trauma symptoms, MH reactions to disasters involve aggregation, a psychological phenomenon when collective trauma experiences create a shared mental space that enables survivors to empathize and support each other. When working with refugees in host communities or refugee camps, GMH providers must be aware that some people continue being marginalized even after fleeing and be prepared to support survivors of sexual and gender-based violence. The severity of refugee trauma, anti-immigrant sentiments, prejudices, and discrimination increase their vulnerability. The following chapter further elaborates on the prioritized needs and the contextually appropriately interventions in political emergencies.

Contextual challenges and the extreme vulnerability of the service recipients in dire need of assistance elevate the importance of specialized professional and multidisciplinary competencies in GMH. This chapter discusses specialized GMH competencies and drafts the path to professionalization of this sector. The proposed curriculum consists of four blocks of systematically organized and interconnected training modules and courses where multidisciplinary GMH professionals can enter at any level based on their primary discipline and goals. The curriculum suggests coursework and additional training that are most helpful for acquiring the GMH specialization as a specialization. The licensing or certification boards predetermine the core courses that are mandatory for any MH profession. The elective courses consistent with nature of GMH work can be multicultural counseling and refugee MH, crisis intervention, trauma-specific interventions, and group dynamics, which assist with understanding the collective reactions to trauma. In a supervised practice, the MH providers can choose a placement that will help them acquire experience and skills that later will be helpful in humanitarian work, e.g., MH providers working with refugees will learn to provide counseling to culturally diverse people who don’t speak English. Continuing education and volunteering with NGOs allow prospective GMH providers to gain insight into humanitarian systems and ethics and learn skills for professional self-reliance.

The Introduction explains why a response to humanitarian emergencies requires specialized humanitarian competencies. It sets the book’s goals and objectives, outlines the target audience and establishes the internal logic, establishes the flow, and specifies the target audience. When responding to humanitarian crises internationally, the mental health (MH) professionals become a part join the international, interdisciplinary, and cross-sectional humanitarian relief efforts. The Introduction outlines the book’s framework, which is global mental health (GMH). The book’s goal is to support GMH providers in their work, provide practical guidelines, and establish the integrity of the decision-making process in the humanitarian situation. It is different from prescribing rigid protocols, which can be counterproductive in unpredictable, volatile, and uncertain contexts of humanitarian emergencies. Introduction delineates the book’s core concepts, defines humanitarian competencies and substantiates the importance of specialized expertise for the GMH responders to humanitarian emergencies. The components of humanitarian competencies set the book’s structure that includes understanding of how humanitarian context shapes MH needs and creates special challenges for interventions. Other components are the knowledge of humanitarian systems and the accountability expectations from GMH providers when serving the most vulnerable people under the direst circumstances.

The chapter examines guidance and regulations for global mental health (GMH) practice that are coming from different sources because of the multidisciplinary and collaborative nature of this work. For a mental health (MH) professional, the primary guidance comes from the professional code of ethics, which is necessary but may not be sufficient for navigating unprecedented and complex humanitarian situations. As a humanitarian actor, the GMH is committed to the core humanitarian values of humanity, neutrality, impartiality, and independence. Humanitarian principles provide aspirational guidance and offer directionality in an uncertainty, but they are poorly translated into operations and can produce moral dilemmas such as when remaining neutral during a conflict. Supplementary principles are designed to protect vulnerable people from all forms of abuse and exploitation by humanitarian aid workers. The second set of guidance comes from the Humanitarian Code of Conduct. It ensures professional and personal integrity and enforces the standards of professional behavior in humanitarian space. The operational model and guidance outlined in the IASC guidelines provide practical recommendations for conducting psychosocial services to the populations affected by humanitarian emergencies. The exercises offer the opportunity to practice applying aspirational and operational guidance when designing ethical MH and psychosocial interventions.

Humanitarian agencies aid millions of people in need, and global mental health (GMH) professionals play an increasingly important role in supporting and advancing the humanitarian agenda. When responding to humanitarian crises, mental health (MH) providers join a larger system of multidisciplinary humanitarian action united by a common goal of saving lives and alleviating suffering. In contrast to individual and spontaneous acts of kindness, humanitarian work is an organized and coordinated helping activity that brings together international and local organizations and actors. The chapter offers insight into the evolutionary, spiritual, and cultural roots of helping behavior. It orients MH professionals to the history, theory, and practice of humanitarianism, as well as the contemporary trends and challenges that humanitarian action faces. Over the past several decades, the humanitarian sector has grown, diversified, and become an industry striding toward improving the effectiveness of aid delivery, and increasing professionalization and accountability. Concerns over the well-being of aid workers, controversies surrounding military humanitarians, and the politicization and misuse of humanitarian aid demonstrate the complexity of the changing humanitarian landscape. Amid reports of unethical practices committed by international aid workers, the international humanitarian community developed regulations and asserted commitment to humanitarian principles, professional integrity, and ethical standards.

Humanitarian settings impose high expectations on the integrity of the GMH actions because the price of ethical indiscretions can be very high, increasing risks for the aid workers and recipients possibly leading to suspension of aid. In humanitarian settings, the code of conduct governs behavior, while morality is a prerogative of the norms imposed by society and personal convictions. Humanitarian ethics typically refer to navigating intractable dilemmas and establishing a frame of reference for practice and professional interactions consistent with professional and humanitarian values. Dilemmas in humanitarian situations often have no good solutions, and their negotiation can be emotionally and morally draining. Ethics offer professional grounding, set expectations, and guide GMH professionals through complex decision-making in ambiguous situations when one cannot decide which professional value is more professional and which moral value is more moral. The chapter offers examples and analyses of ethically questionable practices, such as trauma tourism and the White Savior Complex. It proposes two protocols for negotiating intractable ethical and moral dilemmas and provides case studies to practice using them.

If previous chapter discussed the impact of the disasters caused by acts of nature, this chapter focuses on the MH impact of humanitarian crises exacerbated by political dysfunction and political violence. Examples are fragile or failed states, wars, genocides, and complex political contexts (CPCs) or dictatorships. The war trauma has been comparatively well studied, and there are evidence-based interventions for survivors of different ages and cultures. GMH providers, however, must be aware of the special needs of the survivors of war rape, child soldiers, and former combatants whose community is not always able or willing to support them. In genocides and CPCs, the deliberate victimization is based on religious, racial, ethnic, or gender identity which creates a long-lasting, often transgenerational impact. Political violence is associated with severe trauma and moral injury. This experience alters social cognitions and solidifies social fears and distrust, leading to reluctance to disclose their experience and seek, accept, and offer support to others and inhibits aggregation or sharing the experience and accessing community supports. MH professionals servicing people from countries with CPCs must be aware of how this experience affects survivors’ help-seeking behavior and shapes the attitudes toward health and MH providers who may be perceived as a part of the establishment.

Wars, disasters, famines, and other humanitarian emergencies expose people to extreme stress and trauma and create massive and pressing humanitarian and mental health (MH) needs. This chapter examines the immediate and long-term impact of a humanitarian crisis on MH and identifies systemic issues affecting access to resources, functioning, and coping. MH has been recognized as a global priority because of its decisive impact on health, well-being, functioning, and coping of people affected by humanitarian emergencies. In addition to being a factor of survival, MH becomes a matter of public health and human rights and plays a key role in improving access to health care, reducing global burden of burden, preventing future violence, and strengthening resilience in the face of adversity. Other factors ensuring survival. The global perspective has challenged assumptions of centrality and universality of some concepts in Western MH. The shift from pathologizing reactions to adversity to focusing on overcoming, resilience, and supporting coping has been particularly noticeable in global work and trauma studies. Common misconceptions about MH and trauma in humanitarian emergencies illustrate the importance of understanding the context of humanitarian work.

The desire to help will always find the way. Working with an established humanitarian agency is just one way to put ideals into practice. Another option is to launch a humanitarian project reflecting the founders’ interests, values, and mission. Such a project would allow providers to apply their expertise and skills most effectively, but there are many essential components that must be carefully considered. This chapter is designed as a walk-through, an exercise that encourages readers to think like a humanitarian about what makes a successful and ethical GMH project. This chapter explores different forms of individual involvement and examines its advantages and problematic aspects. Examples of “do-it-yourself” aid when providers work in self-initiated projects are voluntourism, MONGOs (“My Own NGOs”), and GINGOs (“Grassroots NGOs”). Understanding what starting and managing a GMH project entails allows readers to develop an appreciation, explore different choices, and gain a better insight into how humanitarian sector and other NGOs operate. After learning about specifics of the needs assessment, programming, fundraising, and quality assurance in humanitarian work, the readers can use this knowledge to practice the development of an ethical and effective GMH-centered or integrated project.

This chapter serves a dual purpose. It prepares GMH professionals to support the humanitarian aid workers and organize peer support. The materials also offer knowledge and skills that can be used for their own burnout management, self-awareness, and self-care. Responding to humanitarian emergencies can take a heavy psychological toll on humanitarian aid and MH responders. Exposure to mass trauma and suffering and making difficult moral decisions under duress may increase risk for the burnout. Resultant alterations in the perceived value of life may result in taking excessive risks and displaying unsafe behaviors. The rising rates of violence against aid workers underscore the safety imperative, which means prioritizing safety for self and people who receive services. Recognizing and managing cognitive aberrations, such as countertransference and professional fantasies (i.e., “rescuer,”; “superman,” and the “helper’s” fantasy), help to prevent or manage burnout. Self-awareness allows providers to timely recognize their own need for self-care and reach out for support during field work or after returning home. Readjustment back to routine life may be psychologically challenging and takes time. Stress of readjustment can worsen the MH and even result in the loss of relationships or the job. Being prepared can help manage stress and MH issues during the post-mission readjustment.

The chapter analyzes professional, contextual, and multicultural challenges that global mental health (GMH) professionals encounter when working in a humanitarian situation. The unreadiness of the highly regulated and siloed mental health (MH) profession to step outside the comfort zone is compounded by the scarcity of GMH-appropriate concepts, assessments, and interventions, leaving GMH providers with little choice to rely on obsolete or irrelevant tools and protocols. Establishing collaborative models and integrated approaches have demonstrated higher effectiveness but highlighted conflicted professional priorities, i.e., clinical vs public health approaches, or prioritizing immediate (i.e., humanitarian relief) vs long-term needs (i.e., development). The context-related challenges of humanitarian work involve managing complex and unpredictable situations, a hardly available referral system, and limited access to professional support. The need to consider security risks and the power differential elevates the significance of humanitarian expertise and ethics. In the fieldwork, the multicultural challenges go far beyond the cultural differences between the service providers and the service recipients. The challenges also involve working in multicultural, multinational teams and navigating the environment of different professional cultures. Familiarity with humanitarian culture and its etiquette can improve communication, establish productive collaborations, and reduce misunderstandings.

This chapter outlines practical steps for GMH volunteers who want to explore employment opportunities in the humanitarian sector and gain good fieldwork experience. In the humanitarian sector, volunteers undergo the formal hiring process, which involves rigorous expertise, skills, credential verification, and background checks. This is because the deploying agencies carry responsibility for the workers they deploy, and any problematic actions will bear on the agency’s reputation. The hiring process for GMH volunteers can be very competitive, and knowing the eligibility criteria, understanding the hiring process, and preparing for what to expect during a job improves these odds. The steps include reflecting on motivation, researching availability and applying for open positions, selecting the deploying agency, analyzing advantages and disadvantages of working with the large international corporations and the small or local NGOs, and making sure that the humanitarian agency shares the providers’ mission and ground values. With multiple opportunities existing, joining a humanitarian sector also means exploring personal motivation for the deployment and professional interests, and identifying an agency with best capacity to meet the expectations. The exercises allow us to explore personal and professional motivation and gain insight into how this motivation affects work choices and, possibly, the decision-making in the field.

The whole history of global mental health (GMH) work demonstrates how an informal initiative of global-minded mental health (MH) professionals can become a recognized and essential part of the international humanitarian relief system. The chapter defines GMH as a multidisciplinary field of studies and practice with a dual professional identity as MH and humanitarian discipline concerned with providing MH assistance in humanitarian emergencies. Typically, such work takes place in an international setting, but it can also include care for refugees at the locations of their resettlement. In addition to research and direct services, GMH providers conduct research and participate in advocacy and policymaking. GMH providers use their professional skills to serve vulnerable and underserved groups and prioritize integrated approaches (MHPSS and primary care) and community-based interventions. The interventions concentrate on meeting populations’ immediate needs and incorporating long-term agenda. It prioritizes improving coping and functioning and addresses barriers preventing people from accessing resources, available support, and offering a higher level of health care when needed. The chapter reviews important concepts in GMH, emerging trends, and controversies and outlines future directions. It discusses pervasive professional mythology, such as a myth of incapable, passive, helpless, and humble victims.

Grounded in extensive research, the content of this chapter results from a thorough, rigorous, and methodological qualitative data analysis. It serves as a foundational piece, offering insights for taking full advantage of the strategy presented in the last part of the book. It centers around the proposition that the essence of the emergency management and humanitarian space is intricately tied to the relationships among its inhabitants. It posits that how individuals define this space is inherently connected to the meanings they attribute to one another. Utilizing the Institutional Logics theoretical framework, which contends that fundamental institutions shape cognitive processes, the chapter explores how guiding principles, practices, and symbols influence individuals’ perceptions and decision-making. A primary theoretical contribution is that it extends the typology outlined by (Friedland R, Alford RR (1991) Bringing society back in: symbols, practices, and institutional contradictions. In: Powell WW, DiMaggio PJ (eds) The new institutionalism in organizational analysis. University of Chicago Press, Chicago, pp 232–263) and introduces the “relational logic” as a distinct and identifiable macro-level ordering principle governing human relations, with its own inherent values and attitudes. As such, it is an elemental part of an interinstitutional system. Within this framework, it introduces “humanitarian logic” as one of its potential manifestations, defined as the “intrinsic drive to assist those who would otherwise suffer significantly.” It also analyzes the impact of humanitarian logic at the level of society, organizations, and individuals as three nested levels. On the societal level, it studies how humanitarians define the contours and nature of the humanitarian space. At the level of the organization, the focus is on post-disaster needs assessments and fundraising, as two conflicting management demands. At the individual level, the focus is on how each humanitarian applies institutional logics to build a belief system that helps them understand the nature of their work and the meaning of humanitarian work as a whole.

The overwhelming increase in disasters and humanitarian crises is affecting the fabric of human interaction worldwide. The social contract describes an implicit agreement wherein individuals surrender certain liberties to safeguard their natural rights and preserve societal order. The stability necessary for social actors to reach such an agreement is rapidly evaporating, and the negotiations to reach a consensus about the type of society we want to live in do not follow a stable pattern anymore. From the pervasive uncertainty and stress emerges a pressing need for heightened collective consciousness and collaboration among governmental bodies, civil society, and businesses. The opening section delves into the global response to escalating uncertainty and chaos, highlighting the pivotal role of the social contract. It underscores the contemporary trend toward bolstering resilience in the face of mounting disasters and crises. The chapter then introduces the theories of “convergence” developed by Fritz and Mathewson in 1957 and “emergence” developed by Dynes in 1970. These are two complementary theories conceived by disaster scientists to describe the influence of the social contract. Together, they explain post-disaster human behavior within a community and the mobilization of external actors toward affected communities. I use them to explain the materialization of the new social contract that demands the enhancement of systems to safeguard humankind and the environment and investment in disaster risk reduction (DRR). These interconnected systems and sub-systems, such as emergency management and humanitarian action, are shaped fundamentally by the convergence of value systems that wield profound influence over the trajectory of businesses.

This chapter presents essential guidance for companies seeking to adapt to the evolving landscape of uncertainty and change. It delineates four goals intricately linked to the transformative shifts required within corporate environments discussed in the previous chapter. Firstly, it underscores the imperative of cultivating adaptability within the company culture, emphasizing the integration of new information into strategic frameworks and fostering meaningful connections with diverse stakeholders. This cultural metamorphosis, ingrained at all organizational levels, equips companies to adeptly navigate unforeseen challenges inherent in disaster scenarios. The subsequent section illuminates the intricate terrain of navigating emotionally charged landscapes within companies, emphasizing the importance of swiftly assessing and responding to the human element. By focusing on the individual impacts of disasters, rather than their generalized effects, companies can better weather storms and emerge resilient. Lastly, the chapter delves into the quintessential theme of leadership, asserting that achieving the aforementioned goals hinges upon professionals’ authentic connection with diverse community logics and emergency management systems. Central to this discourse is the concept of “the New Pact,” reflecting the growing empowerment of marginalized masses demanding approaches tailored to their needs and identities.

Recently, uncertainty and fear have permeated daily life due to the escalating frequency of disasters and humanitarian crises, profoundly impacting perceptions and decision-making. Consumers worldwide are changing spending patterns, suppliers are trying to keep up with evolving supply chain disruptions and market conditions, and governments are struggling to live up to societal expectations. In response, the world is trying to enhance systems to protect human life and the environment. Emergency management and humanitarian action are the most impactful of these systems, and contrary to what happened in the recent past, they are no longer of exclusive participation of technical experts and policymakers but of all. Corporate leaders have no other alternative but to adapt to this new societal landscape, where pervasive anxiety affects how humans relate and dictates global expectations. The only way possible is not to improve management systems or hire more technical experts but to adapt rapidly to the ever-evolving cognitive processes that affect human thinking and interaction. Hence, the chapter applies institutional logics as Friedland and Alford proposed in 1991 to elucidate how distinct sets of principles, practices, and symbols in each institution serve as cognitive frameworks for interpretation and collective understanding of possibilities and constraints in a time plagued with uncertainty. Finally, the chapter explains how institutional logics operate across three nested levels of analysis—individuals, organizations, and society—providing a comprehensive understanding of their pervasive influence on people’s behaviors.

The central goal of the chapter is to provide theoretical arguments to explain why private companies must learn not only to operate in environments prone to disruption but to do it while increasing business volume. It highlights the benefits of engaging the emergency management and humanitarian systems, including becoming pillars of support and resilience within their communities, fostering loyal customer bases, and contributing to the community’s overall well-being. The core principle is that doing so requires introspection and foresight, complete adherence to ethical business practices, and consideration of the broader societal implications of decisions and operations. The chapter responds why institutional theory, analyzed in the previous chapters, holds importance to this end? It does it by explaining how crises and disasters are altering social behavior. It explains that in response to the heightened alertness, cognitive confusion, and the pressing need for action, global society is adapting and there is now a vast movement worldwide of people coming together into new and existing spaces whose primary goal is to contribute to humanity. Their relations within these systems which I have grouped under the term Risk Reduction Driven Systems (RRDR) are subject to logics in tension and to value systems and social expectations that are permanently changing due to increased uncertainty and chaos. The chapter ends with an important note. It explains that these systems to protect the most vulnerable are deficient due to distorted incentives generated by the fact that the recipients of service are not the ones funding their operations.

In a world suffering increasing disasters and humanitarian crises, corporate leaders must stay informed and proactive, anticipating the seismic shifts reverberating across industries, economies, and societies. However, the private sector is notably poorly qualified to confront these challenges. Probably, the most important reason is the lack of knowledge on how disasters and global challenges disrupt societies, including consumer behavior and the nature of the many systems and subsystems that exist to enhance societal resilience, reduce disaster risk, and protect the lives of people, their well-being, and the world we live in. These challenges are often familiar to us, yet their full magnitude may elude our awareness due to their dispersed nature. My intention was to weave together personal anecdotes, stories of individuals I know, and well-known facts to present a friendly, easily digestible, and concise overview of the dire landscape ahead of us. This chapter underscores the urgency for corporate leaders to understand the impending uncertainty and serves as a comprehensive exploration of the current state of our world, offering insights into the characteristics of the near and distant future. It is designed as an indispensable resource for corporate leaders, guiding them in formulating effective strategies and navigating the profound uncertainties and chaos that lie ahead.

This chapter presents a compelling argument: in today’s tumultuous landscape, companies must adapt or risk becoming obsolete. Central to this adaptation is a profound respect for individuality—a recognition that amidst chaos, people crave personal connection and understanding. The chapter outlines four essential practices to thrive in this environment. Firstly, it advocates for a balanced approach, combining data analysis with qualitative methods to uncover the nuances of individual needs and desires. Secondly, it emphasizes the interconnectedness of global events and the necessity of a broad, vigilant mindset to anticipate and mitigate disruptions. The third practice underscores the importance of integrating with local emergency and humanitarian systems, recognizing the mutual benefits of collaboration and support. Lastly, it highlights the immense value of investing in initiatives that prioritize disaster risk reduction, offering both societal impact and long-term returns. By embracing these practices, companies can not only navigate the chaos of today’s world but also foster resilience, innovation, and meaningful contributions to the well-being of humanity.

This initial chapter is intended to introduce the reader to the main topics covered in the manuscript and prepare you for what you can expect. Acknowledging the qualitative nature of this book, I believe it’s important to offer a more personal insight into who I am. While the initial section of this chapter may not directly align with the book’s core ideas, it serves a crucial purpose for readers questioning: Why should I heed Diego’s insights and advice? The subsequent section provides a brief overview of a key premise in the book, asserting that private companies must take a more proactive role in disaster risk reduction efforts, highlighting the potential for such engagement to enhance market share. It also underscores the significance of fostering strong relationships with various stakeholders within emergency management and humanitarian systems to achieve this objective. Following this, the chapter unfolds into three sections: firstly, an exploration of the indirect objectives of the book; secondly, a guide on how the book is intended to be navigated; and finally, abstracts for each chapter to outline the structure and flow of ideas presented.

You would be mistaken if you think there is nothing wrong with humanitarian action. The values that drive its individual members are essentially good. Its ultimate goal is also good. There is no doubt about that. But believe me when I say that the noxious effects of humanitarian and post-disaster response are way more significant and pervasive than you would expect.

Someone could argue that societies differ from one another because of the weird caprice of destiny, far from it. Societies result from the interactions and exchange among the members of the eco-social systems across time. The collective conscience that springs from these interactions determine available disaster response coping strategies. The values that inform that collective conscience remains fairly unaltered when you find yourself surrounded by your community members, people you love, and others you know well. When you have in your proximity, instead, tons of people that are unfamiliar to you and whose intentions and reasons for being there are unknown, the value system changes. This is what happens amid a post-disaster context filled with external convergers. This means that societal coping strategies are only appropriate and efficient as long as the value system remains impervious to unwanted foreign elements.