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Theory, training and timing: Psychosocial interventions in complex emergencies

The Asian tsunami of December 2004 galvanised mental health and emergency agencies in a way that no other recent disaster has done. The loss of life and forced migration focused national and international agencies on the need to provide appropriate psychosocial care from the very beginning. The prior academic arguments surrounding early intervention paled into insignificance against the urgent need to reduce distress and prevent chronic mental health problems. This chapter notes that there was a major, planned and early intervention following the earthquake in Bam, exactly one year earlier. The lessons from that are only now beginning to filter through and help shape better responses to disasters. It is argued that too many non-governmental organizations (NGOs) and even IGOs are following theoretical positions that have little empirical justification. There is an urgent need for training for mental health and NGO personnel alike to deliver evidence-based psychological first aid. There is no justification for mental health responses to be delayed until weeks after a disaster happens.