Crisis into opportunity: setting up community mental health services in post-tsunami Aceh

The Asian Tsunami killed more than 130,000 people and made 400,000 homeless in Aceh, an area in Indonesia already affected by over thirty years of conflict. This paper examines an approach taken by an International Non-Governmental Organisation (INGO) to address emergency mental health and psychosocial needs in an integrated way, by providing a continuum of care incorporating psychosocial support for the wider community and clinical services for the more severely affected. The model included outreach to the indigenous system. Psychosocial activities were developed in partnership with the local communities. Community-based clinical mental health services were established by identifying and building locally-based capacity at the primary health care level, and potentially sustainable services were established in collaboration with the Ministry of Health. By December 2005, four hundred and eighty three patients had been seen. More than one third suffered from serious mental disorders that predated the Tsunami. Thus, crisis provided an opportunity to address longstanding community mental health needs. The lessons learned from this approach are also discussed.