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/T (Self-care - Individual practices and activities that people engage in regularly to maintain and enhance their physical, mental, and emotional health and wellbeing.)
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/E (Unlike the well-established research bodies examining trauma-related mental health issues among military personnel, healthcare clinicians, and other emergency responders, the study of psychological wellbeing among humanitarian workers remains an emerging field. Academic interest in this area began developing in the 1990s, but the research base remains limited in scope and scale. Most existing studies have predominantly focused on international expatriate staff, creating a significant knowledge gap regarding the mental health experiences of national humanitarian workers. This research disparity is particularly concerning given that national staff constitute the majority of the humanitarian workforce and frequently experience direct exposure to traumatic events and ongoing stressors in their home contexts. Despite their numerical dominance and heightened vulnerability, no dedicated systematic analysis has yet examined trauma-related mental health outcomes specifically among national humanitarian personnel, leaving this population underrepresented in both research and evidence-based support interventions \(Abu-Ras, 2024\).)
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/E (The Mental Health and Psychosocial Support \(MHPSS\) framework has historically been anchored in treatment-oriented interventions and a medical model that primarily addressed mental health concerns after they had already manifested. However, contemporary research is increasingly advocating for a fundamental shift toward prevention-focused, community-centered approaches that recognize mental health as deeply embedded within social, cultural, and environmental contexts.)
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/E (This paradigmatic evolution calls for 'a multilayered and multisectoral approach to prevention and treatment, including provision of living and working conditions that enable healthy psychosocial development, promotion of positive interactions within and between social groups, social protection for the poor, anti-discrimination laws and campaigns, and promotion of the rights of those with mental health conditions \(Mann, 2016\). )
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/E (Humanitarian workers operate in increasingly complex and volatile environments where they face heightened risks to their safety, mental health, and wellbeing. Despite growing awareness of these challenges, existing resources for staff care, and mental health and psychosocial support \(MHPSS\) remain fragmented and unevenly distributed across regions. This document presents a global mapping exercise designed to identify and analyze, available resources that protect and support humanitarian workers. It also includes a focused examination of the specific contexts in teh Democratic Republic of Congo, the Occupied Palestinian Territory and Ukraine through three case studies.)
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/T (Central to this community-based prevention approach is the acknowledgment of diverse sources of resilience and coping mechanisms already present within communities. Faith-based rituals and practices can be important sources of resilience in times of crisis, correlating with increased social support \(Walker, 2012\) and helping people find ways to cope and protect themselves against emotional distress \(Hill and Pargament 2003\).)
/E (Central to this community-based prevention approach is the acknowledgment of diverse sources of resilience and coping mechanisms already present within communities. Faith-based rituals and practices can be important sources of resilience in times of crisis, correlating with increased social support \(Walker, 2012\) and helping people find ways to cope and protect themselves against emotional distress \(Hill and Pargament 2003\).)
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/T (Recent evidence also underscores that social health is a vital but often overlooked pillar of well-being. Social connection is not only protective for communities in crisis but is equally essential for humanitarian workers themselves. According to the WHO Commission on Social Connection \(2025\), social connection reduces the risk of disease, lengthens life expectancy, and strengthens both communities and society at large. Conversely, widespread disconnection, thus loneliness, affects nearly one in six people globally and contributes to hundreds of thousands of premature deaths annually. Recognizing the role of belonging and connection as protective factors is therefore critical when mapping staff care and MHPSS resources.)
/E (Recent evidence also underscores that social health is a vital but often overlooked pillar of well-being. Social connection is not only protective for communities in crisis but is equally essential for humanitarian workers themselves. According to the WHO Commission on Social Connection \(2025\), social connection reduces the risk of disease, lengthens life expectancy, and strengthens both communities and society at large. Conversely, widespread disconnection, thus loneliness, affects nearly one in six people globally and contributes to hundreds of thousands of premature deaths annually. Recognizing the role of belonging and connection as protective factors is therefore critical when mapping staff care and MHPSS resources.)
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/T (The current fragmentation of staff care resources, with significant gaps in accessibility and cultural sensitivity, reflects patterns of inequality. Local humanitarian personnel must have equal access to culturally appropriate mental health resources and decision-making power over their own wellbeing support systems \(Saavedra Flores, 2025\).)
/E (The current fragmentation of staff care resources, with significant gaps in accessibility and cultural sensitivity, reflects patterns of inequality. Local humanitarian personnel must have equal access to culturally appropriate mental health resources and decision-making power over their own wellbeing support systems \(Saavedra Flores, 2025\).)
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/E (This exercise aims to map protection, staff care, and mental health and psychosocial support \(MHPSS\) resources available to humanitarian workers through a desktop review of current tools and guidelines. This process will identify gaps in resource availability and accessibility, with particular attention to underserved populations including national staff and volunteers. )
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/E (The methodology employed a mixed-methods approach :)
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/E (An online survey developed and distributed to mental health and psychosocial support \(MHPSS\) practitioners. The survey was designed to assess current resource usage, identify gaps in available tools, and understand access barriers related to staff care and MHPSS resources.)
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/E (The humanitarian sector continues to lag considerably in recognizing the importance of staff care \(Cameron, 2024\). Although considerable attention is devoted to the safety and security of humanitarian personnel, this focus has traditionally emphasized physical protection, while psychological and mental health needs have received comparatively less attention.)
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/E (The sector also faces structural challenges that hinder the development and implementation of staff care resources. Humanitarian personnel are dispersed across a wide range of organizations operating in diverse and often complex contexts, making coordinated resource development and the standardization of good practices difficult. In addition, duty of care measures have too often been concentrated within large international organizations, leaving smaller local and national organizations with limited access to comparable support.)
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/E (Mental health stigma may be particularly pronounced in humanitarian settings. National staff working in their own communities can face additional pressures linked to local cultural perceptions of psychological support, as well as concerns about confidentiality, professional reputation, and social judgment. Furthermore, financial constraints frequently result in humanitarian funding prioritizing services for affected populations over staff care. As a result, staff wellbeing may be treated as an optional add-on rather than as a core organizational responsibility essential to sustainable operations and the delivery of quality services.)
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/E (Nevertheless, recent developments indicate growing recognition of these challenges. Humanitarian organizations have begun compiling resources to support the wellbeing and effectiveness of their personnel, while studies showing that significant proportions of humanitarian workers are at risk of developing mental health conditions have prompted increased organizational attention. However, these efforts remain at an early stage and have yet to translate into consistently available, accessible, and adequately resourced staff-care systems across the sector.)
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/E (This survey of 27 MHPSS practitioners from humanitarian contexts across Europe, Ukraine, OPT, Syria, Senegal and DRC reveals a fragmented landscape of staff care resources, significant unmet needs, and barriers preventing humanitarian workers from accessing mental health support. )
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/E (Respondents identified three major categories of missing resources that are essential for effective staff care in humanitarian settings:)
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/E (Culturally adapted materials. Practitioners require resources tailored to local contexts, available in multiple languages and reflecting non-Western approaches to collective and spiritual coping rather than individualistic Western psychological models. )
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/E (Practical, field-ready tools represent another significant gap. Humanitarian workers want simple, low-threshold resources designed for high-pressure environments with limited infrastructure. This includes self-help methods, peer support toolkits suitable for volunteer-based teams, and approaches that can be implemented without extensive professional mental health training.)
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/E (Context-specific protocols addressing moral injury, political grief, and working under occupation or in active conflict zones are absent. Current resources borrowed from other sectors fail to address the unique stressors humanitarian workers face, ethical complexities of working in politically charged environments and the cumulative trauma of bearing witness to suffering while facing personal security threats.)
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/E (The survey identified moderate adoption of existing staff care frameworks, with 52% of respondents using the IASC Guidelines on Mental Health and Psychosocial Support and 40% utilizing both the Well-Being Guide and Guidelines for Caring for Staff. However, only 8% reported using Mental Health and Psychosocial Support Minimum Service Package, and minimal uptake of specialized resources such as ReliefWeb MHPSS Resources and PHAP materials \(4% each\) suggests that many available tools remain underutilized or unknown to practitioners.)
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/E (Notably, 52% of respondents indicated using "other" resources beyond the standard options provided, and 68.8% of these resources are accessible to external parties, pointing to internal and organisational resource-sharing practices. The diversity of responses highlights fragmentation, with no unified or comprehensive resource framework emerging as a sector standard.)
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/E (Additional gaps include long-term sustainability guidelines for establishing ongoing staff care programs remote and community-based support methods for geographically dispersed teams, and family-inclusive approaches that recognize how staff wellbeing is shaped by relational and familial factors, especially for national staff who cannot separate their work environment from their home lives.)
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/E (The survey revealed a complex web of interconnected barriers preventing humanitarian workers from accessing existing mental health support, clustered into four main categories:)
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/E (Systemic and resource barriers constitute the foundation of access challenges. These include a shortage of mental health professionals, particularly trauma-trained providers who speak local languages, with services concentrated in urban areas, leaving frontline and rural staff without access. )
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/E (Cost and funding constraints create additional hurdles, as organizations provide limited coverage for therapy sessions, donor funding remains fragmented and unreliable, and insufficient budget allocation treats staff care as an afterthought rather than a priority. Infrastructure challenges such as unstable internet connectivity for online support and geographic distance preventing in-person consultations compound these issues.)
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/E (Cultural and social barriers create powerful disincentives to help-seeking. Mental health stigma remains present, with psychological support viewed as weakness or "Western luxury," causing staff to avoid formal help. Confidentiality concerns through employer-arranged services further discourage uptake. Language and cultural adaptation gaps mean that even available resources often fail to resonate with local staff, while general awareness gaps leave many workers unaware that support exists or how to access it.)
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/E (Organizational and operational barriers reflect how humanitarian work structures obstruct staff care. Time constraints, driven by high-pressure environments, heavy workloads, tight deadlines, and ongoing crises like air raids and insecurity, leave little flexibility for staff to engage with support services or training. )
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/E (Management capacity gaps mean that supervisors often lack skills to recognize distress, provide initial support, or make appropriate referrals, and leadership teams frequently need care themselves. Organizations default to reactive rather than preventive approaches, treating staff care as a responsive service rather than an integrated cultural value embedded in daily operations.)
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/E (Contextual challenges ongoing crises and security issues, including recurring emergencies, sudden context changes, and active conflict, prevent in-person meetings and disrupt consistent service delivery. Staff care programs fail to scale proportionately to need, and insufficient integration into international frameworks leaves many workers unsupported. The absence of support packages for families who indirectly experience deployment stress affects staff wellbeing and reintegration, yet remains largely unaddressed.)
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/E (Research consistently demonstrates that female humanitarian staff report higher rates of common mental health symptoms compared to their male colleagues \(Ager et al., 2012; Eriksson et al., 2013\). This gender disparity suggests that elevated mental health risks experienced by female national staff cannot be attributed solely to inherent stressors of humanitarian work. Gender-specific stressors such as structural sexism and discrimination or economic inequality may contribute to this vulnerability. The desktop review did not reveal specific resources for this group. )
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/E (National frontline workers occupy a unique position compared to international humanitarian workers, as they simultaneously serve as humanitarian staff while living under the same conditions of chronic conflict that affect their communities. Research suggests that for Palestinian frontline workers, psychological wellbeing is closely linked to active involvement in civil society and collective resistance efforts. Political commitment and community participation appear to protect against common trauma responses such as anxiety, social withdrawal, and loss of personal agency. This reflects what researchers term the "political domain of wellbeing," where both traumatic experiences and healing processes are understood within the broader context of political struggle and collective resistance. \(Helbich and Jabr, 2022\).)
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/E (The Gaza MHPSS Technical Working Group, co-chaired by GMHP \(Gaza Mental Health Programme\) and Al-Awda, serves as a coordination hub for strengthening mental health and psychosocial support across the humanitarian response. The West Bank MHPSS Technical Working Group is co-chaired by WHO and Terre des hommes.)
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/E (The TWG's primary objectives include facilitating regular coordination meetings among partners to enhance collaboration, conducting comprehensive mapping of MHPSS services to identify gaps and opportunities for structured assessments, and ensuring that international cooperation supports both immediate and long-term mental health needs. The TWG has conducted a staff-care survey in the West Bank and a referral pathway made available in Gaza to support humanitarian workers' access to mental health services.)
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/E (Staff care mechanisms remain severely limited across most organizations in Occupied Palestinian Territory. While some had established group reflective sessions, psychosocial support activities, team-building exercises, and even a draft MH country policy \(2016\), the occupation dramatically disrupted these frameworks. The massive operational scale and overwhelming workloads made structured staff care nearly impossible to maintain \(UNFPA, 2025\).)
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/E (Structured supervision has been identified as a critical priority for staff development and well-being in Occupied Palestinian Territory. This emotional support component of supervision proves particularly essential for preventing burnout and ensuring ethical, effective service delivery in high-pressure humanitarian contexts \(UNFPA, 2025\).)
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/E (After two years of war on Gaza, humanitarian workers operate under conditions of occupation while experiencing the dual burden of being both aid providers and survivors. Staff face unprecedented demands while grieving personal losses, experiencing repeated displacement and dire humanitarian conditions with minimal access to self-care or reflective sessions. The complete collapse of healthcare infrastructure, including mental health facilities, coupled with critical funding gaps, severe human resource shortages due to casualty rates among humanitarian workers, and absent organizational policies for staff well-being have created a crisis within the crisis. Without adequate supervision, protective measures, or basic safety guarantees, staff operate under extreme stress and constant threat with minimal structured coping mechanisms, resulting in extreme burnout and emotional fatigue \(Obaid, 2025\).)
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/E (The West Bank has experienced severe deterioration under occupation. Humanitarian workers navigate escalating violence and closures that severely restrict movement and access to both affected populations and workplaces. Organizations have adapted by transitioning to online psychological support and resilience-building activities, though virtual methods prove insufficient for addressing cumulative staff stress. Movement restrictions and threat of arrest and violence create conditions where humanitarian workers themselves require protection while attempting to provide services.)
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/E (It is critical to recognize that humanitarian workers in protracted crisis contexts like Gaza often experience shared trauma, serving simultaneously as aid providers and community members directly affected by ongoing occupation and displacement. Research demonstrates that this dual exposure creates unique psychosocial vulnerabilities distinct from those faced by international staff, including heightened secondary traumatic stress, burnout, and moral distress compounded by witnessing harm to their own communities \(Adwi, 2025; Saul, 2014\).)
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/E (Effective staff care must therefore be embedded within a community resilience framework rather than approached solely through individualized interventions. The success of community-based and family-support interventions underscores the critical importance of integrating local community engagement and cultural practices into staff care resources and frameworks. Organizations should acknowledge and respect the cultural beliefs, values, and practices of their staff, particularly national workers, by incorporating traditional healing methods alongside evidence-based interventions.)
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/E (National staff require organizational cultures that normalize mental health discussions, provide peer support networks, and ensure access to culturally appropriate psychosocial services in local languages \(Humanitarian Advisory Group, 2024\). Special attention must be given to the boundary challenges faced by staff providing services within their own communities, where professional and personal roles inevitably overlap, creating risks of compassion fatigue and role overload \(Adwi, 2025\).)
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/E (Tackling systemic workplace stressors)
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>>
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/E (Staff care mechanisms must address the impact of occupation, the systemic workplace stressors, including inequitable compensation, excessive workloads, job insecurity, and lack of decision-making authority, which research identifies as primary drivers of distress among national humanitarian workers, often more impactful than direct trauma exposure \(Adwi, 2025; Humanitarian Advisory Group, 2024\). Organizational policies should protect staff wellbeing through manageable workloads, adequate rest periods, and flexible arrangements that acknowledge family and community obligations.)
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/E (17)
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>>
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/E (Designing crisis-adapted interventions)
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>>
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/E (In acute crisis settings characterized by displacement and infrastructure collapse, staff care approaches must be adapted to function with minimal resources and amidst operational disruptions. Simple, low-threshold interventions such as structured peer support, regular team check-ins, and psychoeducation on stress management can be implemented even when formal counseling services are inaccessible \(Humanitarian Advisory Group, 2024\). Organizations should prioritize continuity of care by maintaining stable team structures where possible and establishing clear pathways for psychological first aid and referral \(Saul, 2014\).)
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/E (Legal and political dimensions)
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>>
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/E (Key informants from Palestinian mental health organizations highlight another layer that humanitarian frameworks rarely address: the legal vulnerability of mental health workers.)
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>>
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/E ("Mental health professionals in Palestine need legal protection and support, just like journalists or human rights workers, but this is almost never included in staff care programs. Politically aware supervision is essential. Supervisors need training in clinical skills but also in helping staff navigate the ethical dilemmas of working under occupation. Standard clinical supervision models developed in stable contexts don't address these realities.")
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/E (Setting operational priorities)
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>>
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/E (Based on UNFPA's \(2025\) situational analysis, organizations should prioritize:)
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>>
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/E (Integrating structured supervision frameworks that strengthen supervisors' capacity to identify distressed staff)
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>>
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/E (Developing peer-support networks to foster collective resilience)
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>>
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/E (Implementing systematic monitoring of staff well-being)
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>>
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/E (Maintaining sustained advocacy for adequate funding and human resources)
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>>
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/E (Adopting hybrid methods that combine virtual platforms with periodic in-person sessions to maintain meaningful engagement while addressing unpredictable operational challenges in both Gaza and the West Bank)
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>>
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>>
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/E (Staff care resources in DR Congo)
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/E (Literature shows that resources that mention community mobilization, local partnerships, and engagement with government agencies have greater reach in the context of Democratic Republic of Congo \(Dickson, 2018; Mukdarut, 2017\). When frontline workers are part of the affected community, as is often the case with national staff, support systems and resources must be developed in collaboration with local actors. This approach ensures that interventions are responsive to local needs, socially acceptable, and sustained beyond the initial phases of a crisis.)
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/E (A second key lesson is the importance of cultural and contextual adaptation. Literature reviews emphasize that mental health interventions are most effective when they are culturally meaningful and sensitive to the social realities of the populations they serve \(Dickson, 2018\). Many MHPSS models and resources, originally developed in Western contexts, fail to resonate in low-resource or conflict-affected settings. Programmes that integrate local languages, religious or faith-based coping practices, and indigenous healing methods are more likely to build trust and participation. For frontline workers, who often experience the same cultural and spiritual frameworks as crisis-affected communities, these locally grounded approaches are particularly valuable in enhancing engagement and reducing stigma around mental health care.)
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/E (19)
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>>
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/E (Another consistent finding across the literature is the significance of building trusting and supportive relationships between MHPSS providers and recipients. Trust, empathy, and confidentiality are essential qualities that determine whether humanitarian workers will engage with available support. Frontline workers, especially those exposed to trauma or moral injury, are more likely to seek help when they perceive the support as safe, confidential, and free from judgment. Peer-based or supervisor-supported care models, where the helper shares similar experiences, often provide more meaningful and sustainable support than purely clinical interventions.)
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/E (Group-based and peer support approaches also emerge as powerful mechanisms for promoting wellbeing and resilience in the context of DR Congo. Group-based MHPSS activities not only provide safe spaces for participants to share their experiences but also foster a sense of belonging and social connectedness. These group interventions help reduce isolation, promote solidarity, and enable collective coping, which are crucial for humanitarian teams working in stressful or insecure environments. For frontline staff, creating structured spaces for peer reflection and mutual learning can serve as an important protective factor.)
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/E (The literature evidence shows that programmes delivered by trained providers are significantly more effective. Investing in capacity building, ongoing supervision, and professional development for MHPSS facilitators, managers, and peer supporters is therefore a key component of effective staff care systems and resources \(Mukdarut, 2017\).)
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/E (Policies and legislation)
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/E (As part of developing the next 2026 action plan for the National Mental Health and Psychosocial Support Working Group, discussions are underway to integrate a specific advocacy activity aimed at including mental health and psychosocial support in the humanitarian project cycle, with particular focus on mental health in the workplace. Although this initiative primarily concerns the health sector in general, it offers a strategic opportunity to advocate for mechanisms specific to humanitarian workers, who face unique stress factors related to emergency and conflict contexts.)
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/E (Between 2024 and 2025, the National Mental Health Program launched the "Mental health in the workplace" initiative, which facilitates exchanges with several actors to promote this dimension. To date, the initiative does not explicitly target humanitarian workers. )
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/E (In line with this initiative, ACF has developed survey activities and psychosocial risk analysis, as well as stress management trainings, and provides psychological care for state health personnel in the health zones where it operates \(notably Mweso in North Kivu and Drodro in Ituri\).)
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/E (ROASAM association, in collaboration with several humanitarian actors and civil society organizations in DRC, has initiated a draft law on mental health. The year 2026 will be dedicated to its finalization, validation by the National Mental Health and Psychosocial Support Program, and advocacy with the Assembly for its adoption \(Tobo, 2023\).)
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/E (20)
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/E (During key informant interviews, practitioners highlighted that due to the scarcity of locally available MHPSS resources in DR Congo, they have developed ad hoc solutions by adapting existing tools, primarily internal organizational materials through translation or contextual modification. However, this practice remains largely siloed, with minimal inter-organizational sharing of adapted resources. Respondents noted that while written materials are being localized, there is a particularly acute gap in audiovisual resources such as contextually adapted videos, which would be more accessible and culturally resonant for frontline workers. This observation underscores the importance of investing in capacity building for mental health providers in DRC, particularly in the areas of vicarious trauma, stress management related to emergency contexts, and culturally adapted approaches to Congolese realities.)
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/E (Key informants additionally emphasize a comprehensive approach to staff mental health and wellbeing that prioritizes accessibility and organizational commitment. They recommend establishing a dedicated service supported by clear organizational policies, ensuring confidentiality to build trust and encourage uptake.)
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/E (The approach should promote positive mental health dimensions through practical examples relevant to daily life, including self-esteem building, empathetic listening, and nonviolent communication. Practitioners advocate for brief, solution-focused therapies with simple, replicable techniques like relaxation exercises and emotion management strategies that accommodate staff time constraints. For post-incident care, they suggest EMDR \(with Psychological First Aid, R-TEP, IGTP protocols\) or CBT approaches.)
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/E (Practitioners stress the importance of monitoring both social and professional contexts to identify stress factors and implement preventive measures. They recommend using frameworks like the IASC pyramid of psychosocial interventions, including context-specific responses such as mini-breaks for staff in difficult operational settings.)
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/E (21)
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/E (Staff Care Resources in Ukraine)
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/E (Prior to the 2022 conflict, Ukraine had already begun significant mental health system reforms. Weissbecker \(2017\) highlighted the need for deinstitutionalization, development of community-based services, and integration of mental health into primary healthcare.)
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/E (Humanitarian workers in Ukraine occupy a particularly challenging position within the ongoing conflict context. The Ukrainian humanitarian response relies heavily on national staff who are themselves directly affected by the war. These workers face the dual burden of providing care while simultaneously experiencing the same traumatic events, displacement, security threats, and losses as the populations they serve \(Nalyvaiko, 2025\).)
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/E (Legislation )
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/E (Ukraine has recently enacted comprehensive mental health legislation through the Law of Ukraine "On the Mental Health System in Ukraine" \(2025\), which will enter into force in 2026. This legislation establishes a broad framework for mental health care, including provisions related to workplace mental health. However, as the law is not yet in force, the references to its articles reflect expected rather than currently operating norms, indicating a legislative gap that currently exists. While the law addresses mental health system development, professional standards, and various aspects of mental health service delivery, it contains minimal provisions specifically addressing organizational duty of care or staff care policies for humanitarian workers or other employees. )
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/E (22)
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>>
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/E (Article 33 on "Workplace mental health" states simply that "Every employer may develop and approve a programme of psychosocial support for employees in the workplace" \(Law of Ukraine "On the Mental Health System in Ukraine," 2025, Article 33\). Until the law enters into force, these provisions remain aspirational standards rather than enforceable legal requirements.)
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/E (Despite the legislative limitations, various mental health interventions have been implemented in practice to support the Ukrainian population and humanitarian workforce. Numerous interventions and resources were implemented, including Problem Management+, CBT, and EMDR \(Goloktionova, 2021\). A significant innovation was the engagement of people with lived experience of mental health conditions in planning and service provision. This approach recognized that those who have experienced mental health challenges and recovery could provide valuable peer support and contribute to reducing stigma \(WHO, 2022\).)
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/E (Nonviolent Peaceforce \(NVP\) has developed a comprehensive staff welfare program in Ukraine that combines evidence-based EMDR protocols with peer support approaches. The program centers on the EMDR Group Resource Enhancement Protocol \(G-REP\), a structured ego-strengthening intervention that can be delivered to individuals or groups either as a standalone activity or as Phase 2 preparation within EMDR therapy. Notably, G-REP does not require prior EMDR therapy training for facilitators, making it more accessible for implementation in humanitarian settings. Peer support forms a crucial pillar of NVP's approach, as this modality is contextually better accepted within the Ukrainian cultural framework. Additionally, NVP collaborates with other humanitarian partners to train paracounselors, expanding the available support infrastructure. A significant innovation has been the establishment of self-care hubs where staff can find respite and connect with colleagues. These spaces also serve as referral points for counseling services. Another innovative and translated into Ukrainian therapeutic method is Symbolic Modelling, \(Lawley & Tompkins, 2000\) using metaphors for self-discovery and transformation for staff care support. )
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/E (Other humanitarian organizations operating in Ukraine tend to offer more classical staff care programs focused primarily on referrals to psychologists. However, these traditional approaches face significant challenges due to insufficient resources and the overwhelming demand for services.)
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>>
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/E (Throughout the Ukraine response, Psychological First Aid proved valuable not only for supporting displaced populations but also for promoting staff and volunteer wellbeing \(IFRC, 2024\). Across multiple National Societies, staff and volunteers integrated PFA's three action principles into their own self-care practices, with some organizations implementing buddy systems to provide peer support and address work-related stress. However, a critical gap emerged in the lack of systematic supervision. This absence of structured supervision was identified across National Societies as a significant weakness in sustaining staff wellbeing, with survey results showing that 21% of respondents from six National Societies received no post-training support, refresher training, or supervision \(IFRC, 2024\).)
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/E (The Caring for Volunteers framework resource available in Ukrainian \(IFRC, n.d.\) helps in preparation and orientation for volunteers, includes clear role descriptions, information on likely stressors, and psychoeducation on normal stress reactions and coping strategies. The framework insists on the importance of creating supportive working conditions, including reasonable working hours, predictable rest cycles, safe deployment practices, and opportunities for volunteers to disengage from highly distressing tasks. Routine mechanisms for monitoring and support, such as daily or weekly team check-ins, supportive supervision, and opportunities for volunteers to express concerns have proven helpful. Finally, organizations should provide accessible referral pathways for professional mental health support. This includes maintaining up-to-date referral lists, having designated focal points responsible for guidance, and ensuring that volunteers know when and how to seek additional help.)
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/E (Trauma Risk Management \(TRiM\) represents another innovative peer-support approach that addresses several barriers to psychological support identified among Ukrainian humanitarian workers. TRiM helps to identify employees who may develop post-traumatic stress disorder after traumatic experiences and provide them with appropriate assistance in a timely manner \(Romano, 2023\). Anyone can apply this knowledge without being a psychologist, which helps people to communicate more easily given the persistent stigma attached to seeking help from mental health professionals. This peer-based model proves relevant in the Ukrainian context where, according to research \(Golub, 2024\) the main barriers to seeking psychological help include insufficient attention to mental health, confidence in managing stress independently, and cost concerns.)
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/E (The minimum Duty of Care package \(Golub, 2024\) proposed by the Swiss Agency for Development and Cooperation, Humanitarian NGO Platform in Ukraine, and Alliance of Ukrainian Civil Society Organizations includes health and life insurance for both staff and volunteers, psychosocial support measures, individual first aid kits \(IFAKs\), personal protective equipment \(PPE\), and training on the usage and application of these items, coupled with introductory training on safety and security management. For psychological support specifically, the minimum standard includes providing volunteers and staff with information on available mental health and psychosocial support services and how to access them, as well as vouchers for individual psychological consultations.)
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>>
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/E (In Ukraine, one organisation provided a flexible benefit to national staff, who are not eligible for R&R, to be used at their discretion on anything that they felt supported their wellbeing \(such as exercise courses and therapy\) \(GISF, 2024\).Caritas Ukraine for example assisted their staff with an ECO-Flow generator to ensure power and internet connectivity during power breakdowns. )
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/E (24)
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/E (Despite these foundations, the survey and consultation process for the Operational Roadmap \(WHO, 2022\) and the key informant interviews revealed significant gaps in staff care resources, particularly for national humanitarian workers and frontline responders. For example, the strengthening of protective environments in the workplace and financial protection as essential components of staff mental health \(WHO, 2022, p. 31\). This includes ensuring adequate rest periods, reasonable workloads, security protocols that minimize risks, and salaries that enable workers to meet their family needs and access private mental health services if desired.)
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/E (Gaps in resources and research presently exist in the Ukrainian context on how to integrate staff care into organizational practice, culturally appropriate assessment tools and interventions, and documentation of peer support and community-based approaches emerging from Ukrainian humanitarian workers themselves. Furthermore, the innovative and resource-intensive programs described are isolated examples of best practices and do not reflect the system as a whole. Most humanitarian workers likely do not have access to them.)
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/E (Recommendations)
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/E (Priority actions include developing simple two-page guides for volunteers on applying staff care, creating online training materials in Ukrainian for volunteers and paracounselors, and translating evidence-based protocols adapted to Ukraine's unique conflict context. Organizations must invest in structuring the existing intuitive peer-to-peer support networks, with veteran support groups \(Equal to Equal\) offering promising pilot opportunities. Critical gaps in systematic supervision and post-training support need addressing, while the minimum duty of care package, including health insurance, psychosocial support, safety equipment, and adequate compensation, requires wider adoption and enhancement for both staff and volunteers.)
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/T ("There is no systematisation between organisations who are competitive due to funding," )
/E ("There is no systematisation between organisations who are competitive due to funding," )
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>>
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/E (While coordinated inter-agency mechanisms are already in place to facilitate knowledge exchange, standardize minimum standards, and enable collaborative resource development, these mechanisms remain unknown to many organizations and need to be more actively promoted and established within the broader humanitarian network.)
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/E (25)
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/E (Limitations & future research questions)
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/T (Additionally, the mapping exercise focused primarily on mental health and psychosocial support resources and organizational staff care practices. However, it did not comprehensively examine the specific physical security threats that humanitarian workers face, nor did it explore the intersection of legal and administrative harassment, labour law compliance, and staff wellbeing. The relationship between these domains and MHPSS remains underexplored in humanitarian contexts globally. )
/E (Additionally, the mapping exercise focused primarily on mental health and psychosocial support resources and organizational staff care practices. However, it did not comprehensively examine the specific physical security threats that humanitarian workers face, nor did it explore the intersection of legal and administrative harassment, labour law compliance, and staff wellbeing. The relationship between these domains and MHPSS remains underexplored in humanitarian contexts globally. )
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/T (Regarding physical security and mental health, a key question emerges: how do inadequate physical security measures and protocols impact the mental health outcomes of humanitarian workers in active conflict zones, and what organizational practices effectively mitigate these psychological effects? )
/E (Regarding physical security and mental health, a key question emerges: how do inadequate physical security measures and protocols impact the mental health outcomes of humanitarian workers in active conflict zones, and what organizational practices effectively mitigate these psychological effects? )
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/T (The relationship between legal harassment and psychosocial wellbeing requires investigation into how legal and administrative harassment, including arbitrary detention, interrogation, and threats of prosecution, affects the psychological wellbeing and help-seeking behaviors of humanitarian workers across different operational contexts. )
/E (The relationship between legal harassment and psychosocial wellbeing requires investigation into how legal and administrative harassment, including arbitrary detention, interrogation, and threats of prosecution, affects the psychological wellbeing and help-seeking behaviors of humanitarian workers across different operational contexts. )
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/T (From a labour law perspective, research is needed to understand how gaps in labour law enforcement, such as unpaid overtime, inadequate rest periods, and lack of formal employment protections, correlate with mental health outcomes and burnout rates among humanitarian personnel. )
/E (From a labour law perspective, research is needed to understand how gaps in labour law enforcement, such as unpaid overtime, inadequate rest periods, and lack of formal employment protections, correlate with mental health outcomes and burnout rates among humanitarian personnel. )
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/T (Finally, an integrated approach question asks: what comprehensive duty of care frameworks effectively address physical security risks, legal protections, and psychosocial support needs simultaneously, and how can organizations implement such frameworks while navigating diverse legal and operational environments? )
/E (Finally, an integrated approach question asks: what comprehensive duty of care frameworks effectively address physical security risks, legal protections, and psychosocial support needs simultaneously, and how can organizations implement such frameworks while navigating diverse legal and operational environments? )
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/T (These research questions would help bridge the gap between operational security, legal compliance, and psychosocial wellbeing, creating a more holistic understanding of humanitarian worker welfare in high-risk contexts.)
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/E (Priority should be given to developing simple two-page guides for volunteers explaining how to apply staff care, online training materials in local languages for volunteers and paracounselors, and evidence-based intervention protocols adapted to each context's unique challenges. )
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/E (In addition, national humanitarian workers often face the dual burden of providing assistance while also being directly affected by the crisis themselves. Staff-care resources should therefore address the specific stressors associated with delivering support while experiencing personal, family, or community-level impacts of the crisis.)
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/E (Key informant interviews across contexts revealed that peer support exists intuitively among humanitarian workers but lacks systematic structure and formalization. In Ukraine, veteran support groups present promising pilot opportunities that could serve as models for broader humanitarian workforce application. Similarly, in contexts marked by protracted armed conflict, social cohesion emerges as both a critical survival mechanism and a foundation for collective protection. Communities that maintain strong social bonds and the capacity to act collectively demonstrate greater resilience in navigating competing demands and securing access to essential services. )
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/E (For humanitarian staff support interventions, these findings underscore the importance of understanding and supporting existing community capacities and peer networks rather than imposing external solutions. Organizations should invest in formalizing these peer support frameworks through training, supervision structures, and integration into organizational staff care systems.)
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/E (In contexts where MHPSS resources are limited and cultural barriers restrict access to mental health support, culturally adapted, evidence-based interventions offer promising solutions. Research on combining Problem Management Plus \(PM+\) with the Emotional Processing \(EP\) module, while adapting it locally, demonstrates the feasibility of maintaining therapeutic efficacy through cultural adaptation processes that incorporate local idioms and concepts of distress, ensure therapeutic techniques align with community values and norms, and adapt delivery methods to respect local preferences. )
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/E (This task-shifting approach, which trains healthcare workers or social workers with appropriate backgrounds to deliver structured, manualized interventions, offers a feasible pathway to bridge service gaps in settings where specialist mental health professionals are scarce and stigma around mental health remains high.)
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/E (MHPSS interventions alone cannot address the fundamental structural challenges facing humanitarian workers in high-risk contexts. Across all three case study contexts, national staff face inadequate compensation, insufficient rest periods, overwhelming workloads, and security protocols that fail to minimize risks adequately. Organizations must prioritize protective workplace environments through enforced rest periods, manageable workloads, robust security protocols, and compensation adequate for current economic realities that enable workers to meet family needs and access private mental health services if desired. )
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/E (The minimum duty of care package developed for Ukraine, including health and life insurance for both staff and volunteers, psychosocial support access, safety equipment, adequate financial compensation, and innovative flexible wellbeing benefits, provides a foundation that requires wider adoption and enhancement across contexts. National staff who cannot access R&R need alternative support mechanisms that recognize their dual burden of providing care while experiencing the crisis themselves.)
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/E (To operationalize these approaches, humanitarian organizations can use ISO 45003:2021 \(Occupational health and safety management Psychological health and safety at work, Guidelines for managing psychosocial risks\) alongside the UN System Mental Health and Well-being Strategy. ISO 45003 provides the first global standard for managing psychosocial risks in the workplace and offers practical guidance on the organizational-level prevention strategies identified as critical gaps in current MHPSS staff care provision.)
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