MHPSS Harmonized Training Module 124554

Harmonized Mental Health
and Psychosocial Support

Training Manual
(F I R S T E D I T I O N)
This Training Manual on Mental
Health and Psychosocial Support
was produced by the Department
of Health in collaboration with
the Department of Education,
Department of Social Welfare
and Development, and Save the
Children Philippines. This initiative
was co-funded by the Department
of Health and Save the Children
Philippines’ Strengthening Child-
Centered Disaster Risk Reduction
and Emergency Response Project
which was funded by the German
Federal Foreign Office.
Copyright © Department of Health

and Save the Children Philippines
December 2018
All rights reserved. Any part of this

publication may be reproduced
without fee of prior permission from
the publishers solely for awareness-
raising purposes, but not for sale.
For commercial and other purposes,
prior written permission from the
publishers must be obtained and a
fee may be incurred.
Harmonized MHPSS Training Manual
FOREWORD
The provision of Mental Health and Psychosocial Support
(MHPSS) to communities and individuals, particularly to
vulnerable groups such as women and children during
emergencies is a crucial and life-saving stance. Allowing
them to easily address their plight and immediately
recover from the disaster is mandated by the Republic Act
10821, the NDRRMC Circular No. 65, and the Children’s
Emergency Relief and Protection Act of 2016.
With the FOURmula One Plus (F 1 +) Medium-term Strategic Framework for 2017-
2022, the DOH shall “focus on sustainable, manageable, and critical interventions that
optimize available resources, supported by evidence and sufficient groundwork, and
produce tangible results that are felt by Filipinos”. The MHPSS being part of the Health
Quad Cluster led by the DOH shall strive to enhance service delivery that transcends
beyond the challenges of disaster response by transforming disaster “victims’ to
“victors” who are able to take care of themselves and address common psychosocial
issues brought about by emergencies and disasters.
While there is a considerable number of MHPSS capacity building activities available

and interventions available in the country and country support from global MHPSS
network, there is a need to harmonize these materials for a more efficient and localized
MHPSS training design in the Philippines in compliance with RA l 082 l. With this, the
Department of Health through the Health Emergency Management Bureau (HEMB)
and the National Mental Health Program of the Disease Prevention and Control
Bureau (DPCB) established the partnership with Save the Children to lead the effort of
harmonizing the existing MHPSS Training Manuals.
Having been subjected to a series of multi-sectoral and inter-agency consultations

including three (3) batches of Pilot Testing in three strategically chosen (General
Santos, Tacloban and Baguio City) to ensure consistency and harmonization in
content and process, this training manual is endorsed with great pride for use. This
shall converge all our efforts of providing necessary psychosocial interventions to the
affected communities during emergencies and disasters.
Gloria J. Balboa, MD, MPH, MHA, CEO VI, CESO III

Director IV, Department of Health
i
MESSAGE FROM
DEPARTMENT OF HEALTH
Exposure to disasters and emergencies not only brings
about destruction and loss of lives, livelihood and property,
but also causes immense and unquantifiable suffering in
the lives of those affected, especially the children, the
poor, and persons with disabilities, whose capacity to
cope with a disaster is limited. With this, psychosocial
health supports are essential to protect mental health
and psychosocial well-being in emergencies which
should be organized through multi-sectoral collaboration
in providing contextually and culturally appropriate Mental Health and Psychosocial
Services (MHPSS).
Aligned to the FOURmula One Plus (Fl +) for Health’s service delivery objective of
ensuring the accessibility of essential quality health products and services at appropriate
levels of care the, DOH shall lead the country in the development of a productive,
resilient, equitable, and people-centered essential health systems including that of
Mental Health.
This harmonized module shall unite all stakeholders who have mandates and interest
in providing psychosocial interventions particularly during emergencies and disasters
by providing the key knowledge needed by the psychosocial responders to ensure that
the psychosocial needs of the affected communities are addressed.
I would like to congratulate the Health Emergency Management Bureau, the National
Mental Health program under the Disease Prevention and Control Bureau, other
partner agencies, hospitals and organizations particularly Save the Children for their
passion and courage to come up with this Harmonized MHPSS Training Manual.
As mental health becomes a very timely and relevant issue in our society, I hope
that this manual will be a useful guide for the implementers to really address and
answer the call of providing culturally appropriate psychosocial interventions to our
communities especially during crisis situations.
Francisco T. Duque III, MD, MSc

Secretary, Department of Health
ii
MESSAGE FROM
DEPARTMENT OF EDUCATION
My warmest congratulations to the Department of Health
(DOH) and its partners for producing a Harmonized Mental
Health and Psychosocial Support (MHPSS) Training
Manual that is beneficial to emergency responders and
professionals for health and education.
I likewise commend the collaborative efforts of the

Department of Education (DepEd), Department of Social
Welfare and Development (DSWD), Save the Children
Philippines and the World Health Organization (WHO) who contributed to the
completion of the MHPSS Training Manual.
Indeed, the Training Manual which is composed of six modules, is an invaluable

material that defines a common understanding of MHPSS concepts, principles,
strategic frameworks, international and national guidelines and standards, coordination
mechanisms for the effective and efficient delivery of MHPSS during emergencies and
disasters.
The Department strongly recommends the utilization of this Manual, especially for
trainers, emergency service providers and other stakeholders in times of calamities
and disasters. DepEd shall also this for the training for the training of our teachers,
personnel and administrators as frontline-responders in schools.
Finally, DepEd reiterates its unwavering support for all relevant endeavors of your
agency.
Thank you!
Leonor Magtolis Briones

Secretary, Department of Education
iii
MESSAGE FROM
DEPARTMENT OF
SOCIAL WELFARE AND
DEVELOPMENT
The Department of Social Welfare and Development
congratulates the Department of Health and the members
of the Technical Working Group for the Development of
the Harmonized Mental Health and Psychosocial Support
(MHPSS) Training Manual.
The provision of MHPSS to individuals, families and

communities particularly to the vulnerable groups of
children, women, persons with disability and the elderly
during emergencies is paramount to their swift and complete recovery. Hence, it is
crucial for stakeholders and responders to have common understanding of the MHPSS
concepts and principles, both international and national guidelines, standards and
mechanisms for its effective delivery to the affected population.
The DSWD acknowledges that this capacity building manual will better equip emergency
responders in the Philippines with adequate knowledge and skills in the delivery of
MHPSS services with a more efficient and localized training content, integrating the
relevant and new legislation that is, Republic Act 10821 or the Children’s Emergency
Relief and Protection Act of 2016.
As such, the Department strongly recommends the implementation of this training

module to further ensure that everyone’s psychological well-being is protected and
promoted in compliance with international humanitarian principles and as outlined by
the NDRRMC Memorandum Circular no. 62, or the National Guidelines on MHPSS.
We hope that with this training manual, responders from all levels will be better
supported and equipped in emergency preparedness and response in the future.
Rolando Joselito D. Bautista

Secretary, Department of Social Welfare and Development
iv
MESSAGE FROM
SAVE THE CHILDREN
PHILIPPINES
The 2017 Child Protection Rapid Assessment (CPRA)
Report of the Department of Social Welfare and
Development (DSWD) showed that children in eight of the
ten assessed evacuation centers manifest psychosocial
issues related to their emotion, behavior and adjustment.
This stark reality was also revealed among children

affected by Typhoon Haiyan thus, the Harmonized
Training Manual on Mental Health and Psychosocial
Support (MHPSS) in Emergencies was developed with the Department of Health as
lead agency.
The MHPSS, which incorporates provisions of the Republic Act 10821 or Children’s
Emergency Relief and Protection Act aims to increase the capacity of humanitarian
responders, both from government and non-government organization to ensure
common understand on the MHPSS delivery framework across actors.
The manual also helps the Department of Health to increase the awareness of all
health actors in the implementation of RA 10821.
We congratulate the Department of Health along with the Department of Education

and Department of Social Welfare and Development in coming up with the training
manual on mental health and psychosocial support in emergencies. Save the Children
Philippines with fund assistance from the Federal Foreign Office of Germany fully
supports this initiative.
Save the Children Philippines is united with you in advocating this noble task:
“Let Us all implement the CEPC of the RA 10821 nationwide, Now!”
Atty. Alberto T. Muyot

Chief Executive Officer, Save the Children Philippines
v
ACKNOWLEDGEMENT
This manual is a product of the collaboration among the Department of Health (DOH)- Disease
Prevention and Control Bureau (DPCB) and Health Emergency Management Bureau (HEMB),
Department of Education (DepEd) and Department of Social Welfare and Development
(DSWD) with support from Save the Children Philippines.
The proponents of this manual would like to acknowledge all the individuals and organizations
who have contributed in the development of this manual.
To Director Gloria J. Balboa of HEMB and Director Napoleon L. Arevalo of DPCB for their
utmost support during the conduct of the various activities in the development of this manual.
To Ms. Frances L. Prescilla Cuevas and Dr. Maridith D. Afuang for the close collaboration in
organizing the activities and consultations;
To Dr. Ronald P. Law of HEMB and Dr. Dinah D. Nadera of AWIT Foundation for the technical
and foundational guidance;
To Ms. Thelma S. Barrera (National Center for Mental Health-NCMH), Mr. Constancio
Paubsanon (NCMH), Ms. Aubrey Bautista (DSWD – Disaster Response and Management
Bureau (DRMB)), Ms. Aileen Respicio (DSWD-DRMB)), Mr. Jerico Germar (DepEd-Disaster
Risk Reduction and Management Services (DRRMS)), Dr. Gerardo Medina (World Health
Organization -WHO), Dr. Jasmine Vergara (WHO), Mr. Hanibal Camua (Save the Children),
Mr. Philip Oledan (Save the Children), Dr. Ruby Reyes (Mariveles Mental Hospital), Mr. Richie
Enecillo (DOH-HEMB) and Mr. Jose Juan (DOH-HEMB) for facilitating the sessions during the
Pilot Testing of the training manual;
To the representatives of AWIT Foundation, Balay Rehabilitation Center, Balik Kalipay Center
for Psychosocial Response, Inc., Care and Counsel Wholeness Center, National Council on
vi
Disability Affairs (NCDA), Early Childhood Care and Development (ECCD) Council, Office of
Civil Defense (OCD), Philippine Red Cross (PRC), Psychological Association of the Philippines
(PAP), Medecins San Frontieres (MSF), United Nations Children’s Fund (UNICEF), and DOH
Centers for Health Development for participating in the consultations and workshops, and
contributing to the content development;
Finally, our deepest gratitude goes to the technical team of Save the Children Philippines led
by Mr. John Ryan Buenaventura and the consultancy team composed of Ms. Sheena Carmel
Opulencia-Calub, Ms. Sucelle Deacosta and Ms. Margaret Yarcia for their unparalleled passion
and dedication to make this initiative a success.
DEPARTMENT OF HEALTH
vii
TABLE OF CONTENTS
Foreword i
Acknowledgement vi
Table of Contents viii
Abbreviations ix
INTRODUCTION xi
Note to Training Organizer and Facilitators xviii
OPENING AND CLIMATE SETTING FOR THE DELIVERY OF 1
THE TRAINING
MODULE I - Disasters and Emergencies: Impact on Individuals, 5
Families, and Communities
Session 1: Disaster, emergencies and other concepts 8
Session 2: Mental health in disasters 14
Session 3: MHPSS issues of at-risk groups in Emergencies 21
End of Module Activity 24
MODULE II - MHPSS Framework: Concepts and Policies 27
Session 1: Basic policy framework for MHPSS structure 30
Session 2: The DRRMC and the Cluster Approach in Disaster 41
Management
MODULE III - Wellbeing, Individual and Family Assessment, and 51
Referral System
Session 1: Mental health, psychosocial support, and wellbeing 54
Session 2: Assessment: Look, Listen, and Link 59
End of Module activity 64
MODULE IV - MHPSS Interventions 66
Session 1: The intervention pyramid 69
Session 2: Psychological First Aid (PFA) 83
Session 3: Self-care and care for carers 90
MODULE V - MHPSS Monitoring and Evaluation 95
Session 1. Principles of Monitoring and Evaluation in MHPSS 98
Session 2: Assessment, Reporting and Feedback Mechanisms 106
MODULE VI - Action Planning 112
Session 1: Action Planning 115
CLOSING CEREMONIES 117
References 118
Annexes 119
Definition of Terms 124
viii
ABBREVIATIONS
4Ws who, what, where and when
CAP Consolidated Appeal Process (CAP)
CCBDRM Comprehensive Community-based Disaster Risk Reduction and
Management
CHED Commission on Higher Education
DA Department of Agriculture
DBM Department of Budget and Management
DENR Department of Environment and Natural Resources
DepEd Department of Education
DFA Department of Foreign Affairs
DILG Department of the Interior and Local Government
DND Department of National Defense
DOH Department of Health
DOLE Department of Labor and Employment
DOST Department of Science and Technology
DoTr Department of Transportation
DPCB Disease Prevention and Control Bureau
DPWH Department of Public Works and Highways
DPWH DPWH – Department of Public Works and Highways
DRMB Disaster Response and Management Bureau
DRRM Disaster Risk Reduction and Management
DRRM-H Disaster Risk Reduction and Management for Health
DRRMC Disaster Risk Reduction and Management Council
DSWD Department of Social Welfare and Development
DTM Displacement Tracking Matrix
EC evacuation center
ECCD Early Childhood Care and Development
ESHP Essential Health Service Packages
FAO Food and Agriculture Organization
GAA General Appropriations Act
GIDA Geographically Isolated and Disadvantaged Areas
HCT Humanitarian Country Team
HEMB Health Emergency Management Bureau
HEPO Health Emergency Program Office
HFA Hyogo Framework for Action
HPCS Health Promotion and Communications Service
IASC Inter-Agency Standing Committee
ICRC International Committee of the Red Cross
ix
ICS incident command system
ICVA International Council of Voluntary Agencies
IDP Internally displaced population
IFRC International Federation of Red Cross and Red Crescent Societies
IOM International Organization for Migration
LGU local government unit
M&E monitoring and evaluation
MHPSS Mental Health and Psychosocial Support
MSF Médecins Sans Frontières
NCMH National Center for Mental Health
NDCC National Disaster Coordinating Council (now NDRRMC)
NDRP National Disaster Response Plan
NDRRMC National Disaster Risk Reduction and Management Council
NDRRMP National Disaster Risk Reduction and Management Plan
NGO non-government organization
OCD Office of Civil Defense
OCHA Office for the Coordination of Humanitarian Affairs
OHCHR Office of the United Nations High Commissioner for Human Rights
OP older person
PFA psychological first aid
PHO provincial health office
PRC Philippine Red Cross
PTSD post-traumatic stress disorder
PWD person with disability
PWSN person with special needs
RA Republic Act
SARS severe acute respiratory syndrome
SCHR Steering Committee for Humanitarian Response
SMART specific, measureable, achievable, relevant and time bound
UN United Nations
UN-Habitat United Nations Human Settlements Programme
UNDP United Nations Development Programme
UNFPA United Nations Population Fund
UNHCR United Nations High Commissioner for Refugees
UNICEF United Nations Children's Fund
WASH Water, Sanitation and Hygiene
WB World Bank
WFP World Food Programme
WHO World Health Organization
x
INTRODUCTION
Provision of Mental Health and Psychosocial Support (MHPSS) to communities and
individuals, particularly to vulnerable groups such as women and children during
emergencies is a crucial and life-saving stance, allowing them to easily address their
plight and recover from the disaster. The Department of Health (DOH) is mandated by
national policies, such as Republic Act 10121 or the National Disaster Risk Reduction
and Management (NDRRM) Act, Republic Act 10821 or the Children’s Emergency
Relief and Protection Act, and NDRRMC Memorandum Circular no 62, or the National
Guidelines on MHPSS, to lead the MHPSS Cluster as part of the Health Response
Cluster and to provide capacity building activities to ensure efficient and effective
delivery of MHPSS services during emergencies.
While there is a considerable number of MHPSS capacity building content and activities
available in the country and from global MHPSS network, the DOH recognized the
need for stakeholders and responders to have a common understanding of MHPSS
concepts and principles, strategic frameworks, international and national guidance
and standards, and coordination mechanisms for the effective delivery of MHPSS
during emergencies and disasters. Thus, existing MHPSS reference materials were
reviewed and used to develop localized MHPSS training content in the Philippines
which is rights-based, empowering and responsive to everyone’s needs.
Milestones of the Harmonization Process

The harmonization process began in 2018 through a series of workshops, meetings
and consultations, engaging different government agencies, local and international
non-government organizations, regional offices, and service providers to ensure an
inclusive training content.
YEAR MILESTONE
• During this period, the MHPSS cluster has been gathering lessons
learned on capacity building activities conducted after major
disasters in the Philippines.
2015-2016
• DOH conducted a workshop to level off on competencies needed

per level of the IASC Pyramid of Intervention.
• The National Guidelines on MHPSS or NDRRMC MC no 62 was
2017
signed.
xi
YEAR MILESTONE
• Save the Children Philippines started a consultancy to engage
with the DOH in the creation of an MHPSS for Children Training
Manual. After some discussion, it was agreed that this technical
support will focus on the harmonization of MHPSS training
materials.
January • MHPSS Training Materials were reviewed and compiled to identify

2018 what are the trainings content gaps and needs in the harmonization
process.
• A workshop was conducted on January 23-25, 2018 which

produced a list of training topics for sectors involved in the delivery
of MHPSS services during emergencies: Health, Protection and
Education.
• Another workshop was conducted on March 20-23, 2018 that led
to the development of a harmonized MHPSS Training Design for
Health, Protection and Education.
March • During this workshop, the competency framework from the

2018 workshop in 2016 was reviewed and revised.
• Focused group discussions (FGDs) were also conducted with

the DOH, DepEd and DSWD to identify sectoral capacity building
needs and gaps for the delivery of MHPSS trainings.
• On April 25-27, 2018, the harmonized MHPSS Training Design
was presented to the partners with draft modules for further review.
• During this workshop, the organizers and partners recognized

April the challenge of creating sectoral MHPSS Training Manual in
2018 a short span of time. Thus, it was agreed that the Harmonized
MHPSS Training Manual that will be developed will focus on basic
MHPSS framework and concepts that can be used across all the
humanitarian sectors and at the same time, can help support the
delivery of MHPSS services.
• The second draft of the Harmonized MHPSS Training Modules
May
were edited and shared to partners for comments. A meeting was
2018
held with the DOH to share updates on the harmonization process.
xii
YEAR MILESTONE
• Some MHPSS experts and key players were gathered for a
cliniquing workshop on June 4, 2018. The Modules in Word
and Powerpoint versions were reviewed in preparation for a
series of pilot testing activities. The Pilot Testing training team
were also identified. Facilitators were from DOH bureaus and
hospitals - Disease Prevention and Control Bureau (DPCB),
Health Emergency Management Bureau (HEMB), National
June Center for Mental Health (NCMH), and Mariveles Mental Hospital
2018 (MMH) - DepEd Disaster Risk Reduction and Management
Services (DRRMS), DSWD Disaster Response Assistance and
Management Bureau (DREAMB), Save the Children Philippines,
and World Health Organization (WHO).
• On June 27-29, 2018, the first leg of the Pilot Testing was
conducted in General Santos City supported by Save the Children
Philippines.
• The second leg of the Pilot Testing was held in Tacloban City on
July 4-6, 2018.
• After the two pilot testing, the training team convened on July
10, 2018 to review the content of the modules and how it was
delivered during the testing. The modules, timing and delivery of
some sessions were modified.
July
2018
• On July 18-20, 2018, a final testing was conducted in Baguio City
with DOH MHPSS Program Regional Coordinators and some
participants from Bulacan local government units.
• After the training, the consultancy team revised the modules and
presentations based on reviews and comments from the pilot
testing activities.
• The Harmonized MHPSS Training Manual was reviewed and
August
modified and duly handed-over to the Department of Health for
2018
final review, layouting and publication.
xiii
Objectives of the Training Manual
The Harmonized MHPSS Training Manual is designed to provide basic understanding
on MHPSS. This is a by-product of consultations and review of existing MHPSS
training materials, tools and designs. It seeks to build on existing capacity building
programs and resources, identifying the core competencies of each level of responder
based on the Inter-Agency Standing Committee (IASC) Pyramid of Intervention: Level
1 – Basic Services, Level 2 – Family and Community Support, Level 3 – Focused
non-specialized support, and Level 4 – Specialized support. Furthermore, the Manual
seeks to give the responders understanding of the common functions and key action
activities as outlined in the National Guidelines on MHPSS.
Users of this Manual

The Manual can be used by emergency responders, emergency professionals for
health, education and social protection, DRRMOs, MHPSS coordinators, and MHPSS
training teams. Individual modules can be used by trainors based on the training needs
and emergency context as stand-alone training materials.
Content and delivery of this Manual

The Harmonized MHPSS in Emergencies Training Manual is composed of six (6)
modules. While each individual module can be used as stand-alone training materials,
the entire manual can be used for a training programme good for two (2) days, including
the opening and closing sessions.
The Training Manual is divided into the following modules:
Module I - Disasters and Emergencies, and their Impact on Individuals,

Families and Communities
• This module discusses the concept of disasters and emergencies based on
existing literature, and how these events affect the individual, families and
communities. The module seeks to provide the participants with a basic
understanding of how disasters affect the mental health and psychosocial
conditions of affected population, particularly the at-risk groups.
• Facilitators: It is recommended that facilitators of this module have undergone
basic training/orientation on Disaster Risk Reduction and Management (DRRM)
provided by the Office of Civil Defense through the local DRRMOs.
Module II – MHPSS Framework: Concepts and Policies

• This module focuses on the international and national legal frameworks and
structures that define the roles and responsibilities of different national agencies
and partners in the delivery of MHPSS services during emergencies. This
module is designed to explain the Inter-Agency Standing Committee (IASC)
xiv
Guidelines on MHPSS and how this relates to our National DRRM Framework
and National Guidelines on MHPSS in Emergencies.
• Facilitators: It is highly required that facilitators have read and fully understand
the IASC Guidelines on MHPSS, NDRRMF and NDRRMC Memorandum
Circular No. 62.
Module III - Wellbeing, Individual and Family Assessment, and Referral

System
• This module gives an overview on the concepts of mental health, psycho-social
support and wellbeing in the context of disasters. It aligns existing functions
with needed skills in the conduct of MHPSS interventions.
• Facilitators: It is required that this module is facilitated by an MHPSS practitioner
Module IV – MHPSS Interventions

• This module gives an overview of existing interventions universally accepted
and used by MHPSS practitioners. While the DOH does not have any approved
or recommended list of interventions yet, the interventions listed in this module
have been used and evaluated by DOH and partners.
• Facilitators: It is required that this module is facilitated by an MHPSS practitioner
Module V - MHPSS Monitoring and Evaluation

• This module seeks to define basic monitoring and evaluation concepts and align
it with the MHPSS response and service delivery. It presents the importance of
monitoring and evaluating not just the quantity but the quality of the services
being provided to the individual, families and communities by all actors.
• Facilitators: It is recommended that the module is delivered by health
practitioners who have undergone basic M&E orientation and/or has experience
in M&E or information management.
Module VI – Action Planning

• This module provides an opportunity to the participants to see how MHPSS in
emergencies can be integrated in local development and/or health emergency
management planning. This module presents the importance of mapping
existing capacities and identifying gaps within communities and organizations
to support an effective MHPSS response during emergencies.
• Facilitators: It is recommended that facilitators have a basic understanding of
local planning parameters and mechanisms
xv
START END ACTVITY LEARNING OUTCOMES
Day 0
1:00 2:00 Registration
2:00 5:00 Opening Ceremonies
Introduction and
Climate Setting
a. Getting to know
you
b. Responsible team
formation
c. Behavior contract
d. Overview of the
harmonization
Day 1
8:00 9:00 Module I Disaster, Knowledge:
Session 1 emergencies and • Understand basics of disasters
other concepts and emergencies, its legal
9:00 10:00 Module I Mental health and framework and the national
Session 2 disasters programmatic and operational
mechanisms
10:00 12:00 Module I MHPSS issues of
Session 3 at-risk groups in
Skills:
Emergencies
• Explain the concept of
Disasters, its relationship and
impact with MHPSS
Attitude:
• Give importance to the value
of MHPSS during disasters
12:00 13:00 LUNCH
13:00 14:00 Module II Basic policy Knowledge
Session 1 structure for MHPSS • Basic knowledge in
framework humanitarian principles &
14:00 15:00 Module II The DRRMC and the process in relation to MHPSS
Session 2 cluster approach • Ensuring the protection and
upholding of the rights of ALL
the affected population with
consideration to at risk groups
in emergencies and disasters
particularly on MHPSS.
• Articulate the concept of
psychosocial well-being
and the meaning and value
of resilience and coping in
extreme life events
xvi
START END ACTVITY LEARNING OUTCOMES

15:00 15:30 Module III Mental health, Knowledge:
Session 1 psychosocial support • understand key MHPSS
and well-being concepts e.g. wellbeing,
15:30 17:00 Module III Assessment: Look, coping, resilience, social
Session 2 Listen, and Link support
Skills:
• Emphatic listening
• Demonstrate appropriate use
of psychosocial interventions
• Articulate the concept of
psychosocial well-being
and the meaning and value
of resilience and coping in
extreme life events.
Attitude:
• Empathy
Day 3
8:00 10:00 Module IV MHPSS Intervention Knowledge:
Session 1 Pyramid • Key considerations in MHPSS
10:00 12:00 Module IV Psychological First interventions
Session 2 Aid (PFA) • Understand intervention
pyramid and identify level
specific interventions
Skills:
• Demonstrate self-care
strategies
• Facilitation and
Communication Skills
• Demonstrate appropriate use
of psychosocial interventions
Attitude:
• Ethical conduct
12:00 13:00 LUNCH
13:00 14:00 Module IV Self-care and caring
Session 3 for carers
14:00 15:00 Module V Principles of Skills:
Session 1 Monitoring and • Define basic monitoring and
Evaluation in MHPSS evaluation concepts and
15:00 16:00 Module V Assessment, overall design and process;
Session 2 Reporting • Appreciate the Monitoring and
and feedback Evaluation tools and indicators
mechanisms on MHPSS; and
• Establish support to MHPSS
information management.
16:00 17:00 Module VI Action Planning
17:00 18:00 Closing
xvii
Note to Training Organizer and Facilitators
In the conduct of a training using this Manual, it is highly recommended that trained
MHPSS practitioners are present and part of the organizing team in the event of
emotional triggers during the training. Organizers must have a clear strategy and action
plan to moderate and address such incidents. Some of these key points were taken
from the Community-based Psychosocial Support: A training kit of the International
Federation of the Red Cross (2009).
Supporting participants
The facilitator must “walk the talk”. He or she must demonstrate good listening skills,
to reassure participants and to activate emotional support within the group, especially
when dealing with sensitive issues as is often the case when the training is about
psychosocial support (IFRC, 2009).
It is recommended that:
• Confidentiality is maintained.
• Participants are encouraged to air their views and concerns and to discuss
different points of view.
• Participants who show signs of discomfort are offered reassurance,
encouragement, support or advice, as appropriate.
• Each individual member of the group should feel valued.
Dealing with strong emotional reactions

Some examples during the sessions might draw different reactions based on personal
experiences of the participants. Avoid probing on these stories. It is best to control how
much they are sharing and focus as a facilitator on how these stories, thoughts and
feelings can be resolved. It is in your discretion if these stories can be shared to the
wider group or if you need to sit with them individually.
Adult Learning
Adults often learn best in the following circumstances:
• when the learning starts from their own reality, building on their experiences
• when the learning achieves identified goals
• when the learning methods are varied
• when the learning is relevant to their daily lives or is meaningful for the future
• when the learning can be put into effect immediately (IFRC, 2009).
xviii
Preparation for the facilitators and organizing team

It is important that a Lead Facilitator is assigned prior to the training. The Lead
Facilitator is expected to:
1. Identify and coordinate with the organizers the needs of the facilitators and
participants
2. Facilitate pre- and post-training processing and feedbacking
3. Gather feedback and prepare short summary to be submitted to the organizers
The organizers and training team are encouraged to conduct pre- and post-training
processing and feedbacking.
The pre-training processing can be conducted a day before the training with guided
questions:
1. What are your needs for the delivery of the sessions?
2. What are your expectations from the organizers? from your fellow facilitators?
3. What support will you need from the Lead Facilitator? from the organizers?
The post-training processing must be done every after training day. The processing
and feedbacking can be done using these guide questions:
1. How do you feel after conducting your session/s?
2. What were the positive outcomes of your session/s?
3. What could have been done differently?
4. Were all the learning outcomes achieved?
Pre- and post-training assessment tools

As part of harmonization process, pre- and post-training needs analysis and post-
training evaluation tools were developed to support the organizers and training
facilitators in assessing the MHPSS knowledge and skills of the participants.
Organizers are encouraged to use these tools and document results for future reference
and evaluation of the MHPSS training. Tools are available in offline (printable) and
online versions.
Links to the tools are as follows:

Pre-Training Needs Analysis Tool
Offline – http://bit.ly/MHPSSPreTNAOffline
Online – http://bit.ly/MHPSSPreTNAOnline
Post-Training Needs Analysis Tool

Offline – http://bit.ly/MHPSSPostTNAOffline
Online – http://bit.ly/MHPSSPostTNAOnline
xviv
Harmonized
Mental Health and
Psychosocial Support
Training Manual
(F I R S T E D I T I O N)
Department of Health
In collaboration with
Department of Education
Department of Social Welfare and Development
with support from Save the Children Philippines
xvv
OPENING AND CLIMATE
SETTING FOR THE DELIVERY
OF THE TRAINING
Opening and Climate Setting1:
To give the participants an overview of the harmonization process, the learning and
skills competencies for MHPSS and agreements related to the delivery of the training.
Link to presentation: http://bit.ly/HarmonizedMHPSSOpening
Parts:
1. Opening Ceremonies: Opening Remarks, Opening Prayer/Doxology, Singing

of the Philippine National Anthem, Getting to know you
2. Responsible Team (RT) Creation
3. Behavior Contract
4. Expectations Check
5. Overview of the Training
1
Based on NCMH’s MHPSS Training Design
1
1. Opening Ceremonies: Opening Remarks, Opening Prayer/Doxology, Singing

of the Philippine National Anthem, Getting to know you
2. Responsible Team (RT) Creation

• DO: Divide the participants to three groups. Ask each team to have a name
for their group.
• SAY: Each RT should assign their RT leader. The RTs should be responsible
for the observation of the behavior contract. RT 1 and RT 2 will be responsible
for the daily recapitulation of activities and icebreakers. For the daily recap,
identify the things that you have discovered (NATUKLASAN), learned
(NATUTUNAN), and felt (NARAMDAMAN). RT 3 will be responsible for the
closing activities.
3. Behavior Contract
• DO: Ask the plenary to identify acceptable behaviors for the duration of the
training and write it on a manila paper. After listing down, ask the RT leaders
to sign the behavior contract.
4. Expectations Check
• DO: Distribute metacards to the participants. Ask them to write down their
expectations on the CONTENT, METHODOLOGY, FACILITATORS and
FELLOW PARTICIPANTS. Post it on a wall or whiteboard and read and
clarify these expectations.
5. Overview of the Training

• SAY: Provision of Mental Health and Psychosocial Support (MHPSS)
to communities and individuals, particularly to vulnerable groups such
as women and children during emergencies is a crucial and life-saving
stance, allowing them to easily address their plight and recover from the
disaster. The Department of Health (DOH), mandated by national policies
such as Republic Act 10121 or the National Disaster Risk Reduction and
Management (NDRRM) Act, Republic Act 10821 or the Comprehensive
Emergency Program for Children (CEPC), and NDRRMC Memorandum
Circular no 62, or the National Guidelines on MHPSS, to lead the MHPSS
Cluster as part of the Health Response Cluster and to provide capacity
building activities to ensure efficient and effective delivery of MHPSS
services during emergencies.
While there is a considerable number of MHPSS capacity building content and

activities available in the country and from global MHPSS network, the DOH
recognized the need to harmonize these materials for a more efficient and localized
MHPSS training content in the Philippines which is rights-based, empowering and
responsive to everyone’s needs.
The Harmonization Process

The harmonization process began as early as 2014 through a series of workshops,
meetings and consultations, engaging different government agencies, local and
international non-government organizations, regional offices, and service providers
2
to ensure an inclusive training content, gathering lessons learned from response
operations after Supertyphoon Yolanda (international name: Haiyan).
The Harmonized MHPSS Training Manual is a by-product of these consultations

and review of existing MHPSS training materials, tools and designs. It seeks to
build on existing capacity building programs and resources, identifying the core
competencies of each level of responder based on the Inter-Agency Standing
Committee (IASC) Pyramid of Intervention: Level 1 – Basic Services, Level 2
– Family and Community Support, Level 3 – Person-to-person non-specialized
support, and Level 4 – Specialized support. The Manual is designed to provide
basic understanding on MHPSS in Emergencies for all levels of responders.
Furthermore, the Manual focuses on the common functions and key action activities
as outlined in the National Guidelines on MHPSS.
Who are the target participants of this training manual?

The training manual can be used by emergency responders, health emergency
professionals, MHPSS coordinators, and MHPSS training teams. Individual
modules can be used by trainors based on the training needs and emergency
context as stand-alone training materials. Training facilitators must have undergone
basic MHPSS training conducted by DOH and/or affiliated agencies.
Emergency responders under the IASC Pyramid of Intervention have individual

capacities and competencies depending on their functions. In previous
consultations, MHPSS responders and practitioners have identified capacity
building competencies that responders must have and can acquire in trainings.
The list below are the competencies proposed in previous consultations and is
continuously being consulted with different partners.
KNOWLEDGE Level 1 Level 2 Level 3 Level 4

Integration of MHPSS concepts and
principles in basic humanitarian response,
such as WASH, FNI, shelter, camp
management, protection, etc.
Human rights, especially of persons,
communities in extreme life situations,
and humanitarian accountability of duty-
bearers and responders
Idea on referral pathway and protocols
Foundational knowledge – IASC,
pyramid, memos and guidelines, relevant
national laws (i.e. RA 10121, 10821)
Psychosocial processing/Psychosocial
support
3
SKILLS Level 1 Level 2 Level 3 Level 4

Facilitation and communication skills
Conducting community risk assessment
Network building skills
Partnership development
Organizational management skills
Community organization and resource
mobilization
Empathic listening
Interpersonal skills
Case management
Conflict management
Counselling skills
Problem solving
Referral skills
Conducting MHPSS assessments
Identification, assessment, management
of common MNS conditions (mhGAP)
SKILLS Level 1 Level 2 Level 3 Level 4

Ethical conduct (Compliance with code of
ethics- humanitarian accountabilities, do
no harm)
Cultural, age, disability and gender
sensitivity
Acknowledgement of local officials and
recognized leaders
Emotional quotient
Nurturing qualities
Spiritual sensitivity
Leadership qualities
4
MODULE 1
MODULE 1
Disasters and Emergencies:
Impact on Individuals, Families,
and Communities
5
MODULE 1:
Disasters and Emergencies:
Impact on Individuals, Families, and Communities
Module Objective:
To provide the participants with a basic understanding of how disasters affect
the mental health and psychosocial conditions of affected individuals and pop-
ulation with a discussion on the cases of at-risk groups.
Facilitators: It is recommended that facilitators of this module have under-

gone basic training or orientation on Disaster Risk Reduction and Management
(DRRM) in the Philippines provided by local DRRMOs.
Link to presentation: http://bit.ly/HarmonizedMHPSSModuleI
6
MODULE 1
MODULE 1: SESSION OUTLINE
Learning
Session Duration Materials References
outcomes
Disaster, 35 mins Define disasters • Notecards • RA 10121
emergencies and emergencies • Manila • RA 10821
and other paper • Sendai
concepts Describe the • Permanent Framework
impact of disasters markers • SAVE IEC
and emergencies materials on
on individuals, RA 10821
families, and • CCBDRRM
communities Training
Manual (Save
the Children)
Mental 50 mins Describe the • Pens • NCMH
health and impact of disasters • Permanent Training
disasters and emergencies markers Manual
to mental health • Slideshow • NDRRMC MC
and wellbeing, • Handouts 62
basic knowledge (IASC • Lahat Handa
in humanitarian Guidelines • AWIT
principles and on MHPSS, Foundation
process in relation NDRRMC Module
to MHPSS MC 62) • PRC module
on grief and
Demonstrate loss
knowledge of the
basic concepts
of disaster
mental health
and psychosocial
support
MHPSS 65 mins Demonstrate • Metacards • Child
issues understanding of • Manila Protection
of at-risk issues regarding paper Minimum
groups in the protection of • Permanent Standards
emergencies the rights of all the markers • NCMH
affected population • Slideshow training
with consideration • Handouts module on
to at risk groups - Case Self-care and
in emergencies Studies People with
and disasters, with Special Needs
particular emphasis
on MHPSS
7
SESSION 1:
DISASTER, EMERGENCIES AND OTHER CONCEPTS
LEARNING OUTCOMES:
• Define disasters and emergencies
• Describe the impact of disasters and emergencies on individuals,
families and communities
SAY: To begin our training, it is important that we have a basic understanding of the
impact of disasters and emergencies on mental health. Such conditions define the
aftermath of disasters and create the context in which responders are supposed to
work and provide mental health and psychosocial support. To start off, we will have a
short activity.
ACTIVITY 1 (15 minutes)
PREPARE: Five metacards posted on the wall with the words DISASTER,
EMERGENCY, RISK, DISASTER RISK REDUCTION and HAZARD written on each
metacard. Metacards, markers, tape and whiteboard or wall for posting metacards
DO: Divide the participants into five groups and distribute metacards. Give them 2
minutes to discuss what Disaster, Emergency, Risk, Disaster Risk Reduction and
Hazard is for them. Ask them to write down their thoughts on metacards and post it on
the whiteboard or wall.
LECTURE (20 minutes):

Definition of disaster, emergency, hazard, risk, disaster risk reduction and
vulnerabilities.
SAY: Looking at your ideas posted on the board/wall, it seems that we have varying
ideas on the meanings of these concepts. It is important to look at and understand the
universally-accepted and legal definitions of these terms. We need them to establish a
common language, which will facilitate the quick delivery of the appropriate response.
8
MODULE 1
SLIDESHOW CONTENT
The importance of understanding DRRM technologies

1. Established common language
2. Gain deeper comprehension of the disciplines and capacitates us in the
planning
What are hazards?2
A hazard is a process, phenomenon or human activity that may cause loss of life,
injury or other health impacts, property damage, social and economic disruption or
environmental degradation (UNISDR, 2017).
Natural hazards are naturally-occurring events or phenomena originating from

the following:
Geological processes: involve the movement of the earth, soil and tectonic
plates. Examples: volcanic eruptions and earthquakes.
Hydro-meteorological factors: involve weather disturbances occurring in
the air or water. Examples: thunderstorms, tornadoes, coastal storm surges,
hailstorms, La Niña, El Niño.
Biological phenomena: involve exposure to pathogenic microorganisms,
toxins and bioactive substances. Examples: bird flu, severe acute respiratory
syndrome (SARS) and Ebola pandemic.
Geological Hydro-meteorological Biological

processes factors phenomena
2
Module 1, The Philippine Context, the Importance of Disaster Risk Reduction (DRR) and Adapting to Rapid Climate
Change. Comprehensive Community-based Disaster Risk Reduction and Management Training (CCBDRRM)
9
Human-induced hazards may be categorized into:

Technological hazards: damaging human-induced events originating
from technological or industrial accidents, dangerous procedures, or
infrastructure failures. Examples: oil spills that destroy marine life, nuclear
meltdowns, train accidents, and fire resulting from an explosion whether
industrial or mechanical or even a chemical spill in a school laboratory.
Armed conflict: dangerous conflicts between or among armed groups,
tribes, or states, causing widespread fear and destruction, and forcing many
people to flee to safe places. Examples: terrorist activities and mass killings.
Everyday hazards and dangers particularly to children. Examples:
items in the home that are labelled as hazardous, open electrical outlets,
and small toys that may cause choking.
Everyday hazards and

Technological Armed
dangers particularly to
hazards conflict
children
Can you identify a hazard from your own locality/community?
While hazards do not automatically lead to loss of life or economic disruption,

steps must be taken to reduce the vulnerabilities of the threatened communities,
to build their resilience and minimize the damage to them.
A hazard results into a disaster when it leads to loss of life and livelihoods, injuries,
displacement and homelessness and/or damage to infrastructure and property.
e.g. A typhoon in an uninhabited island will not result in a disaster
10
MODULE 1
What is a disaster?3
Republic Act 10121 or the National Disaster Risk Reduction and Management
Act of the Philippines, defines disaster as a serious disruption of the functioning
of a community or a society involving widespread human, material, economic
or environmental losses and impacts, which exceeds the ability of the affected
community or society to cope using its own resources.
It is the result of the combination of: the exposure to a hazard; the conditions of
vulnerability that are present; and insufficient capacity or measures to reduce or
cope with the potential negative consequences.
Impacts may include loss of life, injury, disease and other negative effects on
human, physical, mental and social wellbeing, together with damage to property,
destruction of assets, loss of services, social and economic disruption and
environmental degradation.
Are earthquakes, floods and cyclones disasters? Not necessarily. They become
disasters when they adversely and seriously affect human life, livelihood, and
property.
What is disaster risk?4
The potential disaster losses when hazards occur. Disaster risk is dependent on
the strength of hazard; and extent of exposure, vulnerability, and capacity of a
community to withstand the onslaught of the hazard.
The relationship may be expressed as follows:
R= Hazard x Vulnerability x Exposure

Capacity
Vulnerability characteristics and circumstances of a community, system or asset

that make it susceptible to the damaging effects of a hazard.
Exposure is the degree to which a community is likely to experience hazard events

of different magnitude. It also refers to the physical location, characteristics and
population density of a community that “exposes” it to hazards.
3
Republic Act 10121: An Act Strengthening the Philippine Disaster Risk Reduction and Management System
4
Module 1, The Philippine Context, the Importance of Disaster Risk Reduction (DRR) and Adapting to Rapid Climate
Change. Comprehensive Community-based Disaster Risk Reduction and Management Training (CCBDRRM)
11
Capacity is the combination of all the strengths, attributes and resources available
within a community, society or organization.
Vulnerability in this equation, is defined as the characteristics and circumstances

of a community, system or asset that make it susceptible to the damaging effects
of a hazard. Vulnerability may arise from various physical, social, economic,
and environmental factors such as poor design and construction of buildings,
inadequate protection of assets, lack of public information and awareness, limited
official recognition of risks and preparedness measures, and disregard for wise
environmental management.
In every community, there are Vulnerable and Marginalized Groups. These

individuals and groups face higher exposure to disaster risk and poverty including,
but not limited to, women, children, elderly, differently-abled people, and ethnic
minorities. The standard approach to DRRM is it must be disability-inclusive,
engaging individuals in consultations, planning and delivery of DRRM strategies
and activities.5
What then, is an Emergency?6
An emergency is an unforeseen or sudden occurrence, especially danger,

demanding immediate action. Can emergencies become a disaster? If a small
emergency, when not immediately attended to, causes and leads to serious
disruption to the functioning of a community, then yes, emergencies can become
a disaster.
According to the UN, an emergency is an event that can be responded to using
the resources available at hand, implying that there is no need to request external
assistance. A disaster, on the other hand, is characterized by impacts that overwhelm
the capacities of local responders and place demands on resources which are not
available locally. Hence, an event is declared as a “disaster” when there is a need
for external assistance to cope with its impacts. A national government declares a
state of disaster or national calamity as a way to request international humanitarian
assistance and the support of the international community to cope with the impacts
of the disaster.
5
Added during the Pilot Testing of the Harmonized Training Manual in General Santos City, June 27-29, 2018
6
Republic Act 10121: An Act Strengthening the Philippine Disaster Risk Reduction and Management System
12
MODULE 1
What is Disaster Risk Reduction?7
The UN Office for Disaster Risk Reduction (DRR) defines DRR as a concept and
practice of reducing disaster risks through systematic efforts to analyse and reduce
the causal factors of disasters8. This practice includes other concepts such as
preparedness, mitigation, and sustainable development. Every government has
its own way of practicing DRR, depending on the risks and hazards that they have
identified in their own territories.
SAY: Now, let’s go back to our board/wall and see which key ideas we have gotten
right.
DO: Review the metacards and remove/rearrange metacards that are aligned with the
definition.
End of Session insights:

• Disasters are the result of the combination of: the exposure to a hazard; the
conditions of vulnerability that are present; and insufficient capacity or measures
to reduce or cope with the potential negative consequences.
• An emergency is an event that can be responded to using the resources

available at hand, implying that there is no need to request external assistance.
A disaster, on the other hand, is characterized by impacts that overwhelm the
capacities of local responders and place demands on resources which are not
available locally.
7
Emergency and disaster management. UN-SPIDR http://www.un-spider.org/risks-and-disasters/emergency-and-
disaster-management
8
What is Disaster Risk Reduction? UNISDR https://www.unisdr.org/who-we-are/what-is-drr
13
SESSION 2:
MENTAL HEALTH IN DISASTERS
LEARNING OUTCOMES:
• Describe the impact of disasters and emergencies to mental health and
wellbeing, basic knowledge in humanitarian principles and process in
relation to MHPSS
• Demonstrate knowledge of the basic concepts of disaster mental health
and psychosocial support
SAY: Effective response in the aftermath of disasters requires an understanding of

their impact on people and their communities. In this session, we will think of the many
ways disasters affect people.
PREPARE: Scenario sheets, Manila paper

(4), markers, tape and white board or wall
for posting metacards
Community
DO: Divide the group into three groups.
Assign a scenario for each group (earthquake,
Family
typhoon and fire). Distribute the scenarios
sheets to each group
Individual
SAY: In your respective groups, draw three
concentric circles (follow the format). In each
circle, write down INDIVIDUAL, FAMILY, and
COMMUNITY. We will assign a scenario
for each group. We will give you 5 minutes
to write down what you think are the impact
of the disaster to the Individual, Family and
Community. Post the Manila paper on the
board/wall. We will give each group a minute
to present a summary of your outputs.
14
MODULE 1
Activity 2 Scenario Sheet
Earthquake
A 7.2-magnitude earthquake killed 222 people and injured 877. It also damaged
the municipal hall, hospitals, a school, old churches, and roads, and left many
towns without power for a week. The impact on the economy is pegged to be
at PhP 52 million.
Typhoon
A 210 kph typhoon left a death toll of 1,067, with 834 still missing. Moreover,
2,686 persons were injured and 6.24 million persons or 711,682 families were
affected. The typhoon destroyed PhP 36.95 billion worth of infrastructure
(P7.57B), agricultural products (PhP 26.53), and private properties (PhP
2.86B), including 216,817 houses.
Fire
A 10 hour-fire spread rapidly, razing more than 1,000 makeshift houses and
leaving 15,000 people homeless, and without access to food and water.

Key concepts of Disaster Mental Health
SAY: Based on your group outputs, we can see that the impact of emergencies
and disasters cover a wide spectrum of categories: from the physical effects such
as damaged houses to the non-tangible effects like grief. During emergencies
and disasters, affected population become recipients of goodwill and passionate
humanitarian actors who respond to these effects in our different capacities: some of us
provide medical services, others build shelters, and still others establish hygiene and
sanitation facilities. Whatever role we are playing addresses needs of the individual,
families, and communities called for by the disaster situation.
In this lecture, we will focus on disaster mental health and go through some key
concepts that will allow us to understand better how disasters impact the mental health
of the affected population and even responders.
15
SLIDESHOW CONTENT
Key concepts of mental health
What is our understanding of mental health?
Mental health is a state of wellbeing in which every individual realizes own potential,
can cope with the normal stresses of life, can work productively and fruitfully, and is
able to make a contribution to the community, as defined in the National Guidelines
on Mental Health and Psychosocial Support which we will discuss in Module II.
Mental health and psychosocial support is any type of local or outside support
that aims to protect or promote psychosocial wellbeing and/or prevent or treat
mental disorder9.
Grief and loss10

Grief is defined as the psychological-emotional experience following a loss, while
loss is the sense of sadness, fear and insecurity we feel when a loved person is
absent. It can also be felt for things and place.
Why do we grieve?
• We grieve because we love.
Loss is the central experience of any disaster: everyone has lost someone or
something they love.
Mourning
Mourning: culturally appropriate processes that help people to pass through grief
• All cultures mourn but in different ways
• Involves acknowledgement and acceptance of the death, saying farewell
• There are “prescribed” time periods for grieving
• Processes to continue attention towards the dead and to move beyond and
make new attachments
How does disaster affect mourning practices?

• Disaster disrupts the possibility of appropriate mourning:
• Normal rituals are impossible to carry out because of lack of resources and
facilities
9
IASC Guidelines on MHPSS in Emergency Settings, 2007
10
Adapted from Training Curriculum for Mental Health and Psychosocial Support of the International Medical Corps and
AmeriCares
16
MODULE 1
• Bodies are treated inappropriately

• There is uncertainty over missing people
• There may be mass graves
• The absence of markers
• The practice of mourning might have reduced significance given the context
• The social networks are destroyed
• There is desire to remain connected
Massive losses that affect whole communities deprive the individual of the normal
support received from their community if their loss had been a singular occurrence.
Mental Health and Disasters

Emergencies erode normally protective supports, increase the risks of diverse
problems and tend to amplify pre-existing problems of social injustice and inequality.
For example, natural disasters such as floods typically have a disproportionate
impact on poor people, who may be living in relatively dangerous places.
Here are the general principles of Disaster Mental Health:

1. Everyone who sees a disaster is affected by it.
2. Target population is primarily normal.
3. How people have coped with crises in their past will be a good indicator of
how they will handle the disaster.
4. People do not disintegrate in response to disaster.
5. Disturbance is transitory.
6. Disaster relief procedures have been called the “Second Disaster.”
7. Disaster stress reactions may be immediate or delayed.
8. People respond to active interest and concern.
9. Informed early intervention can speed up recovery and prevent serious or
long-term problems.
10. The family is the first line of support for individuals.
11. Support systems are crucial to recovery.
12. A response program must be aligned with the community’s needs and
dynamic, for it to be accepted.
13. A disaster can bring out the best and the worst in people.
These are the mental health and psychosocial concerns that need to be addressed
in emergency response:
17
Social:
• Pre-existing (pre-emergency) social problems (e.g. extreme poverty;
belonging to a group that is discriminated against or marginalized; political
oppression);
• Emergency-induced social problems (e.g. family separation; disruption of
social networks; destruction of community structures, resources and trust;
increased gender-based violence); and
• Humanitarian aid-induced social problems (e.g. undermining of community
structures or traditional support mechanisms).
Psychological
• Pre-existing problems (e.g. severe mental disorder; alcohol abuse);
• Emergency-induced problems (e.g. grief, non-pathological distress;
depression and anxiety disorders, including post-traumatic stress disorder
(PTSD)); and
• Humanitarian aid-related problems (e.g. anxiety due to a lack of information
about food distribution).
For children, the impact of disasters can cover a wide range11 (UNICEF Philippines,
2018):
a. Individual Child
• Basic Needs are not met
• Normal Routine and relationships are disrupted
• Psychological Disturbance
• Exposure to danger
b. Child in the Family

• Helplessness of Heads of families and reversal of roles
• Inability to provide proper guidance
• Inability of the parents to protect their children
• Separation due to death
• Increase of Domestic violence
c. Child in the community

• Community values are change
• Inability to go to schools and other damaged facilities
• Social roles and relationships are changed
• Unintended loss of access to services due to sanction on government
and, rebel groups
11
From DepEd-DRRMS
18
MODULE 1
For adolescent: (Reference. SEE Students; Manual on Psychosocial Interventions

for Secondary School-aged Children)
• They feel a strong responsibility to the family.
• They may feel guilt and shame that they were unable to help those who
were hurt.
• They may feel intense grief.
• They may become self-absorbed and feel self-pity.
• They may experience changes in their relationships with other people.
• They may also start taking risks, engage in self-destructive behavior, have
avoidant behavior, and become aggressive.
• They may experience major shifts in their view of the world accompanied by
a sense of hopelessness about the present and the future.
• They may become defiant of authorities and parents, while they start relying
on peers for socializing
Phases of Disaster
Both community and individual responses to a major disaster tend to progress
according to phases. An interaction of psychological processes with external
events shapes these phases. Examples of significant time-related external events
are the closure of the emergency response phase.
The following represents a compilation of phase lists, selected and described

because of their relevance to disaster mental health planners and workers in
providing ongoing disaster recovery assistance:
1. Threat phase (Days before the actual incident or no warning at all): If

warning is given, some people will make preparations, while some may
ignore. If no warning, people may feel vulnerable, unsafe, and fearful of
future unpredicted tragedies.
2. Impact Phase (Day 1 to 3): Getting over the destruction and its effects
depends on the extent. The greater the scope, destruction and personal
losses associated with the disaster, the greater the psychosocial effects.
3. Heroism (Impact up to 1 week afterwards): Struggle to prevent the loss of
lives and property damage, survival; common emotions are fear, anxiety,
and shock.
4. Honeymoon (2 weeks to 2 months): Relief efforts lift spirit of survivors;
hope of quick recovery run high; optimism often short-lived. Usual feelings
are euphoria at being alive, gratitude, grief, and disbelief.
12
Adapted from National Center for Mental Health MHPSS Training Manual. For full reference see DeWolfe, Deborah
(2000). Training manual for mental health and human service workers in major disasters. https://eric.ed.gov/?id=ED459383
19
5. Disillusionment (Several months to over a year): Unexpected delays and

failures resulting in frustration, confusion in the bureaucracy, people starting
to rebuild their own lives and solving their own problems. Survivors realize
they have lots to do by themselves and their lives may never be the same
again.
6. Reorganization and recovery (Several years): Coordinated individual and
community effort to rebuild and reestablish normalcy; normal functioning is
gradually reestablished.
Types of disaster victim

1. Direct victims – Those killed or injured
2. Indirect victims – Family, friends, co-workers of the direct victims
3. Hidden victims – Crisis workers, service providers
SAY: Based on what we have discussed and what you have written on your circles,
can you identify and share with the group which of the impacts you have mentioned
are related to disaster mental health?
DO: Synthesize their responses based on the lecture about disaster mental health.

• Massive losses that affect whole communities deprive the individual of the
normal support received from their community if their loss had been a singular
occurrence.
• Emergencies erode normally protective supports, increase the risks of diverse

problems and tend to amplify pre-existing problems of social injustice and
inequality.
20
MODULE 1
SESSION 3:
MHPSS ISSUES OF AT-RISK GROUPS IN EMERGENCIES
LEARNING OUTCOMES:
• Demonstrate understanding of issues regarding the protection of the
rights of all the affected population with consideration to at-risk groups
in emergencies and disasters, with emphasis on MHPSS
ACTIVITY 3 (20 minutes):

Power Walk
PREPARE: Role cards with the following labels - Person with severe mental disorder,
government employee, student, non-government organization (NGO) worker, mayor,
army officer, abandoned child, parent, person with disability, infant
DO: Ask eight to ten volunteers from the group. Instruct them to line up horizontally
in front. Randomly provide them individual role cards (to be held by them). As you
provide specific case scenarios, ask the volunteers to follow the rules stated below.
SAY: Move one step FORWARD if You are NOT protected and STAY if the scenario
WILL NOT AFFECT YOU.
Prior to, during and after a disaster, these scenarios can happen.
1. You live a landslide-prone area and it has been raining for several days.
2. Both of your parents were killed during an armed conflict.
3. Recruitment to armed groups while in displacement
4. Displacement due to massive flooding
5. Sexual abuse in evacuation centers
6. Human rights violation
7. Loss of livelihood due to disasters
8. Aftershocks after a high magnitude earthquake
Say: May we ask one from the volunteers to share what he/she felt during the power
walk. How difficult was it to determine if you are protected or not for each of the
scenario? What were your thoughts when deciding whether to step forward, step
backward, or stay?
How about the other participants? What did you observe from the volunteers? Did you
agree with the steps that they took or did not take?
21
Do: Get up to five responses for this discussion before moving on to the lecture.

At-risk groups during emergencies.
SAY: In our previous session, we have discussed the different impacts of disasters to
the affected population. As we saw in our power walk, there are risks and hazards, both
natural and man-made, as well as various scenarios that can further affect the mental
health condition of individuals, families and communities, regardless of your age,
gender, position, etc. Two important messages: Everyone has specific vulnerabilities,
and individuals with same cases may have varying vulnerabilities due to social and
cultural factors. It is important that we do recognize that there are groups that need
special attention and additional support during emergencies because they are more
vulnerable to risks.
SLIDESHOW CONTENT
There is a large diversity of risks, problems and resources within and across each
of the groups. Some individuals within an at-risk group may fare relatively well.
Some groups (e.g. combatants) may be simultaneously at increased risk of facing
some problems (e.g. substance abuse) and at reduced risk of other problems (e.g.
starvation). Some groups may be at risk in one emergency, while being relatively
privileged in another emergency. Where one group is at risk, other groups are
often at risk as well (Sphere Project, 2004). To identify people as ‘at risk’ is not to
suggest that they are passive victims. Although at-risk people need support, they
often have capacities and social networks that enable them to contribute to their
families and to be active in social, religious, and political life.
The Inter-Agency Standing Committee Guidelines on Mental Health and

Psychosocial Support identified people at increased risk of various problems in
diverse emergencies13.
• For development-related, children are more vulnerable (from newborn infants

to young people 18 years of age), such as separated or unaccompanied
children (including orphans), children recruited or used by armed forces
or groups, trafficked children, children in conflict with the law, children
13
IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings
22
MODULE 1
engaged in dangerous labor, children who live or work on the streets and
undernourished/under stimulated children;
• We also must recognize that there are children and adults with disabilities
that are more vulnerable because of their limitations in functional capacities.
• Women (e.g. pregnant women, mothers, single mothers, widows and, in
some cultures, unmarried adult women and teenage girls) and members
of the lesbians, gay, bisexual, transgender, queer, asexual, and intersex
(LGBTQAI) community are vulnerable to gender-related challenges such as
discrimination, abuse, and gender-based violence.
• Men (e.g. ex-combatants, idle men who have lost the means to take care
of their families, young men at risk of detention, abduction or being targets
of violence);
• Elderly people (especially when they have lost family members who were
caregivers);
• Extremely poor people;
• Refugees, internally displaced persons (IDPs) and migrants in irregular
situations (especially trafficked women and children without identification
papers);
• People who have been exposed to extremely stressful events/trauma (e.g.
people who have lost close family members or their entire livelihoods, rape
and torture survivors, witnesses of atrocities, etc.);
• People in the community with pre-existing, severe physical, neurological or
mental disabilities or disorders;
• People in institutions (orphans, elderly people, people with neurological/
mental disabilities or disorders);
• People experiencing severe social stigma (e.g. people with severe mental
disorders, survivors of sexual violence);
• People at specific risk of human rights violations (e.g. political activists,
ethnic or linguistic minorities, people in institutions or detention, people
already exposed to human rights violations).
23
End of Module Activity

(30 minutes)
DO: Give as a handout these four case studies to the participants. Give them five
minutes to read the case studies. In a plenary discussion, ask the participants to
answer the questions below for each case study.
SAY: We have reached the end of Module I. As part of the learning exercise, we have
four case studies which we would like you to read and analyze. Please answer the
following questions:
1. Describe how the hazards became a disaster considering the vulnerabilities,
risks, and hazards?
2. Considering the social and psychological issues in the case study, who are the
potential at-risk groups?
3. Explain how these risk groups can be affected in relation to their mental health
and psychosocial wellbeing.
Activity Handout
Case Study 1
My name is Juana. I live in an informal settlement with 35 other families.
This settlement is 5 metres away from a river which overflows when there is
heavy rainfall. Our house is made up of wood and tires. We have been told
to relocate but we don’t have anywhere else to go. I have 8 children and my
husband is a contractual carpenter.
Case Study 2
My name is Surah and I always encounter ridos14 in our locality. Whenever
there are disputes, we go to the nearest masajid (mosque) and/or relatives.
Unfortunately, our community is also prone to flooding especially during the
monsoon season. I have six brothers and two sisters. We have lost our mother
when she gave birth to my youngest sibling.
14
Rido is feuding between families and clans, is a type of conflict characterized by sporadic outbursts of retaliatory
violence between families and kinship groups as well as between communities. https://asiafoundation.org/resources/pdfs/
PHridoexecsummary.pdf
24
MODULE 1
Case Study 3
My name is Lucio. I am a farmer living near a volcano. The volcano erupted
two weeks ago and I am living with my family in an evacuation center. Sadly,
my leg had to be amputated after I had an accident during the evacuation. My
wife is pregnant with our third child.
Case Study 4
My name is Samuel. I am a nurse working for the municipal health office.
We have recently suffered from a 6.9 earthquake and we are still feeling the
aftershocks. Most of the people have opted to build small huts outside their
houses instead of staying at the evacuation camps. Around 95% of the houses
in the community where I came from were totally damaged.
Post-Activity Processing:
Do: Ask one participant to share their answers for each question. These statements
may be added to the answers of the participants.
Case study 1
• Juana and her family are exposed to a hazard which is the river that overflows
when there is heavy rainfall. All the families living in the area are vulnerable
especially since they are living in an illegal area. The type of housing is also
susceptible to damages especially when there is heavy rain. Having to take
care of a large family is difficult especially when there is an emergency.
Case study 2
• There is human-induced hazard in Surah’s community brought by the ridos. In
cases of evacuation because of a rido, it can lead to prolonged displacement
if and when there is flooding. All members of the community particularly those
belonging to the at-risk groups are very vulnerable to violence, security threats,
natural risks and hazards brought by the flooding.
Case study 3
• Lucio is very vulnerable because apart from being in an evacuation center, he
lost his leg and has to look after the needs of his family particularly his pregnant
wife. Being in displacement in this condition can be very overwhelming for Lucio.
Case study 4
• Service providers and emergency responders are also considered to be affected
by the disaster. Thus, Samuel is vulnerable to mental health and psychosocial
disorders particularly those rooting out from his work as a service provider,
while also tending to his own needs. The people in his community are also
prone to MHPS concerns because of the aftershocks and the displacement.
25
Key messages of this module:
Say: We have now reached the end of Module I. Some of the key messages from this
module are:
1. Understanding and recognizing hazards can reduce risks and can help prevent
disasters.
2. Emergencies erode normally protective supports, increase the risks of diverse
problems and tend to amplify pre-existing problems of social injustice and
inequality.
3. A disaster can bring out the best and the worst in people.
4. How people have coped with crises in their past will be a good indicator of how
they will handle the disaster.
5. Children and individuals belonging to at-risk groups need special support during
disasters.
Additional references:
1. Republic Act 10121 - National Disaster Risk Reduction and Management Act
2. Republic Act 10821 - Children’s Emergency Relief and Protection Act
3. Inter-Agency Standing Committee Guidelines on Mental Health and
Psychosocial Support (MHPSS) in Emergency Settings
26
MODULE 2
MODULE 2
MHPSS Framework:
Concepts and Policies
27
MODULE 2:
MHPSS Framework:
Concepts and Policies
Module Objective:
To explain the Inter-Agency Standing Committee (IASC) Guidelines on MHPSS and
how this relates to our National DRRM Framework and National Guidelines on MHPSS
in Emergencies.
Facilitators: It is highly required that facilitators have read and fully understand the
IASC Guidelines on MHPSS, NDRRMF, and NDRRMC Memorandum Circular No. 62.
Link to presentation: http://bit.ly/HarmonizedMHPSSModuleII
28
MODULE 2
Learning
outcomes
Basic policy 60 mins Articulate the core • Slideshow • IASC
framework principles of the • Handout Guidelines on
for MHPSS IASC Guidelines of copies MHPSS
structure on MHPSS and the of IASC • NDRRMC
NDRRMC National Guidelines Memo Circular
Guidelines on on MHPSS 62
MHPSS and
NDRRMC
MC 62
The DRRMC 60 mins Define the structure • Slideshow • RA 10121
and the of the DRRMC • Handouts • RA 10821
cluster and the cluster of copies of • NDRRMP
approach approach documents • NDRP
Identify and
enumerate
the roles and
responsibilities of
stakeholders in the
cluster approach
29
SESSION 1:
BASIC POLICY FRAMEWORK FOR MHPSS STRUCTURE
LEARNING OUTCOMES:
• Articulate the core principles of the IASC Guidelines on MHPSS and
the NDRRMC National Guidelines on MHPSS
SAY: A basic policy framework provides structure to mental health and psychosocial
support, ensuring its consistent and systematic delivery. The integration of MHPSS
principles in emergency response is articulated in various government programs as
well as international frameworks. Taking a closer look at these policies will provide
responders an appreciation of the responsibilities of lead agencies and partner
organizations in creating an enabling environment for MHPSS in Emergencies, as
well as the resources available for carrying out these responsibilities.

Key concepts and legal frameworks
SLIDESHOW CONTENT
Foundational Legal And Normative Frameworks of MHPSS Policy In The

Philippines
1. IASC Guidelines on MHPSS
What is IASC?
The Inter-Agency Standing Committee (IASC) is the primary mechanism for
inter-agency coordination of humanitarian assistance.
It is a unique forum involving the key UN (e.g. WHO, UNICEF, UNFPA) and non-
UN humanitarian partners (e.g. Save the Children, Médecins Sans Frontières
(MSF) International, Action Against Hunger)
The IASC was established in June 1992 in response to United Nations General
Assembly Resolution 46/182 on the strengthening of humanitarian assistance.
The Philippines as a member of the United Nations is encouraged to observe
30
MODULE 2
and use the guidelines developed by the IASC.
The IASC provides a platform for thematic areas such as Accountability to

Affected Population (AAP), Humanitarian Financing, Risk, Early Warning and
Preparedness, among others.
What is the IASC on MHPSS?

The Inter-Agency Standing Committee Guidelines on Mental Health and
Psychosocial Support (MHPSS) in Emergency Settings (IASC, 2007) were
developed through an inclusive process, with input from UN agencies, NGOs,
and Universities.
The Guidelines help to plan, establish, and coordinate a set of minimum multi-
sectoral responses to protect, support and improve people’s mental health and
psychosocial wellbeing in the midst of an emergency.
The IASC MHPSS Reference Group was established in December 2007. Its
main task is to support and advocate for the implementation of the Guidelines.
The Reference Group consists of more than 30 members, and fosters a unique
collaboration between NGOs, UN and International Agencies and academics,
promoting best practices in MHPSS.
Context for the IASC Guidelines on MHPSS
Populations affected by emergencies frequently experience enormous suffering.
Though a lot of work has been done to address this, a significant gap has been
the absence of a multi-sectoral, inter-agency framework that enables effective
coordination, identifies useful practices, flags potentially harmful practices and
clarifies how different approaches to mental health, and psychosocial support
complement one another
The Guidelines reflect the insights of practitioners from different geographic

regions, disciplines and sectors, and reflect an emerging consensus on good
practice among practitioners
The core idea behind the Guidelines is that, in the early phase of an emergency,
social supports are essential to protect and support mental health and
psychosocial wellbeing.
The Guidelines also recommend selected psychological and psychiatric

interventions for specific problems.
31
Areas Covered by the Guidelines

Specific action sheets provided by the Guidelines cover the following areas:
• Coordination
• Assessment
• Monitoring and Evaluation
• Protection and Human Rights Standards
• Human Resources
• Community Mobilization and Support
• Health Services
• Education
• Dissemination of Information
• Food Security and Nutrition
• Shelter and Site Planning
• Water and Sanitation
Core Principles of the IASC Guidelines on MHPSS

• Human rights and equity
• Participation
• Do no harm
• Building on available resources and capacities
• Integrated support systems
• Multi-layered supports
These core principles were adopted by the local MHPSS Guidelines and
adapted to the Philippine context. In the creation of the National Guidelines
on MHPSS or NDRRMC Memorandum No. 62 which will be discussed more
thoroughly in succeeding sections, several components of the IASC Guidelines
on MHPSS were integrated.
2. NDRRMC Memo 62 series of 2017
It is known as National Guidelines On Mental Health And Psychosocial Support

In Emergencies And Disaster Situations. The Guidelines aim to “enable
humanitarian actors and communities to implement essential minimum high
priority responses in emergencies and disasters that adapt and contextualize
the IASC Guidelines on MHPSS
Specifically, the Guidelines are meant to:

• Aid policy formulation, planning and implementing a set of minimum
multisectoral responses to protect and enhance people’s mental health
and psychosocial wellbeing
32
MODULE 2
• Promote the development of an institutional framework, programs,

strategies, and response systems for managing MHPSS
Memo 62 adapted the Core Principles of the IASC Guidelines on MHPSS to

the local Philippine context. These are presented as the “Basic Principles
Governing Good Practices in MHPSS” which include:
• Affirms human rights and equity
• The provision of MHPSS must promote the human rights of all affected
persons and protect individuals and groups who are at a heightened
risk of human rights violations and discrimination across gender, age
groups, religious beliefs, and ethnicity according to identified needs.
• Emphasizes the principle of doing no harm.
• Humanitarian aid can also cause unintentional harm and it is important
that services in emergency situations do not pose any kind of danger to
the survivor’s wellbeing.
• Ensures participation
• In most emergency situations, a significant number of people exhibit
sufficient resilience to participate in relief and reconstruction efforts.
Maximizing the participation of the affected population allows them to
regain their sense of ownership and agency.
• Provides multi-layered support
• People are affected in different ways and require different kinds of support
during emergencies. There must be a layered system of complementary
support that meets the needs of different groups.
• Promotes integrated support system
• Programs and activities must be integrated as much as possible in order
to avoid creating a highly fragmented care system. For example: having
stand alone services dealing only with people with a specific diagnosis
as PTSD
• Culturally sensitive and appropriate
• Programs and activities that are culturally appropriate and mindful of
gender, age, and religious beliefs result in effective, creative, and
innovative approaches to providing MHPSS in emergencies
• Promotes wellbeing or ginhawa of survivors/victims/workers
• Ginhawa is synonymous to the concept of overall wellbeing.
• Resilience- and strength-based
• Resilience is the remarkable capacity of individuals to withstand and
overcome challenges of all kinds and bounce back stronger and wiser
in the face of great adversity and live relatively normal lives. Strength-
based approaches recognize the affected people’s availability of inner
strength to cope with challenges. This helps affected communities move
33
from being victims to become survivors and help them identify resources
they have to facilitate their own recovery.
• Affirms the significance of spirituality in the recovery process
• MHPSS recognizes the spiritual nature of the different people of the
Philippines and affirms/supports ways by which spirituality (e.g. prayers,
faith, hope, etc) promotes recovery and ginhawa
• Promotes collaboration and partnership
• Efforts towards bringing MHPSS in emergency and disaster situations
must put premium value on collaboration and partnership among
agencies and with the community, as deemed suitable and effective,
based on previous experience or current practice
• Promotes transparency and accountability
• MHPSS service providers and community partners must be accountable
for the provision of effective and ethical services and efficient use of
resources at all phases of humanitarian work
• Builds on available resources and capacities
• Services at all stages of emergency must build local capacities, promote
self-sufficiency, self-help, and bayanihan, and strengthen the resources
already present in order to improve the survivors; lives beyond their
condition prior to the disaster.
• Adheres and maintains professional and ethical standards
• Adherence to and maintenance of professional and ethical standards by
MHPSS service providers encourages sustained cooperation from the
community across time and disaster situations and contributes to the
overall effectiveness of programs
• Ensures stability and sustainability
• MHPSS must never be donor-driven and donor-dependent but must
demonstrate stability across time even in the absence of external support
• Ensures the welfare of service providers
• Organizations and institutions must ensure the safety and overall
wellbeing of service providers from pre-deployment, deployment to
post-deployment phases.
3. Sendai Framework15
What is the Sendai Framework?

A 15-year, voluntary, non-binding agreement which recognizes that the State
has the primary role to reduce disaster risk but that responsibility should be
Sendai framework for disaster risk reduction 2015–2030. In: UN world conference on disaster risk reduction, 2015
15
March 14–18, Sendai, Japan. Geneva: United Nations Office for Disaster Risk Reduction; 2015. Available from: http://
www.wcdrr.org/uploads/Sendai_Framework_for_Disaster_Risk_Reduction_2015-2030.pdf
34
MODULE 2
shared with other stakeholders including local government, the private sector
and other stakeholders. It aims for the following outcome:
The substantial reduction of disaster risk and losses in lives, livelihoods and
health and in the economic, physical, social, cultural and environmental assets
of persons, businesses, communities and countries.
It is the outcome of stakeholder consultations initiated in March 2012 and

inter-governmental negotiations held from July 2014 to March 2015; It was
subsequently adopted by UN Member States on 18 March 2015 at the Third UN
World Conference on Disaster Risk Reduction in Sendai City, Miyagi Prefecture,
Japan. The Philippines was well-represented during the negotiations and have
expressed support to the four priorities of action. It signals the time to review
and refine existing policies such as the National Disaster Risk Reduction
and Management Act in order to further strengthen institutions, both national
government agencies and LGUs, not just to mitigate disasters and respond to
them but also integrate developmental framework into the process of recovery,
rehabilitation, and reconstruction.
The Sendai Framework also places strong emphasis on resilient health

systems by the integration of disaster risk management into health care
provision at all levels, and by the development of the capacity of health
workers in understanding disaster risk and applying and implementing
disaster risk approaches in health work16.
National health systems can be strengthened by promoting and enhancing

the training capacities in the field of disaster medicine; and by supporting and
training community health groups in disaster risk reduction approaches in
health programmes.
The Four Priorities for Action

• Priority 1. Understanding disaster risk
xx Disaster risk management should be based on an understanding of
disaster risk in all its dimensions of vulnerability, capacity, exposure
of persons and assets, hazard characteristics and the environment.
Such knowledge can be used for risk assessment, prevention,
mitigation, preparedness and response.
35
• Priority 2. Strengthening disaster risk governance to manage

disaster risk
xx Disaster risk governance at the national, regional and global levels
is very important for prevention, mitigation, preparedness, response,
recovery, and rehabilitation. It fosters collaboration and partnership.
• Priority 3. Investing in disaster risk reduction for resilience

xx Public and private investment in disaster risk prevention and reduction
through structural and non-structural measures are essential to
enhance the economic, social, health and cultural resilience of
persons, communities, countries and their assets, as well as the
environment.
• Priority 4. Enhancing disaster preparedness for effective response

and to “Build Back Better” in recovery, rehabilitation and
reconstruction
xx The growth of disaster risk means there is a need to strengthen
disaster preparedness for response, take action in anticipation of
events, and ensure capacities are in place for effective response and
recovery at all levels. The recovery, rehabilitation and reconstruction
phase is a critical opportunity to build back better, including through
integrating disaster risk reduction into development measures.
xx Priority 4 specifically calls for the enhancement of recovery

schemes to provide psychosocial support and mental health
services for all people in need.
4. RA 10121. Philippine Disaster Risk Reduction and Management Act of

2010.
Known as “An Act Strengthening the Philippine Disaster Risk Reduction and
Management System, Providing for the National Disaster Risk Reduction and
Management Framework and Institutionalizing the National Disaster Risk
Reduction and Management Plan, Appropriating Funds Therefor and for other
Purposes.”
This law Repealed Presidential Decree No. 1566 enacted in 1978 and
transformed the Philippines’ disaster management system from disaster relief
and response towards disaster risk reduction (DRR).
36
MODULE 2
PARADIGM SHIFT
Top-down and centralized Bottom-up and participatory disaster

disaster management risk reduction
Disaster mainly a reflection of

Disasters as merely a people’s vulnerability
function of physical hazards
Integrated approach to genuine

Focus on disaster social and human development to
response and anticipation reduce disaster risk
RA 10121 acknowledges the need to:

• “Adopt a disaster risk reduction and management approach that is
holistic, comprehensive, integrated, and proactive in lessening the
socioeconomic and environmental impacts of disasters including climate
change, and promote the involvement and participation of all sectors and
all stakeholders concerned, at all levels, especially the local community
• Develop and strengthen the capacities of vulnerable and marginalized
groups to mitigate, prepare for, respond to, and recover from the
effects of disasters;
• Provide maximum care, assistance and services to individuals
and families affected by disaster, implement emergency rehabilitation
projects to lessen the impact of disaster, and facilitate resumption of
normal social and economic activities.
KEY PLAYERS UNDER RA 10121
National Local
Government Government
Civil Community
Society
37
With RA 10121, local government units (LGUs), civil society organizations

(CSOs), and the community itself are empowered as key partners in disaster
risk reduction. This diagram shows how RA 10121 provides for integrated,
coordinated, multi-sectoral, inter-agency, and community-based approach to
disaster risk reduction
5. National Disaster Risk Reduction and Management Plan (NDRRMP)
What is the NDRRMP?

It is the document formulated and implemented by the National DRRM Council
through the Office of Civil Defense (OCD) that sets out goals and specific
objectives for reducing disaster risks together with related actions to accomplish
these objectives.
The NDRRMP in is in conformity with the National Disaster Risk Reduction and
Management Framework (NDRRMF) shown below:
THE NDRRM FRAMEWORK

Safer, adaptive and resilient Filipino communities
toward sustainable development
RISK FACTORS
Mainstreaming
Hazards
DRR and CCA in
Exposures
Planning and
Vulnerabilities
Implementation
Capacities
Rehabilitaton & Recovery Prevention & Mitigation
Response Preparedness
The NDRRMP covers the following four thematic areas:

• Disaster Prevention and Mitigation: Reduce vulnerability and exposure
of communities to all hazards; enhance capacities of communities to
reduce their own risks and cope with the impacts of all hazards
38
MODULE 2
• Disaster Preparedness: Increase the level of awareness of the

community to the threats and impacts of all hazards, risks and
vulnerabilities; equip the community with the necessary skills to
cope with the negative impacts of a disaster; increase the capacity of
institutions; and develop and implement comprehensive national and
local disaster preparedness policies, plans and systems
• Disaster Response: Decrease the number of preventable deaths and
injuries; provide basic subsistence needs of affected population;
immediately restore basic social services
• Disaster Rehabilitation and Recovery: Restore people’s means of
livelihood and continuity of economic activities and business; restore
shelter and other buildings/installation; reconstruct infrastructure
and other public utilities; assist in the physical and psychological
rehabilitation of persons who suffered from the effects of the
disaster
6. RA 10821. Children’s Emergency Relief and Protection Act

DO: SHOW THE RA 10821 LGU VIDEO (7 min 37 sec runtime). If for some
reason video is not able to be played, proceed to the discussion of the summary
of the Act below
The “Children’s Emergency Relief & Protection Act,” or An Act Mandating

the Provision of Emergency Relief and Protection for Children Before, During,
and After Disasters and other Emergency Situations is the first of its kind
anywhere in the world.
It is the Country’s national policy to protect the particular needs of children

before, during, and after crisis through the following 8 Action Plans:
• A Comprehensive Emergency Program to protect children and support
their immediate recovery.
• Heightened surveillance against child trafficking and other violence
against children in the aftermath of disasters and calamities.
• A system of restoring civil documents for children and their families to
better access services and protect against exploitation.
• Increased participation of children in disaster risk reduction (DRR)
planning and post-disaster needs assessments.
• Less disruption of education activities with the reduced use of schools
as evacuation centers and the proper use of temporary learning spaces.
• Improved care and steps for family tracing and reunification for
unaccompanied and separated children.
• Better data collection and reporting related to the affected children—to
39
better understand and respond to their specific needs.

• Child-centered training of all responders for community/barangay
leaders, school personnel and rescuers.
DO: another alternative to showing the video is presenting the following graphic:
C H I
Comprehensive Heightened Increased child
L D R E N
Limited use of Disaggregated Restoration of Enhanced services Nationwide training
Emergency measures to prevent, involvement and schools as data collection that civil registry for orphaned, of responders on
Program for detect and address participation in evacuation centers identifies children documents unaccompanied and child protection and
Children (CEPC) reports and incidents DRR planning and and monitoring of separated children psychosocial
formulated by the of child labor, child post-disaster needs Temporary with measures on intervention
Department of trafficking and other assessment Learning Spaces DATA COLLECTION rapid Family Tracing
Social Welfare and forms of abuse and (TLS) AGE (BELOW 18) CIVIL
REGISTRY and Reunification
DOCUMENTS
Development exploitation HAZARD MAP SEX (MALE/FEMALE) (FTR)
(DSWD) with other EVACUATION MAP
agencies and TEMPORARY LEARNING SPACES (TLS)
FTR
Civil Society RESPONDERS TRAINED
ABC SPECIFICALLY FOR CHILD’S NEEDS
Organizations
VAWC
(CSO)
CEPC
DSWD
CSO
In line with the provisions of the Act:

• All provincial, city and municipal LGUs must localize the National
Comprehensive Emergency Program for Children (CEPC) with their
context
• Stakeholders should ensure meaningful participation of Civil Society
and Children in all phases of disasters and emergencies
• All agencies and organizations working on disaster response must adopt
a child protection policy that all emergency responders should conform
to
• RA 10821 specifically calls for the establishment of child-friendly spaces
where communities create nurturing environments for children to engage
in free and structured play, recreation, leisure and learning activities.
The child-friendly space may provide health, nutrition, and psychosocial
support, and other services or activities which will restore their normal
functioning.

• The integration of MHPSS principles in emergency response is articulated in
various government programs as well as international frameworks.
• Local and international policies recognize that MHPSS during disaster response
begins from the moment basic services are provided to the affected population.
40
MODULE 2
SESSION 2:
THE DRRMC AND THE CLUSTER APPROACH
IN DISASTER MANAGEMENT
LEARNING OUTCOMES:
• Define the structure of the DRRMC and the cluster approach
• Identify and enumerate the roles and responsibilities of stakeholders in
the cluster approach
DO: Ask the participants to form two groups. For Group A, assign the following roles
to four members of the group: Health Coordinator, Education Coordinator, Camp
Coordinator, and Logistics Coordinator. The rest of the members of Group A will be
observers. For Group B, do not assign any roles.
Give this scenario to both groups and allow them to prepare a simple distribution plan
based on the given situation. Give each group 2 minutes to present
Scenario:
You are in the middle of a coordination meeting. It was reported that
Organization ABC will be sending out donations to the Municipality of
Kapayapaan after Typhoon Masigasig hit the island municipality. Their
donations include hygiene kits, kits for building temporary learning
spaces, food packs and support kits for MHPSS service providers. The
donations will pass through the port of Kasaysayan which is 20 minutes
away by boat from the municipality. There are five big evacuation camps
in the island municipality.
Action:
Create a distribution plan based on the given situation. After 5 minutes,
present your plan to the rest of the group.
Post-Activity Processing:
1. What have you observed from the plan of Group A? How about by Group B?
2. For Group A, how was your experience in preparing the plan? How about for
Group B?
41
SAY: As we can observe from the exercise, coordination is a crucial mechanism in

order to ensure the effective delivery of services. If we are not aware of our roles and
responsibilities, it will be difficult for us to determine what we need to do and how to
effectively do it. We have varied understanding of our roles and responsibilities during
emergencies. Some of us are not fully aware of what DRRMCs are and what we should
be doing during disasters. Emergency responders are expected to have undergone
basic DRRM Training organized by your local DRRMOs. In this session, we will give a
basic overview/refresher of the DRRMCs and the cluster approach in the Philippines.

DRRMC and the Cluster Approach
SLIDESHOW CONTENT
Philippine Disaster Risk Reduction and Management Milestones
2016
2010 Children’s
Disaster Risk Emergency Relief
Reduction and and Protection Act
2007 Management Law
Adoption of the
Cluster Approach
1991
Government
Local Autonomy
1978
Presidential
Decree 1566
42
MODULE 2
On June 11, 1978, PD 1566 was issued to strengthen the Philippine disaster
control capability and to establish a community disaster preparedness program
nationwide. Some of the key points of this law is the creation of the National
Disaster Coordinating Council (NDCC) and the localization of the DCC offices17.
In 1991, the Local Government Code paved the way for the increase of the calamity
fund from 1% to 2%.
In line with the United Nations thrust in pursuing a reform program that seeks
to improve the effectiveness of humanitarian response by ensuring greater
predictability, accountability and partnership, the cluster approach is now being
implemented and institutionalized in the Philippine Disaster Management System.
This was contained in the National Disaster Coordinating Council (NDCC) Circular
dated May 10, 2007 entitled “Institutionalization of the Cluster Approach in the
Philippine Disaster Management System, Designation of Cluster Leads and Their
Terms of Reference at the National, Regional and Provincial Level”.
As discussed in the previous session, RA 10821 or the Children’s Emergency Relief

and Protection Act was signed into law in 2017. Different agencies are expected to
cater to the needs of children during disasters based on their functions as part of
the National Disaster Risk Reduction & Management Council (NDRRMC).
The NDRRMC
The National Disaster Risk Reduction & Management Council (NDRRMC) is the
highest organized and authorized body for Disaster Risk Reduction and Management
(DRRM) in the Philippines. Established by virtue of Republic Act 10121 in 2010,
the NDRRMC is composed of various government, non-government, civil sector
and private sector organizations.
Within the NDRRMC, four committees are established to deal with the four
thematic areas set forth in the NDRRM Plan (NDRRMP), the NDRRM Framework
(NDRRMF) and the National Disaster Response Plan (NDRP).
Following RA 10121, the overall lead or focal agency for each of the four priority
areas are the vice-chairpersons of the NDRRMC as seen in the following:
Sendai framework for disaster risk reduction 2015–2030. In: UN world conference on disaster risk reduction, 2015
17
March 14–18, Sendai, Japan. Geneva: United Nations Office for Disaster Risk Reduction; 2015. Available from: http://
www.wcdrr.org/uploads/Sendai_Framework_for_Disaster_Risk_Reduction_2015-2030.pdf
43
DND
Chair
DILG DSWD DOST NEDA

Vice-Chair Vice-Chair Vice-Chair Vice-Chair
Disaster Response Preventions & Rehabilitation
Preparedness Mitigation and Recovery
MEMBERS:
AFP DA DBM DENR DepEd
DOE DOH DOF DOJ DOLE DOT
Executive
DOTC DTI PNRC OCD
Secretary
NEW MEMBERS:
CHED CCC DPWH DFA HUDCC
GSIS NCRFW OPAPP PHIC PNP SSS
LCP LPP LMP LMB ULAP
NAPC- Press Private

VDC Secretary Sector
CSO CSO CSO CSO
Most disasters and emergencies are managed by the DRRMCs at different levels
depending on the severity and magnitude using the principles of the incident
command system (ICS) and the cluster approach.
The Cluster Approach

The Cluster Approach allows the government to (1) designate cluster leads in all
the areas of activity, (2) define leadership roles among government cluster leads
in crafting operational strategies throughout the phases of disaster management,
and (3) identify deliverables at the regional and provincial level.
What is a “Cluster”? A cluster is a group of agencies (international & national) that

are interconnected by their respective mandates, and that come together around
a set of humanitarian interventions in a common area, for purposes of synergies,
surge, effectiveness, efficiency, and accountability.
44
MODULE 2
According to the NDRP18, NDCC Circular No 2 of 2008 identified 8 Clusters that will
facilitate all coordination needed in the provision of the humanitarian assistance. But
through a series of disasters, the cluster approach was later adopted for response
activities of the national agencies for their respective response operations prior
to the provision of humanitarian assistance. It was later observed that the Cluster
approach proved effective in providing assistance to the affected population during
response operations.
Based on RA 10121 and the NDRP, these are the lead and member agencies for
each cluster.
Cluster Member
Cluster Lead Cluster Agency
Agency
PAG-ASA, NFA, DOH,
Food and Non-Food
DSWD PNP, AFP, PCG, OCD,
Items (NFIs)
DA, PRC, BFP
HEALTH DSWD, OCD, DND
[Health Services (Public through AFP, DILG,
Health and PNP, BFP, DepEd,
Hospitals), Water, DOTC through PCG,
Sanitation and Hygiene DOH DFA, DOST, DENR
(WASH), Nutrition, through MGB, PRC,
Mental Health Volunteers/Civil Society
and Psychosocial Organizations/ and other
Support (MHPSS)] Health Sector Partners
PAG-ASA, MGB, DepEd,
Protection Camp
DOH, PNP, DILG, AFP,
Coordination and
DSWD PCG, OCD, DA, NFA,
Management
HUDCC, NHA, PRC,
(PCCM)
NNC, DPWH, BFP, IOM
PAG-ASA, DSWD, PNP,
Logistics OCD
AFP, MGB, DPWH, PCG,
DSWD, PNP, AFP,
PCG, DPWH, PIA and
Media, PLDT, Smart
Emergency
OCD Communications Inc. and
Telecommunications
Sun Cellular, BFP, NTC,
DOH, REACTPhils. Inc-
CRS AFP
18
National Disaster Response Plan for Hydro-Meteorological Hazards, June 2014.
45
Cluster Member
Cluster Lead Cluster Agency
Agency
Save the Children and
UNICEF, local and
international NGOs and
Education DepEd
CSOs, private partners,
DSWD, OCD, TESDA,
DPWH, MGB, PNP
DILG, OCD, PCG,
BFP, MGB, DPWH,
Search, Rescue and PRC,MMDA,
AFP
Retrieval Volunteers/Civil Society
Organizations, NBI,
DOH, DFA, Telcos,
Management of the Dead OCD, DOH, DSWD,
DILG
and the Missing PRC, NBI, DFA, PNP
DPWH, NHA, HUDCC,
Emergency Shelter DSWD
DILG, OCD
Functions/Tasks:
• Craft operational strategies covering all phases in disaster management
that will provide direction for cluster partners on how, what, when and where
to contribute;
• Facilitate a process that will ensure a well-coordinated and effective
humanitarian response;
• Ensure continuous improvement in the implementation of the cluster
approach through identification of best practices and carrying out lessons
learned either individually or in collaboration with other clusters
In an effort to harmonize with international humanitarian clusters, our lead

government agencies have identified foreign co-leads in the coordinating disaster
response.
Cluster Local Lead Foreign Counterpart

International
Camp Coordination and
DSWD Organization for
Management
Migration (IOM)
United Nations Refugee
Protection DSWD
Agency (UNHCR)
46
MODULE 2
Cluster Local Lead Foreign Counterpart

United Nations
Early Recovery OCD Development
Programme (UNDP)
World Food Programme
Logistics OCD
(WFP)
Food DSWD WFP
Food and Agriculture
Agriculture DA
Organization (FAO)
International Labor
Livelihood DSWD
Organization (ILO)
UNICEF and Save the
Education DepEd
Children
World Health
Health DOH
Organization (WHO)
International Federation
Emergency Shelter DSWD
of the Red Cross (IFRC)
NDRP Clusters
The NDRP prescribes the relevant activities on how the disaster response shall be
conducted as augmentation or assumption of response functions to the disaster
affected LGUs. The contents of the NDRP also include identifying roles and
responsibilities of organizations/institutions during disaster/emergency phase.
There are currently three NDRPs launched by the NDRRMC:

• NDRP for Hydro-Meteorological Hazards
• NDRP for Earthquake and Tsunamis
• NDRP for Consequence Management (Terrorism-related incidents)
The same 8 Clusters were adopted during the preparation of the NDRP. The
objective of the adoption is to have a seamless coordination system with the
international humanitarian assistance Cluster Groups during disaster response
operations. Activation of the Response Cluster is determined by the NDRRMC.
The organization structure of the Response Cluster is shown in the figure on the
next page.
47
ORGANIZATION STRUCTURE
OF THE RESPONSE CLUSTER
NDRRMC
Chairperson
DSWD
Vice Chairperson for Response
DepEd DSWD DOH DND OCD DILG

through the AFP
Education FNI Cluster Health Search, Logistics Management

(WASH, Medical, of the Dead
Nutrition, and
Rescue &
MHPSS) Retrieval and Missing
PCCM Emergency (MDM)
(Protection Camp Telecoms
Coordination
Management)
Roles and responsibilities of each sector2
National Level
• Ensure the inclusion of humanitarian partners in the cluster taking
• stock of their mandates and programme priorities
• Establish and maintain appropriate humanitarian coordination
• mechanisms at the national level
• Attend to priority cross-cutting cutting issues
• Perform needs assessment and analysis
• Promote emergency preparedness
• Initiate planning and strategy development
• Promote application of standards
• Conduct monitoring and reporting
• Raise advocacy and lead resource mobilization
• Conduct training and capacity building
Regional Level
• Provide first line of support (technical or operational) to complement the
roles and responsibilities of national counterparts19.
19
This definition or description is applicable only if national and regional level clusters are both activated at the same time.
There have been several events where regional level clusters were activated but none at the national level. The roles and
responsibilities of the cluster at national or subnational levels are the same, appropriate and applicable to the relevant
level (WHO)
48
MODULE 2
COMPOSITION OF THE LDRRMC (SEC. 11.A)
Governor/
Mayor
Chair
MEMBERS:
DRRM Engineering Health

Officer Officer Officer
ABC PNRC PNP AFP
Gender and Planning and

Superintendent Bureau of
Development Development
of Schools Fire Protection
Officer Officer
Agriculture Veterinary Budget Social Welfare

Officer Officer Officer & Development
Officer
Private
CSO CSO CSO CSO
Sector
Provincial Level
• Develop baseline database of provincial demography sectoral data and
other basic information to facilitate rapid needs assessment of affected
areas, timely mobilization of resources, and delivery of urgent assistance to
the right beneficiaries through the clusters.
An important link in the national-local chain are the Regional Disaster Risk
Reduction and Management Councils (RDRRMCs) and the Local DRRMCs. The
structure of the latter is as follows:
Coordination function
Memo no. 62 highlights the importance of Coordination as a cross-cutting
functions across all emergency responders. As part of preparedness, all
agencies are expected to establish and strengthen coordination mechanisms for
inter-sectoral MHPSS at all levels. Upon the activation of the clusters, different
agencies are expected to constantly communicate with each other, share
information and data, coordinate the provision of services based on
agency mandates. Inter-cluster coordination plays a critical role in facilitating the
development of the strategic response plan and assures a coherent and coordinated
approach to planning and operationalizing the shared strategic objectives as set
out in the strategic response plan.
49
End of Module Activity

(15 minutes)
Plenary Discussion
DISCUSSION POINTS
1. Who among you have experienced working with the clusters? Please
share your experience.
2. What do you think are the benefits of a coordinated response?
SAY: We have now reached the end of Module II. Some of the key messages from this
module are:
1. A basic policy framework provides structure to mental health and psychosocial

support, ensuring its consistent and systematic delivery.
2. Most disasters and emergencies are managed by the DRRMCs at different
levels depending on the severity and magnitude using the principles of the
incident command system (ICS) and the cluster approach.
SAY: Do you have questions? Any insights that you would like to share with everyone?
1. Republic Act 10121 - National Disaster Risk Reduction and Management Act
2. Republic Act 10821 - Children’s Emergency Relief and Protection Act
3. Inter-Agency Standing Committee Guidelines on Mental Health and Psychosocial
Support (MHPSS) in Emergency Settings
4. National Disaster Response Plans for Earthquakes and Tsunamis, Consequence
Management and Hydro-Meteorological Hazards
50
MODULE 3
MODULE 3
Wellbeing, Individual and Family
Assessment, and Referral System
51
MODULE 3:
Wellbeing, Individual and Family Assessment,
and Referral System
Module Objective:
To list the conceptual and functional foundations of MHPSS in emergencies
Facilitators: It is required that this module is facilitated by an MHPSS practitioner.
Link to presentation: http://bit.ly/HarmonizedMHPSSModuleIII
52
MODULE 3
Learning
outcomes
Mental 75 mins Define wellbeing • Slideshow • IASC
health, in the context • Metacards Guidelines on
psychosocial of disasters MHPSS
support and and emergency • NDRRMC
wellbeing situations Memo
Circular 62
Understand the
value of resilience,
adaptive coping,
and social support
in extreme life
events
Use the Bilog ng

Buhay framework
in identifying
strengths and
needs of individuals
in emergencies.
Assessment: 50 mins Identify commonly • Slideshow • PFA Module
Look, Listen, seen signs of • PFA Card • IASC
and Link distress resulting Guidelines
from disaster
experience
Demonstrate active
listening
Enumerate the
services available
for mental health
and psychosocial
problems
encountered during
disasters.
53
SESSION 1:
MENTAL HEALTH, PSYCHOSOCIAL SUPPORT,
AND WELLBEING
LEARNING OUTCOMES:
• Define wellbeing in the context of disasters and emergency situations
• Understand the value of resilience, adaptive coping, and social support
in extreme life events
• Use the Bilog ng Buhay framework in identifying strengths and needs
of individuals in emergencies.
SAY: In the aftermath of disasters, promoting mental health must be based on an

understanding of what wellbeing means, especially in the Philippine context. The
wellbeing framework, alongside the Mga Bilog ng Buhay framework and knowledge
of the concepts of coping and resilience will be useful references in the attempt to
provide a holistic MHPSS program to affected communities.
Mindfulness Exercise20.
SAY: Now that we have acquired substantial understanding of the structure of MHPSS
and the different guidelines that make up its core, we will now look at MHPSS and what
it means at the level of the individual. We will begin this module with a mindfulness
exercise.
Mindfulness Exercise Script:

Let us begin the exercise by sitting into a comfortable posture with your feet flat on the
floor and your hands on your lap. Close your eyes and breathe normally. If you are not
comfortable in closing your eyes, you may simply look down (pause for 30 seconds).
Bringing your attention to your body, notice how your body is seated. Notice the weight
of your body on the chair. Inhale, and exhale (pause for 30 seconds).
20
Notes to the Facilitator: Mindfulness is an intervention taken from Buddhist meditation which enables individuals to
become aware of their inner and outer selves. Mindful individuals are found to be more conscious of what is happening
around them and are able to control their reactions to events more effectively. It is recommended that facilitators recite
the script in a calm and slow manner.
54
MODULE 3
As you inhale, notice how the air enters your body. Notice how the air goes out of your
body as you exhale (pause for 30 seconds).
Notice what is on your mind. What are you thinking about at this moment? Notice the
sounds you hear. Notice the volume: What kind of sound is it (pause for 30 seconds)?
Bringing your attention to your feet on the floor, notice the sensations of your feet - the
pressure, heaviness, lightness of your feet. Bringing your attention to the stomach. Is
it tense or tight? Let it soften. Inhale, and exhale (pause for 30 seconds).
Bringing your attention to your hands and your arms, feel all the sensations. Loosen
them and soften your shoulders. Notice the sensations as you loosen them. Bringing
your attention to your neck and throat, are they stiff or tense? Loosen them and notice
the feeling as you loosen them (pause for 30 seconds).
Notice your entire body. Inhale, and exhale. When I count to three, you may open your
eyes. One, two, three.
Post-activity processing (5 minutes)
SAY: What did you notice while doing the activity?

(Allow a short time for sharing)
SAY: What we just did is called a mindfulness exercise. Being mindful helps us become
focused and aware of the things happening inside our mind and body. Based on what
you shared, the two feedback on each other: our mind knows when the body is unwell,
and vice versa. We feel good when both are aligned and in- good condition. During
disasters and emergency situations, this alignment is threatened, leading to impaired
mental wellbeing. We must then understand what it means to keep it in check.

Identifying Mental Health Indicators in the Context of Disasters and
Emergencies
DO: Group participants into a manageable number and distribute three colors of
metacards for the activity
SAY: How would you describe good mental wellbeing before, during, and after a
disaster? What are its components? Discuss within the group and write your answers
on the cards.
55
DO: Encourage sharing of answers and then discuss the contents of the visual aid
on indicators of mental health, the value of resilience, adaptive coping, and social
support.

“wellbeing Framework”, Mga Bilog ng Buhay Framework, and coping and
resilience
SLIDESHOW CONTENT
The wellbeing Framework
Seven Aspects of wellbeing
Biological – refers to the many interrelated requirements and functions necessary

to live. It includes respiration, hydration, nutrition and overall functioning of the
body.
Material – includes the non-living aspects of the physical environment and all that
is in it such as roads, vehicles, tools, equipment, and structures in which people
live and work.
Mental – concerns thinking and other functions of the mind including learning,
acquiring information and being able to use it.
Emotional – refers to how we feel and our ability to be happy and free of negative
emotions such as fear, anger, and helplessness.
Social – involves human interaction that may be influenced by legal, political,

economic or cultural factors. It is our ability to know what to do and how to behave
when we encounter others. This requires rules and patterns that make these
interactions more predictable.
Cultural – consists of learned patterns of belief, thought and behavior. It defines

how things are supposed to be within groups or societies. It influences how we
interpret what we experience and gives meaning to events and interactions. It
defines what behavior is normal or abnormal.
Spiritual – concerns beliefs and practices which expresses a person’s faith in and
relationship with a “Higher Power” whether this is expressed through one of the
56
MODULE 3
world’s major religions or through indigenous beliefs.
These seven aspects of wellbeing must be measured in terms of how they

contribute to:
• Safety
• Protection of human rights
• People’s participation
• Sustainable development
Mga Bilog ng Buhay Framework

In the process of coping and transforming ourselves from being victims to being
survivors we can use the “Mga Bilog ng Buhay” framework derived from our
understanding of Filipino psychology. Under this framework, the Filipino identity is
thought to consist of four dimensions:
1. Loob (Inner reality) – consists of positive and negative changes in thoughts
and feelings which result from the adverse or extreme life event.
2. Kapwa (External reality) – consists of adaptive or maladaptive changes in
our relationship with the family, at work and with the environment.
3. Kaginhawaan (Peace of mind) – refers to our state of inner peace which
may be sustained by faith in a “Higher Power” or ability to give positive
meaning to the adverse event.
4. Kakayahan (Empowerment) – comes from our ability to recognize and
use our own resources as well as the availability of external support.
These are interconnected aspects of a whole. As each aspect is assessed and

addressed, the survivor regains trust in himself and in others. He is reconnected
and relationships are restored. The survivor sees inter-connectedness in all things
and constructs the more positive view of the traumatic event.
Recovery is the achievement of a significant decrease or removal of unpleasant

consequences of the event in terms of these four dimensions.
Mga Bilog ng Buhay

Kaginhawaan
Kalooban Kapwa
Kakayanan
57
Definitions
Resilience: The ability to recover or regain readily our normal level of functioning
or particular state.
Coping: The process of attempting to actively manage demands that are appraised
by those affected as taxing or exceeding usual personal or community resources.
Group discussion and plenary

(10 mins group discussion, 10 mins plenary
presentation).
Divide the participants into groups. Each group will hold a discussion around the
following points and present the highlights to the plenary.
DISCUSSION POINTS
1. How would you relate the wellbeing and Mga Bilog ng Buhay frameworks,
to define what wellbeing means for a Filipino?
2. In your experience as a service responder, what are some of the coping
practices that you have observed among survivors of of disasters?
3. Do these practices contribute to honing resilience? Why/why not?
4. How does your role in the delivery of MHPSS contribute to the promotion
of resilience?

• In the process of coping and transforming ourselves from being victims to being
understanding of Filipino psychology.
• The individual has different approaches and practices to coping that we must
understand and consider when we provide our services especially during
emergencies.
58
MODULE 3
SESSION 2:
ASSESSMENT: LOOK, LISTEN, AND LINK
LEARNING OUTCOMES:
• Identify commonly seen signs of distress resulting from disaster
experience
• Demonstrate active listening
• Enumerate the services available for mental health and psychosocial
problems encountered during disasters
SAY: During emergencies, affected individuals may be tired, hungry, or thirsty, etc.
Service responders can provide some basic comforts such as food, water or blankets.
It is also important to look for people who may need medical attention for injuries
or illness. At the same time, there are individuals who would need more attention
and help. For this session, what will be discussed is the importance of identifying
commonly seen signs of distress resulting from a disaster/emergency experience.
Responders need to familiarize themselves with reactions of people in distress, to be
able to determine what kind of services they need.
(LOOK) LECTURE (10 minutes):

Distress reactions to watch out for in the aftermath of a disaster.
SLIDESHOW CONTENT
Distress Reactions to Crisis

• Physical symptoms: shaking, headaches, fatigue, loss of appetite, aches
and pains
• Anxiety, fear
• Weeping, grief and sadness
• Guilt, shame (for having survived, or for not saving others)
• Elation for having survived
• Being on guard, jumpy
• Anger, irritability
• Being immobile, withdrawn
• Disorientation: not knowing one’s name, where one is from or what happened
• Inability to speak, or to respond to others
59
• Confusion, emotionally numbness, being in a daze or state of disbelief

• Inability to care for oneself or one’s children (not eating or drinking, or able
to make simple decisions)
SAY: Children would have similar reactions to crisis, but in most cases, they may
have difficulties expressing it. According to Save the Children, “common reactions of
children who have been through distressing events include problems with sleeping,
feelings of anxiety and depression, social withdrawal from others, concentration
difficulties, crying, clinging behaviour, anger and regression. Most children survive
distressing events without developing long-term mental health problems and many
recover by themselves. However, recovery can be helped when children receive
appropriate support at an early stage, and this can reduce the risk of developing long-
term mental health problems dramatically” (Psychological first aid training manual for
child practitioners, 2017).
There are different distress reactions for different people in different situations.
Depending on the distress reactions, there are also different ways to help the person
in distress. We must know what help is available in the community for the common
distress reactions.
(LISTEN) LECTURE (10 minutes):

Listening and gathering information from members of disaster-affected
communities.
SAY: Say: By properly listening to victims of disasters, service responders can draw
a wealth of helpful information that will enable better delivery of mental health and
psychosocial support. This session talks about active listening.
SLIDESHOW CONTENT
What is active listening21?

• A way of listening and responding to another person that improves mutual
understanding
• A structured form of listening and responding that focuses the attention on
the speaker
21
Conflict Research Consortium, University of Colorado. “Active Listening.” 1998.
60
MODULE 3
Things to Say and Do22

• Try to find a quiet place to talk and minimize outside distractions.
• Stay near the person but keep an appropriate distance depending on
their age, gender, and culture.
• Let them know you hear them, for example, nod your head and say…
“Hmm.”
• Be patient and calm.
• Provide factual information. If you have it. Be honest about what you
know and what you don’t know. “I don’t know but I will try to find
out about that for you.”
• Give information in a way the person can understand – keep it
simple.
• Acknowledge how they are feeling, and any losses or important
events they share with you, such as loss of home or death of a
loved one. Say, “I’m so sorry…”
• Respect privacy.
• Keep the person’s story confidential, especially when they disclose
very private events.
• Acknowledge the person’s strengths and how they have helped
themselves.
Things NOT to Say and Do

• Don’t pressure someone to tell their story.
• Don’t interrupt or rush someone’s story.
• Don’t give your opinions of the person’s situation, just listen.
• Don’t touch the person if you’re not sure it is appropriate to do so.
• Don’t judge what they have or haven’t done, or how they are feeling.
Don’t say…” You shouldn’t feel that way.” or “You should feel lucky
you survived.”
• Don’t share things you are unsure of.
• Don’t use terms that are too technical.
• Don’t tell them someone else’s story.
• Don’t talk about your own troubles.
• Don’t give false promises or false reassurances.
• Don’t feel you have to try to solve all the person’s problems for them.
• Don’t take away the person’s strength and sense of being able to
care for themselves.
22
World Health Organization, War Trauma Foundation and World Vision International (2011). Psychological first aid:
Guide for field workers. WHO: Geneva.
61
(LINK) LECTURE (10 minutes):
SAY: In an effective MHPSS program, service responders understand that each sector
plays a particular role in service delivery. They must then learn how to use the existing
MHPSS referral pathway for tasks that must be left in the hands of the appropriate
agency or organization to handle particular concerns. Through this session, participants
will find an opportunity to learn more about this pathway, and how it can be optimized
for MHPSS in disasters.
In times of emergencies, the service responder’s role is not to solve all of people’s
problems for them, but help them to address their own needs. Linking them with
information, services, and social support will help them to regain control of their
situation. This part of the module will help you gain insights on the services that are
available for mental health and psychosocial problems encountered during disasters.
A referral is the process of directing a client to another service provider because
s/he requires help that is beyond the expertise or scope of work of the current
service provider. A referral can be made to a variety of services, for example health,
psychosocial activities, protection services, nutrition, education, shelter, material or
financial assistance, physical rehabilitation, community centre and/ or a social service
agency .
Some tools on assessing needs will be discussed in Module IV.
SLIDESHOW CONTENT
Linking has the following goals:

• Help people address basic needs and access services.
• Help people cope with problems.
• Give information.
• Connect people with loved ones and social support.
Help people address basic needs and access services.

• Ask: What needs do they request? What services are available?
• Don’t overlook the needs of vulnerable or marginalized people.
• Follow-up if you promise to do so.
62
MODULE 3
Help people cope with problems

• Distressed people may feel overwhelmed with worries.
• Help them prioritize urgent needs (what to do first).
• Help them identify supports in their life.
• Give practical suggestions on how they can meet their needs (e.g.,
registering for food aid).
• Help them remember how they coped in the past and what helps them to
feel better.
Give information.
• Find accurate information before helping.
• Keep updated.
• Make sure people are informed where and how to access services -
especially vulnerable people.
• Say only what you know – don’t make up information.
• Keep messages simple and accurate, repeat often.
• Give the same information to groups to decrease rumours.
• Explain source and reliability of information you give.
• Let them know when and where you will update them.
Connect people with loved ones and social support.

• Keep families together and children with caregivers.
• Help people contact friends and loved ones.
• Give access to religious support.
• Affected people may be able to help each other - bring them together.
• Make sure people know about how to access services (especially vulnerable
people).
The NCMH recommends this flowchart after an assessment:
SERVICE PROVIDERS:
Psychosocial
Social Worker, BHW, Midwife, Nurses, NO
CLIENT Processing HOME
MD (*Assessment if psychosocial
Needed
support is needed
YES
Service providers capable of providing
MHPSS/Psychosocial Intervention
NO Mental Health
Improved? Specialist
(Psychiatrist)
YES
HOME
63
End of Module Activity (15 minutes):

Pakikisama, Pakikinig, at Pakikiramdam
DO: Ask the participants to look for a partner. Go to an empty space outside of
the training area (if this is not possible, find an empty space in the room where all
participants would fit). One of the pairs must be blindfolded while the other one will be
giving directions. Those who are not blindfolded must give directions to their partner
to reach the other end of the empty space. The first one to reach the end of the room
wins.
SAY: How did you find the activity? To those who reached the end, what did you do
to accomplish the task? What made it easy and difficult? (Get up to five responses).
In every given scenario, especially during emergencies, we give value to Trust

(Pagtitiwala), Sensitivity (Pakikiramdam), and Listening (Pakikinig). What we did is just
a simple reminder of how important it is when victim-survivors trust us and share their
experiences with us during the disaster, and how listening to them and being sensitive
to their thoughts and feelings can help them cope with the effects of the emergency or
disaster. While we have a long list of tasks and responsibilities as responders, being
able to apply these values as we respond to their needs can help a lot.
However, there are cases when listening is not enough. This is when we refer them to
other entities who possess expertise in special services.
SAY: We have now reached the end of Module III. Some of the key messages from
this module are:
• In the process of coping and transforming ourselves from being victims to being
understanding of Filipino psychology.
• By properly listening to victims of disasters, responders can draw a wealth
of helpful information that will enable better delivery of mental health and
psychosocial support.
• In an effective MHPSS program, responders understand that each sector
plays a particular role in service delivery. They must then learn how to use the
existing MHPSS referral pathway for tasks that must be left in the hands of the
appropriate agency or organization to handle particular concerns.
64
MODULE 3
1. Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and

Psychosocial Support (MHPSS) in Emergency Settings
2. Department of Health and University of the Philippines (2009). Manual for
Trainers: Enhancing Capacities in Mental Health and Psychosocial Support in
Emergencies and Disasters.
3. American Psychological Association (2013). Recovering emotionally from
disaster. URL: https://bit.ly/1iMOxJU
4. Centers for Disease Control and Prevention (2018). wellbeing concepts. URL:
https://bit.ly/2wvIXeq
5. Shear, Katherine (2016). Managing Grief after Disaster. National Center for
PTSD. URL: https://bit.ly/2O6Y7im
65
MODULE 4
MHPSS Interventions
66
MODULE 4
MODULE 4:
MHPSS Interventions
Module Objective:
To give an overview of existing interventions universally accepted and used by MH-
PSS practitioners during emergencies
Facilitators: It is required that this module is facilitated by an MHPSS practitioner or

trained facilitator.
Link to presentation: http://bit.ly/HarmonizedMHPSSModuleIV
67
Learning
outcomes
Intervention 120 mins Demonstrate • Slideshow • IASC
Pyramid understanding of • Metacards Guidelines
the intervention on MHPSS
pyramid
Describe the kinds

of interventions
that correspond
to each level of
the intervention
pyramid
Psychological 120 mins Demonstrate • Slideshow • IASC
First Aid (PFA) knowledge of Guidelines
conducting PFA on MHPSS
• NCMH
MHPSS
Trainers’
Manual
Self-care or 60 mins Describe principles • Pens • PFA Module

caring for of self-care, and • Worksheets
carers how to conduct • Coloring
activities that materials
facilitate self-care
68
MODULE 4
SESSION 1:
MENTAL HEALTH, PSYCHOSOCIAL SUPPORT,
AND WELLBEING
LEARNING OUTCOMES:
• Demonstrate understanding of the intervention pyramid
• Describe the kinds of interventions that correspond to each level of the
intervention pyramid
SAY: The intervention pyramid outlines the kinds of services that respond to different
needs. Service responders should be able to locate what they offer within this pyramid,
to ensure effective MHPSS delivery. We will be looking at the different levels of
intervention in the pyramid. We will also look closely at what types of intervention can
be provided by responders in each level.

Isang Tanong, Isang Sagot
DO: Ask four volunteers to stand in front and assign each of them a number from
numbers 1 to 4 to represent each level of intervention. Flash the functions of each
level on the screen and give the rest of the group 10 secs to go to the number that
corresponds to the statement.
Statements:
1. Mass communication on constructive coping methods - Level 2
2. Advocating that these services are put in place with responsible actors - Level 1
3. Basic mental health care by primary health care workers - Level 3
4. Activation of social networks, such as through women’s groups and youth clubs
- Level 2
5. Provision of food packs and hygiene kits - Level 1
6. Establishment of child-friendly space and women-friendly space - Level 2
7. Psychosocial Processing - Level 3
8. “Libreng Ligo”, “Libreng Laba”, “Libreng Tawag” - Level 2
9. Establishment of conjugal space - Level 2
10. Provision of a prayer room - Level 2
11. Management of a drug dependent - Level 4
12. Providing basic health care services (Health Caravan) - Level 1
69
13. Facilitate grieving rituals - Level 2

14. Cleansing rites of tribes - Level 4
15. Grief Processing - Level 3
16. Psychotherapy - Level 4
17. Use of antipsychotics - Level 4
18. Controlling communicable diseases and preventing disease outbreaks - Level 1
19. Family Tracing and Reunification - Level 2
20. Cash for work - Level 2
SAY: What have you noticed from the activities of each level of the Intervention
Pyramid? What have you noticed with the Pyramid itself?
If you have observed, Level 1 tasks cover a lot of different sectors and not just Health or
MHPSS cluster. In the Pyramid, Level 1 is the widest base because we are addressing
all the basic needs of the affected population. As you go up the levels of the pyramid, the
services and tasks become more focused and the needs are becoming more definite.
Thus, the coverage of the services are also reduced as your needs and interventions
becomes more focused.

Introduction to the intervention pyramid
The intervention pyramid presents the integrated and layered approach that defines
an effective MHPSS program. It provides service responders with an appreciation
of the different needs of affected communities, as well as the roles of each sector in
helping provide sustainable and coordinated interventions.
70
MODULE 4
SLIDESHOW CONTENT
SPECIALIZED
SERVICES
FOCUSED,
NON-SPECIALIZED
SUPPORTS
COMMUNITY AND
FAMILY SUPPORTS
BASIC SERVICES
AND SECURITY
Basic services and security. The wellbeing of all people should be protected
through the (re)establishment of security, adequate governance and services that
address basic physical needs (food, shelter, water, basic health care, control of
communicable diseases). In most emergencies, specialists in sectors such as
food, health and shelter provide basic services.
Community and family supports. The second layer represents the emergency
response for a smaller number of people who are able to maintain their mental
health and psychosocial wellbeing if they receive help in accessing key community
and family supports. In most emergencies, there are significant disruptions of family
and community networks due to loss, displacement, family separation, community
fears and distrust. Moreover, even when family and community networks remain
intact, people in emergencies will benefit from help in accessing greater community
and family supports.
71
Focused, non-specialised supports. The third layer represents the supports

necessary for the still smaller number of people who additionally require more
focused individual, family or group interventions by trained and supervised workers
(but who may not have had years of training in specialised care). For example,
survivors of gender-based violence might need a mixture of emotional and
livelihood support from community workers. This layer also includes psychological
first aid (PFA) and basic mental health care by primary health care workers.
Specialised services. The top layer of the pyramid represents the additional
support required for the small percentage of the population whose suffering, despite
the supports already mentioned, is intolerable and who may have significant
difficulties in basic daily functioning. This assistance should include psychological
or psychiatric supports for people with severe mental disorders whenever their
needs exceed the capacities of existing primary/general health services. Such
problems require either (a) referral to specialised services if they exist, or (b)
initiation of longer-term training and supervision of primary/general health care
providers. Although specialised services are needed only for a small percentage
of the population, in most large emergencies this group amounts to thousands of
individuals.
Key to organising mental health and psychosocial support is to develop a layered

system of complementary supports that meets the needs of different groups. All
layers of the pyramid are important and should ideally be implemented concurrently.
Specialized services
• Traditional specialized healing (e.g. cleansing and purification rituals)
• Clinical social work or psychological treatment
• Use of antipsychotics/psychotherapy
• Drug or alcohol treatment
• Treatment of known psychotic clients in relapse and new cases/confinement
in a mental facility
Focused, non-specialized supports

• Case management
• Family visits
• Support groups
• Structured play/art activities
• Psychosocial hotlines
• Non-clinical family or individual counseling (e.g. school counseling)
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MODULE 4
Community and family supports

• Play, art, recreational and sporting activities
• Structured group activities
• Child-friendly spaces/women-friendly spaces
• Cultural and spiritual activities, grieving rituals
• Resumption of social networks
• Teacher/parents training
Basic services and security

• Provision of food, water, hygiene/dignity kits
• Basic health care
• Ensuring safety/protection against abuse
• Providing information
As the needs of those affected increase, so does the need for training for those
responding.
Mental health interventions

require professional
expertise and
extensive experience
 MORE TRAINING
Counselling, targeted support
groups require extensive training
on specific topics
PFA, support to affected population and

implementation of activities require first aid
training and basic psychosocial support
training
HIGHER NEEDS
Assistance to grouups, addressing protection

needs require awareness of psychosocial issues
Basic support - usually requires training based on the type of

services needed e.g. medical first aid, rescue and retrieval,
setting up water points, etc.
73
Level 1: Basic Services and Support

At this earliest stage, the affected population are already receiving some form
of MHPSS intervention by the basic services and security that responders are
providing them. Thus, the activities mentioned in this level help alleviate basic
psychosocial issues/ needs of the affected population.
It is important that responders observe the key principles of rights-based and

dignified service delivery. For example, in extending help to areas where Muslims
are a majority, it is preferred that women care providers dress modestly and are not
considered offensive to their religion. It is also recommended that veils are worn in
masjids (mosque) that are used as evacuation centers.
Rapid MHPSS risk assessment is also done at the beginning of the response and
it is expected that assessment should be done by ALL frontline service providers
in emergency settings.
Social and psychological considerations

• Document impact of lack of services and security on MHPS wellbeing and
use this for advocacy
• Advocate for the protection of children from violence, abuse and exploitation,
the promotion of family unity, re-establishing safe and supportive education
• Advocate for delivery of humanitarian assistance in a manner that promotes
wellbeing
• Work to promote ways of delivering aid that promote self-reliance and dignity
• Facilitate community involvement in decision-making and assistance
• Disseminate essential information to affected populations on situation and
emergency response
Level 2: Community and Family Support

The focus is more on the family and community. The National Guidelines on MHPSS
recognizes venues where MHPSS services are being delivered, like evacuation
camps, temporary learning spaces (TLS) for school children, women and child-
friendly spaces, and even churches.
Activities done in this level address the MHPS needs of family and communities that
were not initially addressed at the onset of the emergency. Delivering interventions
designed for group settings may yield different results and insights that can help
facilitate and speed up the recovery of affected communities. Service responders
should know how to conduct such interventions, and explore how these can boost
a sense of connectedness in the aftermath of a disaster.
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MODULE 4
Social and psychological considerations

• Support play, art, recreational and sporting activities
• Provide structured groups activities for expression and the development of
life skills and coping mechanisms
• Support children and youth friendly spaces/environments
• Promote meaningful opportunities to participate in rebuilding society
• Provide information on positive coping mechanisms
• Facilitate the inclusion of isolated individuals (orphans, widows, widowers,
elderly people, people with severe mental disorders or disabilities or those
without their families) into social networks
• Provide culturally appropriate guidance on how parents and family members
can help children
• Support parents and families to cope with their own difficulties
• Support the establishment of parent groups/committees
• Promote early childhood stimulation (with nutrition)
• Promote informal family visits for caregivers in need of extra support
• Support family access to basic services
• Help caregivers and educators to better cope and to support children
• Strengthen community based supports for adult caregivers
• Strengthen child-to-child or youth support
• Promote the resumption of cultural and spiritual activities, including
appropriate grieving rituals
• Strengthen social networks
• Facilitate teacher training on psychosocial care and support
• Lead group discussions on how the community may help at-risk groups
identified in the assessment as needing protection and support
Level 3: Focused, non-specialized supports

At this stage, observable health-related concerns are being addressed by service
providers, particularly increasing the capacity of health facilities in providing care
to the population and provision of psychosocial activities to the individual, family
and community.
This level is not for the general population, but for people who are:
• Struggling to cope within their existing care network
• Not progressing in terms of their development
• Unable to function as well as their peers
• In need of activities that address their psychosocial needs more directly
75
Focused psychosocial support activities require trained and experienced staff.

Interventions may include:
• Case management
• Family visits
• Support groups
• Structured play activities
• Psychosocial hotlines
• Non-clinical family or individual counseling (e.g. school counseling)
Level 4: Specialized support

For level 4, referrals are the best form of intervention particularly for cases related
to abuse, mental, neurological and substance abuse disorders which are being
handled by medical professionals.
Interventions may include:

• Traditional specialized healing (e.g. cleansing and purification rituals)
• Clinical social work or psychological treatment
• Psychotherapy
• Drug or alcohol treatment
• Specialized mental health care
Enhancing MHPSS skills and knowledge

As part of the harmonization process, there are several existing training materials
that were reviewed and can be used for further capacity enhancement. Handouts
will be distributed to share with you a summary of these materials.
For Levels 1 to 4 responders, these are some of the training materials that can
be used.
Child Friendly Spaces in Emergencies: • Save the Children

A Handbook for Save the Children Staff
Interim Mental Health & Psychosocial Support • MHPSS.Net
Emergency-Toolkit
Mental Health and Psychosocial Support in Emergencies: • IASC
What Humanitarian Health Actors should know?
• Department of
Pocket Emergency Tool
Health
76
MODULE 4
For Levels 2 to 4 responders, these are the materials reviewed that can be used.
Emergency Psychosocial Support for Secondary School- • UNESCO

aged Students Affected by Typhoon Yolanda in the
Philippines
• Department of
MANUAL FOR TRAINERS Enhancing Capacities in
Health
Mental Health and Psychosocial Support in Emergencies
• University of the
and Disasters
Philippines
• National
Commission on
Muslim Filipinos
• Anak Mindanao
Mental Health and Psychosocial Support for Muslim
• Balay
Filipinos
• National
Commission on
Muslim Filipinos
Women Center
• National Center
NCMH Trainer’s Manual
for Mental Health
Operational Guidance Mental Health & Psychosocial • UNHCR
Support Programming for Refugee Operations
Psychological first aid for children II • Save the Children
Psychological first aid training manual for child practitioners • Save the Children
• WHO
• Wartrauma
Psychological first aid: Guide for field workers
Foundation
• World Vision
The children’s resilience programme Psychosocial sup- • IFRC and Save
port in and out of schools Facilitators Guide the Children
The children’s resilience programme Psychosocial sup- • IFRC and Save
port in and out of schools Understanding Children’s Well- the Children
being
Training Curriculum for Mental Health and Psychosocial • International
Support Medical Corps
77
Handout
Title of Type of
Date Course Target
course/ course/
released organisers participants
material material
Pocket Toolkit March • Department of Health
Emergency 2012 Health Emergency
Tool Management
Staff
Interim Mental Toolkit April 2017 • MHPSS.Net MHPSS
Health & practitioners,
Psychosocial policy and
Support decision-makers
Emergency-
Toolkit
Operational Operational 2013 • UNHCR UNHCR Country
Guidance Guide Operations staff
Mental
Health &
Psychosocial
Support
Programming
for Refugee
Operations
Child Friendly Staff October • Save the Save the
Spaces in Handbook 2008 Children Children Staff
Emergencies:
A Handbook
for Save the
Children Staff
The children’s Facilitator's May 2012 • IFRC and Save Training
resilience Guide the Children Facilitators
programme
Psychosocial
support in and
out of schools
Facilitators
Guide
78
MODULE 4
Title of Type of
Date Course Target
course/ course/
material material
The children’s Training May 2012 • IFRC and Save Training
resilience Manual the Children Facilitators
programme
Psychosocial
support in and
out of schools
Understanding
Children’s
Wellbeing
Training Training 2014 • International Social Workers,
Curriculum Manual Medical Corps Guidance
for Mental Counselors, PNP
Health and Women’s Desk
Psychosocial Officers, Nurses,
Support Midwives,
and Day Care
Officers
MANUAL FOR Trainer's November • Department of 1) health care
TRAINERS Manual 2009 Health providers in
Enhancing • University of delivering
Capacities the Philippines MHPSS services
in Mental especially in
Health and emergencies and
Psychosocial as 2) program
Support managers
in ensuring MHPSS
Emergencies is incorporated in
and Disasters general primary
health care
services.
Psychological Field 2011 • WHO Field Workers
first aid: Workers • War Trauma
Guide for field Guide Foundation
workers • World Vision
79
Title of Type of
Date Course Target
course/ course/
material material
Emergency Teacher's 2015 • UNESCO Teachers
Psychosocial Manual
Support for
Secondary
School-aged
Students
Affected by
Typhoon
Yolanda in the
Philippines
Mental Guidelines 2010 • IASC humanitarian
Health and health actors
Psychosocial working at
Support in national and sub-
Emergencies: national level
What
Humanitarian
Health Actors
should know?
Psychological Training 2017 • Save the Child
first aid Manual Children Practitioners
training
manual
for child
practitioners
Psychological Training 2017 • Save the staff working with
first aid for Manual Children children who are
children II severely affected
psychologically
by acute crisis
NCMH Training n.d. • National MHPSS
Trainer's Manual Center for responders and
Manual Mental Health trainers
80
MODULE 4
Title of Type of
Date Course Target
course/ course/
material material
Mental Training n.d. • National MHPSS
Health and Module Commission responders and
Psychosocial on Muslim trainers
Support Filipinos
for Muslim • Anak
Filipinos Mindanao
• Balay
• National
Commission
on Muslim
Filipinos
Women Center
Plenary activity
(10 mins groupwork, 15 mins sharing to the plenary)
SAY: Form three (3) groups. A disaster scenario will be assigned to your group.
Identify interventions per level, write them on metacards and post them on the MHPSS
Intervention Pyramid.
DISASTER SCENARIOS
1. An earthquake just occurred in a mountainous area destroying homes
and leaving people homeless and wandering the streets. Some families
reported members who went missing during the confusion after the
earthquake. Power got cut off and no mobile signal is available.
2. Following a strong typhoon, waist-high flooding in several barangays
occurred. It has been a week and the residents are still unable to go
back to their homes as the water has not yet receded. Majority are living
in the classrooms of the local schools. Classes have been suspended.
3. Continuous fighting between government forces and terrorists in
Mindanao displaced 100,000 people, 90% of whom were Muslims.
They were brought to different gymnasiums which were turned into
evacuation centers. Due to poor management of the evacuation camps
and unsanitary environment, the evacuees have started to get sick.
81
SAY: Thank you for your responses. How did you find the exercise? (Allow sharing of
one to two participants from each group). What did you learn from the exercise? What
can you say about the responses of Group 1? Of Group 2? Of Group 3? Which types
of intervention did you find difficult to locate in the pyramid?
Through the activity, you are supposed to demonstrate your mastery of the kinds of
interventions to be provided based on each level of the pyramid. You will face the
same challenge during disaster scenarios: as service providers, you should be able
to quickly assess the situation and determine the appropriate action based on the
intervention pyramid.

• The intervention pyramid presents the integrated and layered approach that
defines an effective MHPSS program. It provides service responders with an
appreciation of the different needs of affected communities, as well as the roles
of each sector in helping provide sustainable and coordinated interventions.
82
MODULE 4
SESSION 2:
PSYCHOLOGICAL FIRST AID (PFA)
LEARNING OUTCOMES:
• Demonstrate knowledge of conducting PFA
• Describe principles of self-care, and how to conduct activities that
facilitate self-care
SAY: Learning how to deliver Psychological First Aid (PFA) is useful for any service
responder catering to members of disaster-affected communities. This session trains
the participants how to conduct PFA, and provides additional notes on catering to
children.
SLIDESHOW CONTENT
1. Introduction to Psychological First Aid (PFA)2
What is PFA?
Psychological first aid (PFA) describes a humane, supportive response to a fellow
human being who is suffering and who may need support. Aiming to stabilize,
reduce symptoms, and return the survivor to functional capacity in the aftermath of
a critical incident, it involves the following themes:
• providing practical care and support, which does not intrude;
• assessing needs and concerns;
• helping people to address basic needs (for example, food and water,
information);
• listening to people, but not pressuring them to talk;
• comforting people and helping them to feel calm;
• helping people connect to information, services and social supports;
• protecting people from further harm.
83
PFA involves factors that seem to be most helpful to people’s long-term recovery.
These include:
• feeling safe, connected to others, calm and hopeful;
• having access to social, physical and emotional support; and
• feeling able to help themselves, as individuals and communities.
Who is PFA for?

PFA is for distressed people who have been recently exposed to a serious crisis
event. Help may be provided to both children and adults.
Some people need much more advanced support than PFA alone. They are:
• people with serious, life-threatening injuries who need emergency medical
care
• people who are so upset that they cannot care for themselves or their
children
• people who may hurt themselves
• people who may hurt others
When is PFA provided?

PFA is aimed at helping people who have been very recently affected by a crisis
event. This is usually during or immediately after an event. However, it may
sometimes be days or weeks after, depending on how long the event lasted and
how severe it was.
Where is PFA provided?

PFA may be offered wherever it is safe enough to do so. This is often in community
settings, such as at the scene of an accident, or places where distressed people
are served, such as health centers, shelters or camps, schools and distribution
sites for food or other types of help.
Ideally, PFA is provided where there is some privacy to talk with the person. For
people who have been exposed to certain types of crisis events, such as sexual
violence, privacy is essential for confidentiality and to respect the person’s dignity.
Preparing for PFA

• Learn about the crisis event.
• Learn about available services and supports.
• Learn about safety and security concerns.
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MODULE 4
3 Goals of Providing PFA3

1. Relieve both emotional and physical suffering
2. Improve people’s short term functioning
3. Accelerate the individual’s course of recovery
Roles of Psychological First Aider:

• Provide social support
• Educate about normal and abnormal stress reactions
• Teach stress management techniques
• Mobilize community resources
• Provide support and reassurance
• Aid in accessing appropriate services
• Undertake risk assessment to help prevent harm to self or to others
• Create a partnership and help find solutions
• Assist in early detection and intervention
Examples of Psychological First Aid:

Family support services; information support services; tracing services;
reassurance; presence of crisis workers; rituals and other support structures;
defusing; crisis management briefings;
PFA Core Actions:

• Contact and engagement – initiate non-intrusive, compassionate and helpful
manner
• Safety and comfort – enhance ongoing safety, provide physical and
emotional comfort
• Stabilization – calm and orient emotionally overwhelmed/disoriented
survivors
• Information gathering – identify immediate needs and concerns – tailor PFA
interventions
• Practical assistance – clarify the need, discuss action plan, act to address
the need
• Connection with social supports – enhance access, encourage use, discuss
support-seeking and giving, modeling support
• Information on coping – give basic information about stress reactions, teach
relaxation techniques, address negative emotions
• Linkage with collaborative services – provide link to additional services,
promote continuity of care.
85
General Principles of PFA

• First, protect from danger
• Focus on the “here and now” situation
• Provide accurate information about the situation
• Assist with mobilization of resources
• Do not give false assurances
• Recognize the importance of taking action
• Reunite with family members
• Provide and ensure emotional support
• Focus on strengths and resilience
• Encourage self-reliance
• Respect feelings and cultures of others
12 Principles of PFA Program

1. Making connection
2. Helping people be safe
3. Being kind, calm and compassionate
4. Meeting people’s basic needs
5. Listening
6. Giving realistic assurance
7. Encouraging good coping
8. Helping people connect
9. Giving accurate and timely information
10. Making referral to a disaster mental health worker
11. Taking care of yourself
Delivering PFA: Professional Behavior:

• Operate only within the framework of an authorized disaster response
system
• Model healthy responses: calm, courteous, organized, helpful
• Be visible and available
• Maintain confidentiality
• Remain within the scope of your expertise and designated role
• Make appropriate referrals
• Be knowledgeable and sensitive (culture and diversity)
• Pay attention to your own emotional and physical reactions
• Practice self-care
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MODULE 4
Don’ts in Delivering PFA:

• Do not make assumptions (about what the survivors are experiencing or
what they have gone through)
• Do not assume that everyone exposed to a disaster will be traumatized
• Do not pathologize (do not label “reactions” as symptoms)
• Do not talk down to or patronize the survivor, or focus on his helplessness/
weaknesses, mistakes, disability. Focus on what he has done effectively to
help others
• Do not assume that all survivors want to talk or need to talk to you (being
physically present in a supportive, calm way helps survivors feel safer and
more able to cope)
• Do not “debrief” by asking details of what happened
• Do not speculate or offer possibly inaccurate information (know the facts
before answering their questions)
Guidelines for Delivering PFA

• Politely observe first, don’t intrude (ask simple respectful questions to know
how you may help).
• Provide practical assistance to make contact (food, water, blankets).
• Initiate contact only after you have observed the situation, the person, the
family.
• Be prepared that survivors will either avoid you or flood you with contact.
• Speak calmly. Be patient, responsive and sensitive.
• Be prepared to listen. (focus on hearing what they want to tell you, an dhow
you can be of help)
• Acknowledge the positive features of what the survivor has done to keep
safe.
• Give information that addresses directly the survivor’s immediate goals and
clarify answers
• Give accurate and age-appropriate information
• When communicating with a translator, look and talk to the client, not the
translator.
• Remember the goal of PFA.
Referral: The act of recommending that a person speak to a professional who is

more competent to handle the difficulties and complexities of his/her needs.
Referral may be necessary when the stress reactions of individuals affected by the
disasters are causing impairments (inability to take care of self or inability to work).
When to refer:
87
• When a person hints or talks openly of suicide

• If there is a possibility of child abuse or any criminal activity
• The problem is beyond your training
• The problem is beyond your capability
• The problem does not fit the purpose of the community responder program
• The person seems to be socially isolated
• You have difficulty maintaining real contact with the person
• You become aware of dependency on alcohol and drugs
• When the person is engaging in risky or threatening behavior
• When you yourself become: restless, confused, have negative recurring
thoughts, dream about the case and feel you are the only one who can help
PFA and children

• Crisis events often disrupt children’s familiar world, including the people,
places and routines that make them feel secure.
• Children who are affected by a crisis may be at risk of sexual violence,
abuse and exploitation, which tends to be more common in the chaos of
large crisis situations.
• Children have different levels of vulnerability
xx Young children are often particularly vulnerable since they cannot meet
their basic needs or protect themselves, and their caregivers may be
overwhelmed.
xx Older children may be trafficked, sexually exploited or recruited into
armed forces.
xx Girls and boys face different risks: Usually girls face the greatest risk of
sexual violence and exploitation, and those who have been abused may
be stigmatized and isolated.
• How children react to the hardships of a crisis depends on
xx their age and developmental stage.
xx the ways their caregivers and other adults interact with them. For
example, young children may not fully understand what is happening
around them, and are especially in need of support from caregivers.
• In general, children cope better when they have a stable, calm adult around
them.
• Children and young people may experience similar distress reactions as
adults do. They may also have some of the following specific distress
reactions:
xx Young children may return to earlier behaviors (for example, bedwetting
or thumb-sucking), they may cling to caregivers, and reduce their play or
use repetitive play related to the distressing event.
88
MODULE 4
xx School-age children may believe they caused bad things to happen,

develop new fears, may be less affectionate, feel alone and be
preoccupied with protecting or rescuing people in the crisis.
xx Adolescents may feel “nothing”, feel different from or isolated from their
friends, or they may display risk-taking behavior and negative attitudes.
• Family and other caregivers are important sources of protection and
emotional support for children. Those separated from caregivers may find
themselves in unfamiliar places and around unfamiliar people during a crisis
event. They may be very fearful and may not be able to properly judge the
risks and danger around them.
• Important first step: reunite separated children with their families or
caregivers.
xx Note: Service providers should not do this on their own to avoid worsening
the child’s situation. Instead, they should try to link immediately with
a trustworthy child protection agency that can begin the process of
registering the child and ensuring they are cared for.
• When children are with their caregivers, try to support the caregivers in
taking care of their own children.
Video showing (30 mins): Show the Introduction to PFA videos (see additional
references).

• PFA may be offered wherever it is safe enough to do so. This is often in community
settings, such as at the scene of an accident, or places where distressed people
are served, such as health centers, shelters or camps, schools and distribution
sites for food or other types of help
89
SESSION 3:
SELF-CARE AND CARE FOR CARERS
ACTIVITY (20 mins filling out the worksheet,

20 mins sharing with the group
Divide the participants into groups of no more than seven members. Participants will
be given either of the two worksheets:
The illustration of a human figure, and of a sailboat out at sea
The illustration of a human figure, and of a tree
Afterwards, any member who is comfortable doing so, will share the content of their
worksheet with their group, and proceed to a discussion based on the points below.
ACTIVITY GUIDE
• Human figure:
xx (Left half) What are your
strengths in terms of
knowledge, skills, and attitudes
as a service provider?
xx (Right half) What do you still
need to develop to be a better
service provider?
• Sails: What are your dreams and
motivations?
• Oar: What are your coping
techniques?
• Boat: What tools and resources
in your family, organization, and
community help you fulfill your role
as service provider effectively?
• Waves: What challenges do you
face in their tasks as service
providers?
90
MODULE 4
• Human figure:
xx (Left half) What are your
strengths in terms of
knowledge, skills, and attitudes
as a service provider?
xx (Right half) What do you still
need to develop to be a better
service provider?
• Roots: Who are the people that
compose your support system?
• Trunk: What are your strengths,
skills, and values?
• Leaves: What your wishes and
dreams?
• Wind: What challenges do you
face in life?
• Fruits: What have you achieved in
the past?
• Branches: What are your coping
techniques?
Discussion points:
1. What were the similarities among members in terms of knowledge, skills, and
attitudes, and the rooms for improvement?
2. What were the common coping techniques?
3. How can service providers help each other?
4. How can practices in the disaster response community be improved to
promote the wellbeing of service providers?
Post-activity processing (5 mins):

SAY: In your work as a service provider, you will be drawing from your personal
and environmental resources as you cope with the challenges of everyday life. It is
important to know who you are (your values, skills, and strengths), where to get help
(your support system), what you are up against (the challenges), and what you can do
to bear these challenges (coping techniques) as well as be reminded of what you still
want to achieve (wishes and dreams), to get you through the tough times.
91
SAY: Emergency responders are hidden victims in the aftermath of disasters. They
are exposed to various kinds of stressors: the visible impacts of the disaster on the
environment, the psychosocial effect on the members of the community, and the
demands of their work. Learning how to care for themselves is important so that they
become effective source of support to the people they are serving.
SLIDESHOW CONTENT2
Common Stress Reactions of Carers:

• Difficulties sleeping
• Substance use
• Disconnection and numbing
• Irritability, anger, and frustration
• Vicarious traumatization in the form of shock, fearfulness, horror,
helplessness
• Confusion, lack of attention, and difficulty making decisions
• Physical reactions (headaches, stomachaches, easily startled)
• Depressive or anxiety reactions
• Decreased social activities
• Diminished self-care
Sources of stress for service providers:

• Long working hours
• Overwhelming responsibilities
• Lack of a clear job description
• Poor communication or management
• Unsafe working conditions
• Hearing stories of people’s pain and suffering
• Exposure to destruction, injury, death or violence
Ways to manage your stress

• Think about what has helped you cope in the past and what you can do to
stay strong.
• Try to take time to eat, rest and relax, even for short periods.
• Try to keep reasonable working hours so you do not become too exhausted.
Consider, for example, dividing the workload, working in shifts during the
92
MODULE 4
acute phase of the crisis and taking regular rest periods.

• Remember that you are not responsible for solving all of people’s problems.
Do what you can to help people help themselves.
• Minimize your intake of alcohol, caffeine or nicotine and avoid nonprescription
drugs.
• Check in with fellow helpers to see how they are doing, and have them
check in with you. Find ways to support each other.
• Talk with friends, loved ones or other people you trust for support.
Reflection points after helping in a crisis situation

• Talk about your experience of helping in the crisis situation with a supervisor,
colleague or someone else you trust.
• Acknowledge what you were able to do to help others, even in small ways.
• Learn to reflect on and accept what you did well, what did not go very well,
and the limits of what you could do in the circumstances.
• Take some time, if possible, to rest and relax before beginning your work
and life duties again.
Reminder
• If you find yourself with upsetting thoughts or memories about the event,
feel very nervous or extremely sad, have trouble sleeping, or drink a lot of
alcohol or take drugs, it is important to get support from someone you trust.
• Speak to a health care professional or, if available, a mental health specialist
if these difficulties continue for more than one month.
• Practice self and team care
• Ask the following questions:
Before During After

xx Are you ready to xx How can you xx How can you take
help? stay physically time to rest, recover
and emotionally and reflect?
healthy?
xx How can you
support colleagues
and they support
you?
• It is best for helpers to be connected with an agency or group to ensure

safety and good coordination.
• When your helping role in the crisis is over, be sure to take time for rest, and
reflection.
93
SAY: We have now reached the end of Module IV. Some of the key messages from
this module are:
1. Effective MHPSS should feature a layered system of complementary supports

that meets the needs of different groups.
2. All layers of the intervention pyramid are important and should ideally be im-
plemented concurrently.
3. Familiarization with the different interventions will enhance the capacity of
service responders to help victims of disaster-affected communities
4. Service responders are themselves exposed to stressors during crisis situa-
tions, and must practice self-care.
SAY: Do you have questions? Any insights that you would like to share with every-
one?
Additional references
1. Centers for Disease Control and Prevention (2018). Coping with a Disaster or
Traumatic Event: Responders: Tips for taking care of yourself. URL: https://bit.
ly/2AwJ1N4
2. Johns Hopkins University and Coursera. Online course: Psychological First
Aid. URL: https://bit.ly/2cRWuG8
3. Knowledge Channel (2016). Video: Basics of Psychological First Aid. URL:
https://bit.ly/2O5yCho
4. Video: What Psychological First Aid is Not. URL: https://bit.ly/2n5gxVg
5. Video: Empathic Listening. URL: https://bit.ly/2LYaaRI
6. Video: PFA Demo. URL: https://bit.ly/2KlOQAG
7. National Child Traumatic Stress Network and National Center for PTSD (2006).
Psychological First Aid Field Operations Guide.
8. Second edition. URL: https://bit.ly/2OCK3OP
9. Inter-Agency Referral Guidance Note for MHPSS (2017). URL: http://bit.
ly/2Kr0kTA
94
MODULE 5
MODULE 5
MHPSS Monitoring and Evaluation
95
MODULE 5:
MHPSS Monitoring and Evaluation
Module Objective:
To define basic monitoring and evaluation concepts and processes, and align it with
the MHPSS response and service delivery.
Facilitators: It is recommended that the module is delivered by health practitioners

who have undergone basic M&E orientation and/or has experience in M&E or infor-
mation management.
Link to presentation: http://bit.ly/HarmonizedMHPSSModuleV
96
MODULE 5
Learning
outcomes
Principles of 60 mins Appreciate the • Slideshow • IASC
Monitoring Monitoring and • Notecards Guidelines
and Evaluation tools • Permanent • NDRRMC
Evaluation and indicators on markers MC 62
in MHPSS MHPSS • Metacards • IASC’s Who
• Scenarios is Where,
• Handout When, doing
(NDRRMC What (4Ws)
MC 62 M&E in Mental
Guidelines) Health and
Psychosocial
Support
Assessment, 45 mins Appreciate • Slideshow • NCMH Rapid
Reporting, the existing • Handout: Assessment
and assessment, Rapid Tool for
Feedback reporting and Assessment Mental
mechanisms feedback tools and Tool for Health and
mechanisms Mental Psychosocial
Health and Support in
Identify indicators Psychosocial Emergency
that can be used to Support in Settings
measure results of Emergency • IASC’s Who
MHPSS response Settings is Where,
• Handout: When, doing
Children’s What (4Ws)
MIRA in Mental
Health and
Psychosocial
Support
• Save the
Children
Philippines
Children’s
MIRA
97
SESSION 1:
PRINCIPLES OF MONITORING AND EVALUATION
IN MHPSS
LEARNING OUTCOMES:
• Appreciate the Monitoring and Evaluation tools and indicators on
MHPSS
SAY: Monitoring and evaluation (M&E) of MHPSS interventions is necessary for the
constant improvement of the delivery of services. This session provides an introduction
to M&E concepts, as well as the parameters for its proper conduct.
ACTIVITY 1A (15 minutes)
DO: Group the participants into four. Hand each group with the following scenarios:
1. Flooding emergency in an urban area with 100,000 affected families
2. 7.2 magnitude earthquake in a municipality with frequent aftershocks (no data
on affected population)
3. Disease outbreak with a death toll of 50 children
4. Armed crisis between rebel groups and the government affecting two
municipalities with over 50,000 affected individuals
SAY: Looking at the scenario given to your group, identify as many MHPSS services
as possible are needed by the communities per Levels 1 - 3 of the IASC Pyramid of
Intervention. Kindly post them on the wall once you have finished. We will get back to
your responses after this session.
Possible scenarios:
• Level 1 - Provision of food and water in evacuation centers,
“Libreng Sakay” for stranded passengers, evacuation
assistance to flooded households
Scenario 1
• Level 2 - Provision of family hygiene kits and family food
packs
• Level 3 - PFA
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MODULE 5
• Level 1 - Immediate evacuation assistance to affected

population, First Aid treatment to injured victims
Scenario 2
• Level 2 - PFA for children and adults
• Level 3 - Psychosocial hotlines
• Level 1 - PFA for Children, distribution of medicines

Scenario 3 • Level 2 - Grieving rituals
• Level 3 - Case management
• Level 1 - Immediate evacuation

• Level 2 - Construction of temporary learning spaces, child-
Scenario 4
friendly spaces
• Level 3 - Structured play/art activities

Basic M&E concepts
SLIDESHOW CONTENT2
Monitoring and Evaluation of MHPSS interventions25

All of us have done monitoring and evaluation in various occasions, whether we are
aware of it or not. In disaster response, we do systematic monitoring by collecting
and analyzing information to inform humanitarian decision-making related to
ongoing or potential new activities. To make it systematic, we use tools that have
been generally accepted or prescribed.
Evaluation, on the other hand, includes the analysis of the relevance and
effectiveness of ongoing or completed activities.
25
IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings
99
There are standards and indicators that can be used as a reference in monitoring
and evaluating the quality and quantity of the services being delivered. Numerous
documents have been created and agreed internationally and locally to guide
service providers and decision-makers.
Purpose
To improve humanitarian action by collecting information on the implementation and
impact of aid and using it to guide program improvements in a changing context.
Conducting M&E of MHPSS
1. Define a set of indicators for monitoring, according to defined objectives

and activities.
The exact choice of indicators depends on the goals of the program and on
what is important and feasible in the emergency situation. Process, satisfaction
and outcome indicators should be formulated consistent with pre-defined
objectives.
Collecting data on indicators at the onset of an emergencies provides baseline

information not only for minimum responses (such as those outlined in this
document) but also for long-term, comprehensive humanitarian action.
Indicators should be SMART (Specific, Measurable, Achievable, Relevant and

Time-bound).
• Specific means the indicator should be narrow and focus on the ‘who’
and ‘what’ of the intervention. Additionally, ‘how’ and ‘where’ the ‘who’
is doing the ‘what’ is important to include in the indicator as it provides
the action for the intervention. For example, if you are providing health
services, identify what health services are you providing such as
immunization, psychosocial processing, first aid, etc.
• Measurable means it has the capacity to be counted, observed,
analyzed, tested, or challenged. Examples: number of children that was
immunized, number of individuals that have consulted for psychosocial
support, number of medicines distributed, etc.
• Achievable or Attainable means that the indicator can be realistically
achieved. Example: If your indicator is number of immunized children,
how do you monitor? Are you allowed to keep a list of the names of
these children? If not, what can be a proxy or alternative indicator? You
can use the number of vials consumed as a proxy.
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MODULE 5
• Relevant means that the indicator must be related to the general

outcome or objective of your response.
• Time- bound means that the indicator is attached to a time frame. For
example, if the affected population are inside the evacuation center, it is
possible that they will be sent home in a few days or weeks depending
on the magnitude of the emergency. Thus, if you are monitoring number
of children being immunized in the evacuation center, it would be good
to keep a record of their origin barangays or communities to ensure that
there will be no duplication of services once they go home.
Typically, only a few indicators can feasibly be monitored over time. Indicators
should therefore be chosen on the principle of ‘few but powerful’. They should
be defined in such a way that they can be easily assessed, without interfering
with the daily work of the team or the community.
Data on indicators should be disaggregated by age, gender and location

whenever possible.
2. Conduct assessments in an ethical and appropriately participatory

manner.
Participatory M&E is the first step in a dialogue with affected populations,

which, if done well, not only provides information but may also help people to
take control of their situation by collaboratively identifying problems, resources
and potential solutions. Feedback on the results and process should be sought
from participants.
M&E must involve diverse sections of the affected population, including

children, youth, women, men, elderly people and different religious, cultural and
socio-economic groups. It should aim to include community leaders, educators
and health and community workers and to correct, not reinforce, patterns of
exclusion.
Analysis assessments should analyze the situation with a focus on identifying

priorities for action, rather than merely collecting and reporting information.
When operating in situations of conflict, assessors must be aware of the parties

involved in the conflict and of their dynamics. care must be taken to maintain
impartiality and independence and to avoid inflaming social tensions/conflict or
endangering community members or staff.
101
Methodologies (including indicators and instruments) should be culturally and

contextually sensitive and relevant. The assessment team should include
individuals familiar with the local context, who are – as far as is known – not
distrusted by interviewees, and should respect local cultural traditions and
practices. M&E should aim to avoid using terminology that in the local cultural
context could contribute to stigmatization.
Privacy, confidentiality and the best interests of the interviewees must be

respected. In line with the principle of ‘do no harm’, care must be taken to avoid
raising unrealistic expectations during assessments (e.g. interviewees should
understand that assessors may not return if they do not receive funding).
Assessors should be trained in the ethical principles mentioned above and

should possess basic interviewing and good interpersonal skills. assessment
teams should have an appropriate gender balance and should be knowledgeable
both in MHPSS and the local context.
Relevant qualitative methods of data collection include literature review, group

activities (e.g. focus group discussions), key informant interviews, observations
and site visits. Quantitative methods, such as short questionnaires and reviews
of existing data in health systems, can also be helpful. As far as is possible,
multiple sources of data should be used to cross-check and validate information/
analysis.
3. Use monitoring for reflection, learning and change.
SAY: We will share with you the Monitoring and Evaluation requirements indicated
in NDRRMC Memorandum No. 62 for your reference.
Handout 1: Key actions during preparedness and response phases of the

disaster27
Function: Monitoring and Evaluation (Common function)

Preparednes Response
• Review and generate information • Conduct rapid assessment
on capacities and vulnerabilities of of vulnerable population,
communities and resources; infrastructure, services, and
risks according to available
tools prescribed;
27
Overview of NDRRMC MC No. 62, s. 2017, Table 1, page 11: M&E
102
MODULE 5

• Identify vulnerable groups like children, • Provide geographical profile of
women, older persons (OP), persons each affected catchment area
with disabilities (PWDs), indigenous including assessment results;
people (IPs), people with special needs • Provide information on contact
(PWSNs), and people with pre-existing details of key agencies or
mental illness; organizations that provide
• Develop inter-agency, culturally and specific services;
gender-sensitive, as well as age- • Document MHPSS activities
appropriate MHPSS rapid tools for conducted, as well as other
emergencies; information related to projects
• Build capacity on MHPSS assessment, or services including the
monitoring, evaluation, and learning mechanism for assessing and
(MEAL). Community-based trainings monitoring outcomes;
for such competencies must be • Collate and communicate
prioritized; assessment, monitoring,
• Conduct MHPSS risk analysis, and evaluation, and information to
integrate into a community response government and civil society
plan, including an early warning organizations (CSOs); and
system, and strengthen local capacity • Assess helpfulness of most
to implement such plans; commonly used MHPSS
• Forge partnership with, but not limited activities.
to, academics and practitioners in
conducting research on assessment,
evaluation and theory building on
MHPSS;
• Review previous MHPSS responses
and identify good practices, challenges
and gaps;
• Map psychosocial dimensions of
existing resources, gaps, practices and
at-risk groups regarding shelter and
safe planning; and
• Develop recommendations based
on the results of the monitoring,
evaluation, assessment and learning
(MEAL) tools used.
103
Handout 2: Non-exhaustive List to Demonstrate Specific Activities According to

the Different Key Actions3

• Review and generate information • Conduct rapid assessment
on capacities and vulnerabilities of of vulnerable population,
communities and resources; infrastructure, services, and
• Identify vulnerable groups like children, risks according to available
women, older persons (OP), persons tools prescribed; Conduct rapid
with disabilities (PWDs), indigenous assessment of vulnerable
people (IPs), people with special needs population, infrastructure,
(PWSNs), and people with pre-existing services, and risks according to
mental illness; available tools prescribed;
• Develop inter-agency, culturally and • Provide geographical profile of
gender-sensitive, as well as age- each affected catchment area
appropriate MHPSS rapid tools for including assessment results;
emergencies; • Provide information on contact
• Build capacity on MHPSS assessment, details of key agencies or
monitoring, evaluation, and learning organizations that provide
(MEAL). Community-based trainings specific services;
for such competencies must be • Document MHPSS activities
prioritized; conducted, as well as other
• Conduct MHPSS risk analysis, and information related to projects
integrate into a community response or services including the
plan, including an early warning mechanism for assessing and
system, and strengthen local capacity monitoring outcomes;
to implement such plans; • Collate and communicate
• Forge partnership with, but not limited assessment, monitoring,
to, academics and practitioners in evaluation, and information to
conducting research on assessment, government and civil society
evaluation and theory building on organizations (CSOs); and
MHPSS; • Assess helpfulness of most
• Review previous MHPSS responses commonly used MHPSS
and identify good practices, challenges activities.
and gaps;
• Map psychosocial dimensions of
existing resources, gaps, practices and
at-risk groups regarding shelter and
safe planning; and
• Develop recommendations based
on the results of the monitoring,
evaluation, assessment and learning
(MEAL) tools used.
104
MODULE 5

• Collecting data on indicators at the onset of an emergencies provides
baseline information not only for minimum responses but also for long-term,
comprehensive humanitarian action.
• M&E must involve diverse sections of the affected population, including

children, youth, women, men, elderly people and different religious, cultural and
socio-economic groups. It should aim to include community leaders, educators
and health and community workers and to correct, not reinforce, patterns of
exclusion.
105
SESSION 2:
ASSESSMENT, REPORTING AND FEEDBACK
MECHANISMS
LEARNING OUTCOMES:
• Appreciate the existing assessment, reporting and feedback tools and
mechanisms
• Identify indicators that can be used to measure results of MHPSS
response
ACTIVITY 1B (15 minutes)
SAY: Going back to the services you have listed earlier, identify what possible indicators
can be used to monitor the services per level of the IASC Pyramid of Intervention
Possible scenarios:
• Level 1 - number of individuals that have received kits
• Level 2 - number of families that have received food packs
Scenario 1 and kits
• Level 3 - number of individuals that have received
psychosocial counselling
• Level 1 - number of medicines distributed, number of
individuals attended to
Scenario 2 • Level 2 - number of families that have received assistance
• Level 3 - number of individuals that have been assisted
by the hotline
• Level 1 - number of medicines distributed, number of

individuals attended to
Scenario 3
• Level 2 - number of families assisted
• Level 3 - number of cases handled
• Level 1 - number of evacuees assisted

• Level 2 - number of children using child-friendly spaces
Scenario 4
• Level 3 - number of individuals participating in structured
art activities
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MODULE 5
DO: Give the groups 10 minutes to list the indicators then proceed to the lecture.
SAY: There are several reporting tools and format that are being used during
emergencies. There are also a lot of mechanisms to get feedback from the communities
and service providers on the quality and quantity of the services being delivered and
served to to the affected population. Currently, we do not have a standardized MHPSS
M&E Tool, but there are several assessment forms and data collection tools that are
being used to support service delivery and M&E.

MHPSS Assessment and 4Ws
MHPSS Assessments
DO: Distribute copies of the MHPSS Rapid Assessment Tool of DOH and the
Instructional Guide and the Children’s MIRA
Mental health and psychosocial support (MHPSS) assessments in emergencies

provide an understanding of the emergency situation; an analysis of threats to and
capacities for mental health and psychosocial wellbeing; and an analysis of relevant
resources to determine, in consultation with stakeholders, whether a response is
required and, if so, the nature of the response.
Understanding how to support affected populations to more constructively address

MHPSS needs is essential. An assessment must also be part of an ongoing process
of collecting and analysing data in collaboration with key stakeholders, especially the
affected community, for the purposes of improved programming.
In our everyday life, we always conduct assessments. We try to assess the situation to
be fully aware of what are our needs and how can we address these needs. That is the
value of assessments. We as responders are encouraged to use this tool so there will
be uniformity in identifying the needs of the communities and to allow us to determine
SMART indicators for monitoring and evaluation.
What you have are sample tools used during assessments.

1. This Rapid Assessment Tool for Mental Health and Psychosocial Support in
Emergency Settings was developed to provide immediate assessment of the
vulnerable population and relevant resources in the first 24 hours of onset in
mass emergencies and disasters. It does not attempt to cover all domains of
107
mental health and psychosocial support, rather focus more on the capabilities
of the affected community to provide psychosocial interventions and mental
health services for at risk-groups and individuals. This tool aims to specify the
urgency for psychosocial intervention and determine the appropriate response
needed for emergencies and disasters within the local context of the country28.
2. On the other hand, the Children’s MIRA or Multi-Cluster/Sector Initial Rapid
Assessment Tool was developed by Save the Children Philippines in support to
RA 10821 mandating all disaster responders to conduct assessments to identify
specific needs of children.
When you use an assessment, monitoring or evaluation tool, whether it is prescribed

by the government or your agency, it is good to reflect on the following:
1. Who are our sources of data and information? Are they reliable e.g. is it an
official document signed by an organization or agency, is it published by the
government?
2. What services are available in the community based on the IASC Pyramid of
Intervention?
3. Does this tool provide me with the information that I need to be able to respond?
4. Does it provide me with the number of affected population that I need to respond
to?
Reminders when evaluating MHPSS interventions in the community:
1. Ensure that assessments are coordinated.

• Coordinate assessments with other organizations that are assessing
psychosocial/mental health issues, to ensure efficient use of resources,
achieve the most accurate and comprehensive understanding of the MHPSS
situation, and avoid burdening a population unnecessarily with duplicated
assessments.
2. Collect and analyze key information relevant to mental health and

psychosocial support.
• The assessment should collect information disaggregated by age, sex and
location whenever possible.
• Review the services being delivered if they are adequate, timely and support
the overall goal of the cluster.
28
Introduction: Rapid Assessment Tool for Mental Health and Psychosocial Support in Emergency Settings, Department
of Health
108
MODULE 5
3. Conduct assessments in an ethical and participatory manner29

• The IASC Guidelines on MHPSS reminds us on its guiding principles
stated in Module III in the conduct of assessments such as Participation of
relevant stakeholders (e.g. governments, NGO’s, community and religious
organizations, local research and university capacities, affected populations)
in design, implementation, interpretation of results, and translation of results
into recommendations and Inclusiveness of different sections of the affected
population, including attention to children, youth,women, men, older people,
people with mental health problems, people with disabilities and different
cultural, religious, and socio-economic groups.
4. Collate and disseminate assessment results.

• Organizations should share the results of their assessments in a timely and
accessible manner with the community, the coordination group and with
other relevant organizations. Information that is private, that could identify
individuals or particular communities, or that could endanger members of
the affected population or staff members should not be disclosed publicly.
Such information should be shared only in the interest of protecting affected
people or staff members, and then only with relevant actors.
4Ws: Who, What, Where and When
SAY: We all agree that humanitarian actors in emergencies often encounter challenges
in knowing Who is Where, When, doing What (4Ws) with regard to mental health and
psychosocial support (MHPSS). Such knowledge is essential to inform coordination.
You will encounter (if you have not before) the term 4Ws. 4Ws tools are used in many
areas of aid to map activities conducted across large geographical areas. 4Ws tools
generally aim to map supports by government and non-governmental agencies,
including pre-emergency services and supports. In past emergencies, the 4Ws tool
is modified to address the needs of the responders based on the context of the
emergency.
4Ws tool for MHPSS is useful for the following :

• Providing a big picture of the size and nature of the MHPSS response
• Identifying gaps in the MHPSS response to enable coordinated action
• Enabling referral by making information available about who is where, when,
doing what
29
As discussed in session 1 of this module.
109
• Improving transparency and legitimacy of MHPSS through structured

documentation
• Improving possibilities for reviewing patterns of practice and for drawing lessons
for future response.
Limitations
• Collecting data from different agencies requires leverage. In many situations
only agencies with coordination responsibilities will be able to successfully
collect the data.
• The data collection relies largely on self-report. Some actors may decide to
provide self-enhancing data.
Opportunities
• Opportunities exist to develop specific database software programs (e.g.
Access) and applications (e.g. for smartphones) to facilitate data collection.
• This 4Ws tool can also be used in various ways to analyze humanitarian
activities in the MHPSS field.
End of Module Activity (15 minutes):
DO: Go back to the indicators they have listed in the activity.
SAY: Look at the indicators you have listed based on your scenarios and compare it
with the MHPSS Rapid Assessment Tool of the DOH and the Children’s MIRA.
1. Are there similar indicators?

2. What can you say about the indicators listed in the tool?
3. Are the indicators in each scenario similar with the other scenarios?
SAY: We have now reached the end of Module V. Some of the key messages from
this module are:
1. Make a distinction between feedback related to day-to day activities, usually
related to the existing assistance modalities (for example targeted criteria,
preferred assistance options, schedule for distribution) and the ones related to
a broader level of the humanitarian response.
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MODULE 5
2. Coordinate and harmonize the different formal and informal feedback

mechanisms avoiding duplications and promoting their establishment when
none exists.
3. Advocate for an informed decision-making process for all feedback mechanisms
and ensure that it becomes a continuous learning process for all stakeholders.
4. Develop specific procedures ensuring anonymity and confidentiality when
doing so.
5. Follow-up and referral procedures of sensitive issues such as sexual exploitation
and abuse should be the responsibility of the relevant sector agency.
6. Keep the feedback loop closed: Feedback should be collected, acknowledged,
analyzed, and responded to.
7. Emphasize the importance of information in making decisions, and the need to
share information on a regular basis.
Additional references
1. IASC on MHPSS (2017). A Common Monitoring and Evaluation Framework

for Field test version Mental Health and Psychosocial Support in Emergency
Settings. URL: http://bit.ly/2KlqveD
2. International Federation of the Red Cross (2017). IFRC Monitoring and
evaluation framework for psychosocial support interventions Guidance Note.
URL: http://bit.ly/2Kly0lq
3. Columbia University, Columbia Group for Children in Adversity & the CPC
Learning Network (2014). Methodologies and Tools for Measuring Mental
Health and Psychosocial Wellbeing of Children in Humanitarian Contexts:
Report of a Mapping Exercise for the Child Protection Working Group (CPWG)
and Mental Health & Psychosocial Support (MHPSS) Reference Group. URL:
http://bit.ly/2LWMEV7
111
MODULE
Action Planning
6
112
MODULE 6
MODULE 6:
Action Planning
Module Objective:
To allow participants to present ways of mapping existing capacities and identifying
gaps within communities and organizations to support an effective MHPSS response
during emergencies.
Link to presentation: http://bit.ly/HarmonizedMHPSSModuleVI
113
Learning
outcomes
Action 60 mins Determine the • Slideshow • NCMH
Planning relevance of • Laptop for Trainer’s
MHPSS concepts each group Manual
and principles in • Projector
DRRM Planning, • Manila paper
resource • Permanent
management and markers
advocacy activities
Demonstrate
knowledge in
applying MHPSS
concepts and
principles in
LDRRM planning,
resource
management and
advocacy activities
before, during and
after emergencies
Develop an
action plan in
implementing
MHPSS
114
MODULE 6
SESSION 1:
ACTION PLANNING
SAY: We have reached the last module of our training. It features a very important
step in synthesizing our learnings for the past three days. By learning how to integrate
mental health and psychosocial support (MHPSS) in the DRRM Plans of their
organizations, service responders are a step closer to ensuring a holistic approach
to disaster response. This session should give you an opportunity to articulate the
provision of MHPSS in concrete, realistic, achievable, detailed, measurable, and
sustainable terms, to facilitate action.

Action Planning (include guide questions)
PREPARE: Laptops and projector, or Manila paper or action plan matrix printout,
markers, and tape
DO: Ask the participants to group themselves by organization/sector/office/LGU. Once

grouped, give them the handout and ask them to fill it out for 30 minutes. Spend the
next 30 minutes for reporting, or if time is inadequate, ask them to submit their outputs
and give it to the Regional Mental Health Program Coordinator for follow-up.
SAY: Do you have questions about action planning? Any insights that you would like
to share with everyone?
115
Target audience NCMH Rapid Assessment Opportunities (What other platforms/
Responsible
116
Thematic (Who will Tool for Mental Health and mechanisms can be established for Timeframe/
Organization/Agency
Area /Activity benefit from this Psychosocial Support in this activity e.g. partnership with Period
(Who is accountable?)
activity?) Emergency Settings local CSOs, creation of a network)
Capacity-
building
Coordination
Human
Resources
Advocacy
Monitoring
and Reporting
CLOSING CEREMONIES
For the closing ceremonies, allow the last RT to prepare the closing activities. Allow
them to be creative in doing the synthesis of the entire training.
Closing activities can be done through expression of commitments, statements from

a representative of the training participants, or ceremonial distribution of certificates.
117
REFERENCES
1. Comprehensive Community-based Disaster Risk Reduction and Management Training (CCBDRRM) Module
1: The Philippine Context, the Importance of Disaster Risk Reduction (DRR) and Adapting to Rapid Climate
Change
2. Conflict Research Consortium. University of Colorado. “Active Listening.” 1998.
3. DeWolfe, Deborah. Training manual for mental health and human service workers in major disasters. 2000.
https://eric.ed.gov/?id=ED459383
4. Inter-Agency Standing Committee. IASC Guidelines on Mental Health and Psychosocial Support MHPSS in
Emergency Settings. Geneva. 2007.
5. IASC. Inter-Agency Referral Form and Guidance Note. p.5. Geneva: IASC, 2017
6. International Medical Corps and AmeriCares. Training Curriculum for Mental Health and Psychosocial
Support. 2014
7. National Center for Mental Health. MHPSS Training Manual.
8. National Disaster Coordinating Council. History of Disaster Management in the Philippines. 2005 http://
www2.wpro.who.int/internet/files/eha/tookit_health_cluster/History%20of%20Disaster%20Management%20
in%20the%20Philippines%20NDCC%202005.pdf
9. National Disaster Risk Reduction and Management Council. National Disaster Response Plan for Hydro-
Meteorological Hazards, June 2014.
10. Republic Act 10121: An Act Strengthening the Philippine Disaster Risk Reduction and Management System,
2010.
11. UN Office for Disaster Risk Reduction (UNISDR). What is Disaster Risk Reduction? https://www.unisdr.org/
who-we-are/what-is-drr
12. UNISDR. Sendai Framework for Disaster Risk Reduction 2015–2030. In: UN World Conference on Disaster
Risk Reduction, 2015 March 14–18, Sendai, Japan. Geneva: UNISDR, 2015. http://www.wcdrr.org/uploads/
Sendai_Framework_for_Disaster_Risk_Reduction_2015-2030.pdf
13. UNISDR. Fact sheet: Health in the Context of the Sendai Framework for Disaster Risk Reduction. Geneva:
UNISDR, 2015. https://www.unisdr.org/files/46621_healthinsendaiframeworkfactsheet.pdf
14. UN Space-based information for Disaster Management and Emergency Response (UN-SPIDR). “Emergency
and disaster management.” http://www.un-spider.org/risks-and-disasters/emergency-and-disaster-
management
15. Vicente, Bernardino. Flowchart for MHPSS Intervention of National Center for Mental Health. NCMH, 2008.
16. World Health Organization. War Trauma Foundation and World Vision International. “Psychological first aid:
Guide for field workers.” Geneva: WHO, 2011.
118
ANNEXES
• Rapid MHPSS Assessment Tool:
The Tool for Rapid Assessment of Mental Health and Psychosocial Support in
Emergency Settings was developed by the National Center for Mental Health to
provide immediate assessment of the vulnerable population and relevant resources
in the first 24 hours of onset in mass emergencies and disasters.
Link: http://bit.ly/RapidMHPSSAssessmentTool
• Instructional Guide on the Use of the MHPSS Assessment Tool:

This document provides a background and steps on how to use the Rapid
Assessment Tool for Mental Health and Psychosocial Support in Emergency
Settings.
Link: http://bit.ly/AssessmentToolGuide
• Philippines Children’s MIRA:

This document is developed by Save the Children Philippines, endorsed by the
Department of Social Welfare and Development, to guide humanitarian actors in
conducting Multi-Cluster/Sector Initial Rapid Assessment for Children.
Link: http://bit.ly/ChildrensMIRA
119
LIST OF PARTICIPANTS
Organization/ Organization/
Name Name
Agency Agency
Commission on the Maria Adela A.
Aeriel Ann Gonzales DSWD PSB
Welfare of Children Guerrero
Department of Maria Isabel Lanada OCD Central
Aileen Respicio Social Welfare and
Maridith Afuang MS III, DOH-HEMB
Development
Deputy Executive
Allen Dela Fuente DOH / ATENEO Mateo Lee, Jr.
Director, NCDA
Amado Parawan Save the Children Mhariz Agustin PNCO, PNP-WCPC
Philippine National Micah Denise Del PDO III, ECCD
Amie Claire Belen
Police Mundo Council
Department of
Anthony Versola Michael Irwin Vibar DOH DPCB
Education
Nancy E. Fortes DSWD - CBB
Department of
Aubrey Bautista Social Welfare and Paolo Aquino TA, DepEd-DRRMS
Development Department of Health
Paulina A. Calo
Chona Sotto Save the Children Region IV A
Constancio National Center for Social Welfare Officer,
Predinson Morales
Paubsonan Jr. Mental Health PRC
Dinah Nadera AWIT Ramon Ferrer Jr DOH NCR
Erwin Sarmiento Documenter Raymand Roy Sardido TA, DepEd-DRRMS
Frances Prescilla Rebecca Baloloy Balik Kalipay
CHPO, DOH
Cuevas Richie Enecillo DOH HEMB
Philippine Association
Gayle Gomez Rodeliza Barnentos- CP Specialist,
of Psychiatri
Casado UNICEF
Director IV, DOH-
Gloria Balboa Ruth Ann Mutuc DOH IV A
HEMB
Phil Psychiatric Sahlee Montevirgen DOH MIMAROPA
Imelda M. Martin
Association Sarah Deocampo MH-Supervisor, MSF
Jay Juan DOH Tanya Mara Gagalac DOH HEMB
Chief Protection Nurse II, DPCB-
Jess Far Timotei Jemima Rabe
Specialist, UNICEF ENCDD
Jim Rey Baloloy Balik Kalipay Wilma Bañaga Save the Children
Johanna Marie Astrid Zenaida Beltejar Manager, PRC
Documenter
Sister
World Health
John Ryan Dr. Gerardo Medina
Save the Children Organization
Buenaventura
World Health
Jonalyn A. Lucas NCDA – DSWD Dr. Jasmine Vergara
Organization
Jose A. Juan Jr DOH HEMB National Center for
Ms. Thelma Barrera
Julie Villadolid Tech Coord, WHO Mental Health
Mariveles Mental
Balay Rehabilitation Dr. Rubylinda Reyes
Kaloy Anasarias Hospital
Center
Hanibal Camua Save the Children
Leonora Lanceta Red Cross
120
121
122
123
DEFINITION OF TERMS
Affected people – people who are in need of urgent humanitarian assistance (WHO).
Directly affected are those who have suffered injury, illness or other health effects;
who were evacuated, displaced, relocated or have suffered direct damage to their
livelihoods, economic, physical, social, cultural and environmental assets. Indirectly
affected are people who have suffered consequences, other than or in addition to
direct effects, over time, due to disruption or changes in economy, critical infrastructure,
basic services, commerce or work, or social, health and psychological consequences.
Assessment and Referral – Appraisal, analysis and evaluation of a patient’s condition,

disorder, data, and overall state, which in turn would classify a client for further mental
health services, such as directing to a psychiatrist
Assistive Coping – Providing support that help to reduce anxiety, lessen other
distressing reactions, improve the situation, or help people get through bad times
Briefing/Disaster Orientation – Providing information as to the extent of the disaster;

programs, services & resources available to the affected population
Build back better – The use of the recovery, rehabilitation and reconstruction phases
after a disaster to increase the resilience of nations and communities through integrating
disaster risk reduction measures into the restoration of physical infrastructure
and societal systems, and into the revitalization of livelihoods, economies and the
environment.
Capacity – is the combination of all the strengths, attributes and resources available
within a community, society or organization.
Cognitive Behaviour Therapy – A psychotherapeutic approach that aims to influence

problematic and dysfunctional emotions, behaviors and cognitions through a goal-
oriented, systematic procedure
Consolation – Any simple act of providing comfort to a survivor
Crisis Counseling – A process for actively influencing the psychological functioning

of individuals during a period of disequilibrium
Debriefing – A group session allowing the ventilation and sharing of experiences,

feelings, and reactions during the critical incident
124
Defusing – An intervention that refers to the process of talking it out - taking the fuse
out of an emotional bomb (explosive situation). It involves allowing victims and workers
the opportunity to ventilate about their disaster related memories, stresses, losses,
and methods of coping, and be able to do so in a safe and supportive atmosphere. The
defusing process usually involves informal and impromptu sessions.
Direct Victims – Those who were injured, lost loved one/s, lost properties & directly
experienced the disaster
Disaster – a serious disruption of the functioning of a community or a society involving

widespread human, material, economic or environmental losses and impacts, which
exceeds the ability of the affected community or society to cope using its own resources
(RA 10121).
Disaster risk reduction – Disaster risk reduction is aimed at preventing new and
reducing existing disaster risk and managing residual risk, all of which contribute to
strengthening resilience and therefore to the achievement of sustainable development.
Emergency – is an unforeseen or sudden occurrence, especially danger, demanding

immediate action.
Evacuation – Moving people and assets temporarily to safer places before, during or
after the occurrence of a hazardous event in order to protect them.
Exposure – is the degree to which a community is likely to experience hazard events

of different magnitude. It also refers to the physical location, characteristics and
population density of a community that “exposes” it to hazards.
Facilitating Rituals/Spiritual Activities – Assisting in religious or solemn ceremonies

in relation to post-event adversities
Grief – the psychological-emotional experience following a loss, while loss is the

sense of sadness, fear and insecurity we feel when a loved person is absent. It can
also be felt for things and place
Grief Counseling – facilitates the process of resolution in the natural reactions to loss
Hazard – A process, phenomenon or human activity that may cause loss of life,
injury or other health impacts, property damage, social and economic disruption or
environmental degradation.
125
Hospitalization – Placing of a patient/confinement in a hospital for treatment
Human Service Providers – Those who provide services for victims during and after
the disaster
Indigenous population – A group that has different national or cultural traditions from
the majority of the population
Indirect Victims – Relatives & friends of direct victims who did not directly experience
the disaster
Information and Referral – A service where in the immediate needs and concerns of
survivors are assessed, evaluated, and matched with available resources
Internally Displaced Population – Persons or groups of persons who have been

forced ot obliged to flee or leave their homes or places of habitual residence, in
particular as a result of or in order to avoid the effects of armed conflict, situations, of
generalized violence, violations of human rights or natural or human-made disasters,
and who have not crossed an internationally recognized State border.
Intervention for High Risk Groups – Providing specific services to achieve and
maintain psychological wellbeing in groups such as women, children, elderly, disabled,
indigenous population and internally displaced people
Material Support – Provision given in terms of basic necessities such as food, clothing,
shelter, medicine, building materials, or money
Mental health – is a state of wellbeing in which every individual realizes own potential,
can cope with the normal stresses of life, can work productively and fruitfully, and is
able to make a contribution to the community.
Mental Health Services – Mental health services refer to local or outside support that
aims to prevent or treat mental disorders or possible mental disorders (IASC, 2007),
and usually have a psychiatric connotation. Primary mental health services are usually
preventive and associated with intervention for high risk groups, while secondary
mental health services refer to treatment, hospitalization, and psychopharmacology.
Psychological First Aid – Psychological first aid is a humane supportive response

or activity directed to victims of disasters with the intention to check or mitigate further
psychosocial harm (IASC, 2007; PFA, 2006). It is generally temporary, immediate,
informal, brief, and may be integrated with other activities.
126
Psychosocial Education – A program of instruction that involves aspects of
psychological and social behavior
Psychosocial Intervention – Psychosocial intervention refers to local or outside

support and aims to protect or promote psychosocial wellbeing (IASC, 2007). These
are formal types of intervention, specific, planned, intentional, and can stand alone.
Psychotherapy – An interpersonal, relational intervention used by trained

psychotherapists to aid clients in problems of living. This usually includes increasing
individual sense of wellbeing and reducing subjective discomforting experience
Restoration of Normal Activities – Activities that promote normalcy and returning

the old lifestyle or normalizing the social life
Restoring Family Links – A service that enhance access to family members and
other primary support persons (PFA, 2007)
Risk – Anticipated consequences of a specific hazard interacting with a specific

community (at a specific time)
Social and Community Support – Relates to activities that promote emotional

wellbeing and recovery following disasters within the community and assists people in
fostering connections as soon as possible
Stress Management – Activities designed to make one aware of his stressors, level of
stress & how one cope. Such awareness can make one handle & cope better.
Support Group Formation – Gathering individuals with the same needs or concerns
to form a supportive network that can help facilitate recovery
Vulnerability – Any factor which increase the risks arising from a specific hazard in a
specific community (a risk modifier)
127
Department of Education
THIS MANUAL
Department of National Defense
WAS DEVELOPED
WITH TECHNICAL
SUPPORT FROM: Philippine National Police
Department of Social Welfare and Development
National Center for Mental Health
Mariveles Mental Hospital
Ateneo de Manila University
Philippine Psychiatric Association
UNICEF
Save the Children Philippines
Council for the Welfare of Children
Balay Rehabilitation Center
Philippine Red Cross
World Health Organization
AWIT Foundation
Balik Kalipay
Copyright
and Save the Children Philippines
December 2018

MHPSS Harmonized Training Module 124554

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Harmonized Mental Health

and Psychosocial Support

Copyright © Department of Health

All rights reserved. Any part of this

While there is a considerable number of MHPSS capacity building activities available

Having been subjected to a series of multi-sectoral and inter-agency consultations

Gloria J. Balboa, MD, MPH, MHA, CEO VI, CESO III

Francisco T. Duque III, MD, MSc

I likewise commend the collaborative efforts of the

Indeed, the Training Manual which is composed of six modules, is an invaluable

Leonor Magtolis Briones

The provision of MHPSS to individuals, families and

As such, the Department strongly recommends the implementation of this training

Rolando Joselito D. Bautista

This stark reality was also revealed among children

We congratulate the Department of Health along with the Department of Education

Atty. Alberto T. Muyot

Milestones of the Harmonization Process

• DOH conducted a workshop to level off on competencies needed

January • MHPSS Training Materials were reviewed and compiled to identify

• A workshop was conducted on January 23-25, 2018 which

March • During this workshop, the competency framework from the

• Focused group discussions (FGDs) were also conducted with

• During this workshop, the organizers and partners recognized

Users of this Manual

Content and delivery of this Manual

The Training Manual is divided into the following modules:

Module I - Disasters and Emergencies, and their Impact on Individuals,

Module II – MHPSS Framework: Concepts and Policies

Module III - Wellbeing, Individual and Family Assessment, and Referral

Module IV – MHPSS Interventions

Module V - MHPSS Monitoring and Evaluation

Module VI – Action Planning

START END ACTVITY LEARNING OUTCOMES

Dealing with strong emotional reactions

Preparation for the facilitators and organizing team

Pre- and post-training assessment tools

Links to the tools are as follows:

Post-Training Needs Analysis Tool

Link to presentation: http://bit.ly/HarmonizedMHPSSOpening

1. Opening Ceremonies: Opening Remarks, Opening Prayer/Doxology, Singing

1. Opening Ceremonies: Opening Remarks, Opening Prayer/Doxology, Singing

2. Responsible Team (RT) Creation

5. Overview of the Training

While there is a considerable number of MHPSS capacity building content and

The Harmonization Process

The Harmonized MHPSS Training Manual is a by-product of these consultations

Who are the target participants of this training manual?

Emergency responders under the IASC Pyramid of Intervention have individual

KNOWLEDGE Level 1 Level 2 Level 3 Level 4

SKILLS Level 1 Level 2 Level 3 Level 4

SKILLS Level 1 Level 2 Level 3 Level 4

Facilitators: It is recommended that facilitators of this module have under-

Link to presentation: http://bit.ly/HarmonizedMHPSSModuleI

MODULE 1: SESSION OUTLINE

ACTIVITY 1 (15 minutes)

LECTURE (20 minutes):

The importance of understanding DRRM technologies

What are hazards?2