What gaps, if any, do you see in how staff wellness is promoted among humanitarian workers? What concrete improvements could be made?

This question was posed to participants in PHAP's online consultation event on Humanitarian effectiveness and staff wellness. You can read more about the event at phap.org/WHS-30Jul2015.

More sharing of experiences.
- Independent consultant (United Kingdom)

Advocacy with donors and the media - staff wellness costs money.
- Advisor, World Food Program (Italy)

[Even within our organization,] there is inconsistency in the application of wellness support with different service providers and different levels of availability of services. We do not currently have a policy that compels staff to use the service; and i feel we need to increase levels of uptake for all our humanitarian team.
- Emergency HR Coordinator, International NGO

It can be hard in the earliest stages of the response to do activities that promote wellness, and for many national staff who join the response they will have no such training prior to a response. Extending training to them is critical.
- Senior emergency response manager, International NGO

Few organizations have or prioritize the resources.
- Independent consultant (United States)

It is often talked about in theory but difficult to put into practice. In practice, it is still a "macho" environment where you are expected to be very tough.
- Cash Transfers and Social Protection Specialist (France)

De-stigmatize accessing of services. Getting organizational leadership on board and spearheading efforts.
- Principal, Consultant group (United States)

In many ways staff wellness is not mainstreamed in spite of efforts since early 1990s to do so via mentality shifts, staff policy changes, and visible personnel/staff welfare departments; often personal and organizational/field crises precipitate such developments on behalf of staff wellbeing; the faith-based sector has fared much better in that there is a proliferation of materials to help guide sending groups in mission/humanitarian/development/health work. Resiliency emphases are good but not enough; staff protection and safety is good but not enough; a comprehensive approach that involves the needs of the organisation as well as staff themselves, with a view towards the wellbeing of people of concern is needed.
- Consulting Psychologist (Switzerland)

Staff wellness is just making its way on to the agenda of humanitarian organizations, although it has long been a topic of great importance for humanitarian workers themselves.
- Wellness Trainer (Indonesia)

Regular review and upgrading of staff wellness promotion policies.
- Area Coordinator, International NGO (Philippines)

Managers often do not take this seriously enough, staff just often want to get the job done, and may not know how to stand up for their own wellbeing/ safety – and there is no accountability to ensure that robust protocols are in place!
- Global Advisor, International NGO (United States)

Start by acknowledging it and putting systems in place to prevent burn out – not just deal with it when it happens.
- Consultant/ Volunteer (Kenya)

Once a mission is finished there is limited follow-up though the effects on physical and mental health may come after - when there is very limited support. This is even more of an issue with respect to national staff.
- Director, UN Agency (Switzerland)

Well-being and stress management issues are within the overall ""duty of care"" that an employer owes to its employees, yet the consideration extends far beyond the employer's duty of care. Wellbeing at work is most of the time rarely properly implemented in the humanitarian sector and organizations... including with the major stakeholders. Many reasons would explain where we stand today with regards to implementation of such pivotal framework (poor level of implementation... humanitarian sector lagging 20 yrs behind Standard and Recommended Practices of the commercial/ private sector for instance...). A Wellness/ Wellbeing framework could be developed and adapted to the humanitarian sector based on best practices. Then maybe through the impulsion of institutional donor agencies (or whoever could have the most leverage on change...), (I)NGOs could be checked against those best practices and standards through online surveys distributed to ALL stakeholders... not only would an external evaluation give an independent and anonymous voice to humanitarian staff but it would also help some benchmarking within the humanitarian sector. It would also help make employers realize the importance of such a topic vs their duty of care towards their workforce and possibly instill the necessary changes within the organization.
- Advisor, Intergovernmental agency (Kenya)

There are plenty of gaps: most organisations do not have any or not enough staff counselors; there is a disconnect between human resources and the well-being of staff deployed; there seems to be the expectation that willingness to deploy to difficult locations equals that people will have no personal challenges facing the issues they observe - security incidents, people starving, poor living and working conditions.
- Humanitarian Affairs Officer, UN Agency (Switzerland)

Staff wellness is not generally promoted at all. Furthermore, some practitioners are reluctant to go to GP's regarding mental health issues in case they have to share medical records with future employers or in case this impacts upon their ability to acquire insurance policies in the future (most insurers require disclosure of ant mental health issues).
- Director, NGO (United Kingdom)

There is still a stigma on work/ life balance. Working in humanitarian action can be rewarding, but I do believe it can coexist with a balanced life. Yet, the idea of "sacrifice" or a tendency to forget important wellness basis is still too common.
- Deputy Director of Human Resources, International NGO (Switzerland)

Communication gaps, lack of interest, priority measures and culture.
- Welfare Assistant, UN Agency (DRC)

What is needed is a change on the paradigm itself. The aid workers are not used to and/ or trained to allow themselves to express weakness. It should be an integrated approach from INGOs, NGO and IOs for it to change.
- Head of mission, International NGO (Italy)

More direct contact and assessment of the field conditions where humanitarian workers are based would improve the ability of staff health to understand and support humanitarian staff in the field. More emphasis (and time) on ongoing support for the health needs (physical and psychological) of those in the field and not just pre-departure information and preparation would be beneficial.
- Travel Health Advisor, Red Cross and Red Crescent Movement

The organizational pressure to perform and achieve targets is quite intense, giving crazy deadlines and communicating expectations that don't factor the wellness of staff. Solution: when setting organizational goals and targets, staff wellness needs to be considered in every step of the way.
- Senior Field Team Leader, International NGO (Kenya)

1) Ongoing workplace assessments: During missions ongoing workplace health assessments need to be conducted to enhance worker health and safety is warranted. This takes place to a varying degree with some organizations. 2) Lack of clear guidelines for pre and post travel screening - validated screening tools (physical and mental health). 3) Investment in staff health: many projects to not allow adequate resources for staff health, to ensure adequate screening, follow up or develop evidence based practices. 4) Lack of evaluation/ tracking illness and injuries or a centralized reporting database to monitor humanitarian health in order to target initiatives.
- Travel Health Advisor, Red Cross and Red Crescent Movement

I think that there is still such a stigma around mental health, in particular mental health and humanitarian workers, that any work done to break down this barrier would have a long lasting effect.
- Consultant (Canada)

A cultural shift is needed to make it uncomfortable not to seek support ourselves and not to support our teams. Wellbeing of humanitarian workers being specifically measured in all programmes and KPIs for all managers related to support of their people. Expectation from all funders of a staff wellbeing component in all funding applications as good practice. Advocacy around this issue with funders and with humanitarian organisations.
- Psychosocial advisor, Red Cross and Red Crescent Movement

This is often a forgotten or even denied important issue, which ranges from staff safety and security, to mental and physical health and overall well-being. From whatever angle we look at it, health should be taken very seriously. I think it’s a professional responsibility to do so. You cannot help/assist/serve anyone if you are not healthy yourself first. But I think there are a lot of biases around this in the humanitarian sector and fears of being perceived with a wrong attitude. This is the first gap I would like to raise and be discussed, there is an ideological gap that needs to be paid attention to, first. Health and being well – it’s a pre-condition to be useful and serve well. I’ve seen that in my experience so far, so many times I’ve lost track. In principle, as humanitarians we are also human beings, just like anybody else or like the other human beings we are trying to assist/protect. Denying this fact makes us feel or have the dangerous perception that we are some sort of super-humans or humanitarian heroes. We are not. We can work hard and harder, we can even put service first, but at some point we also need to take care of our health if we want to continue serving. As simple as this may sound, I think there is still this underlying perception particularly in field work that you have to put yourself last if you are a "good humanitarian worker". Which is not true, particularly in the long run, for many of us who are here to stay and not for a six months or one year experience. Otherwise in the long run it could be quite dangerous for us, for our teams, for the results we are trying to achieve with our work and even for the very people we are trying to protect. I am also one who often pushes herself too much, but have also learnt important and hard lessons at my own mistakes along the way. In the last six years working in war-zones doing humanitarian field work, I had the fortune to have some colleagues, friends and senior managers who kept an eye on me and I have done the same for them. This is not only because as individual and staff we also have a right to health -which is the same right we try to raise for the people we defend- but there is a strong link between staff health/wellbeing (both physical and mental) and the QUALITY of the services we deliver, the way we relate to those whom we are supposed to serve and on how much the work we do is effective, particularly on the medium-longer term. There are very serious organizations studying these issues, like the Headington Institute, several UN agencies and NGOs now have staff counsellors and other support systems. I know, it’s not perfect and we’ve a long way to go, but it’s a start compared to 10/15 years ago.
- UN Agency (South Sudan)

There are still some "cowboys" out there that don't see the value in staff wellness. We need to ensure that all support it and that it can be funded appropriately.
- Senior Recruiter, International NGO (United States)

Huge gaps in national staff care which need to be addressed.
- Regional Director, Health organization (Kenya)

It would seem that the majority of agencies that provide counseling either depend on contracted services or have a counselor sitting in headquarters who is only deployed following a critical incident.
- Regional Staff Counsellor, UN Agency (Sudan)

A more cohesive approach and good oversight of staff wellness within agencies and across the sector. An approach overseeing this as a priority and a significant factor in team and individual effectiveness would work somewhat towards acknowledging behaviours attributable to stress and to accessing resources and or therapies for building resilience and mitigating stress. In some emergency contexts is should be possible for agencies to come together to provide resources for staff wellness.
- Health Advisor, International NGO (Ireland)

Many managers focus on the tasks and fail to recognize talents, bringing about lack of recognition of individual capacities and achievements.
- Officer, Humanitarian network (Switzerland)

I think it should be standardised, not just in terms of guidelines, but a toolkit for how organisations can actually implement staff welfare policies. You hear all too much 'there's no budget' which may be true, but without an attitude change and advocacy for better MHPSS for staff, then donors will of course never support increased budget. But if you don't ask... In every orientation there should be stress management / self-care documentation / standardised guidance to online tools & resources (of which there are many) given to new employees, and through HR there should be regular updates either stress management training / or self-care tools so people can identify when they're struggling or burning out and then actually ask for help. There seems to be too much of an attitude that it's the individual's role entirely to care for themselves, but without guidance or support to do so, especially in these contexts, it's near impossible
- Coordinator, International NGO (South Sudan)

There's a lot of stigma around the issue of self-care and too often burnout is considered a badge of honor.
- Project Coordinator, foundation (United States)

In my experience, a lot is being done to promote staff safety and wellness in the area of physical welness but there are still gaps in the ares of mental wellness. For staff working in field offices, especially local staff, they are not getting time for rest and recuperation. Psycosocial counselling services are also not available to many.
- Country Director, International NGO (Tanzania)

- Short or fixed term contracts leave humanitarian workers vulnerable - organisational responsibility will end at the end of the contract. - Burn-out in humanitarian work is often seen as acceptable/part of the career. - Leadership should be taken at the highest levels in organisations - behaviour modelling around work - life balance, understanding and flexibility around personal issues needing time off work, enforcement of time off, counselling services with a real person who has an understanding of humanitarian work, 'supervision sessions' for those in front line positions and those managing those in front-line positions. Regular rotation of positions. Focus on personal development as a therapeutic outlet- ie. support to personal development that supports learning and sense making but also gives time out of a very hectic context.
- Project manager, International NGO (United Kingdom)

Often local staff do not get the same access to initiatives that support staff wellness in fragile states or conflict situations. These staff may be being multiply impacted by the situation that is affecting their country, their community, their family. The pressures when your country/community is in crisis are huge when the wider family look to you for support.
- Program manager, International NGO (United Kingdom)

The aid sector culture needs to change: machismo and stigma against people asking for help (which is considered as a sign of weakness) are affecting staff wellness. What I think is really needed is an environment that really takes care of the staff in a preventative way (not merely a recovery approach). This takes time but can be achieved introducing small changes. 1. Every organisation should adhere to the guidelines that are already there (Antares for example); 2. More research is needed to evaluate the effectiveness of the psychosocial support currently provided... what is done and what is needed? 3. The guidelines and best practices should always be tailored to address the diversity of staff (women, men, international, national).
- Researcher (United Kingdom)

For me, the gap is in making emergency a profession where experts are deployed from one emergency to another without recognizing the long-term effects on the psychological impact on the staff and their family members.
- Chairperson of staff association, UN Agency (United States)

Dealing with trauma and getting emotionally close to victims/ survivors to whom something worse happens. General support networks are very weak especially amongst local NGOs.
- Head of MENA region, International NGO (United Kingdom)

Many! We don't respect work-life balance at all It is hard to get a posting with a partner, which would allow a more normal family life, even if both are working in the sector. When I recently returned from a deployment my supervisor questioned me wanting to take a few days of leave to recover a bit. We send people to difficult situations and are really bad at ensuring there are means of relaxation (sports, books ebing sent, internet connection to speak to family and friends).
- Humanitarian Affairs Officer, UN Agency (United States)

Inconsistent reaction to burn out. Little support for families who bear the brunt of the person's mood changes. Too much choice for staff members as to whether they accept debriefing.
- Humanitarian Affairs Officer, UN Agency (Switzerland)

The focus of staff wellness needs to be normalised and part of the 'culture' of the work and humanitarian organisations - this appears to be a gap here. (My limited experience) is that few humanitarians are willing to proactively prioritise their well-being. We cannot eliminate stress or traumatic events but we can mitigate against it and put effective systems in place to react efficiently & offer support when needed.
- L&D staff, International NGO (Ireland)

It is not prioritized. Humanitarian agencies should be required to demonstrate efforts taken to support staff well-being when in, or returning from the field.
- Senior Programme Officer, International NGO (United States)

During early stage of emergency humanitarian responses, human resources are usually scarce that people work around the clock to deliver reliefs. At such time, greater attention to staff wellness should be given by leaders and management at organisations' headquarters or at closest command centers. Protocols favoring staff wellness need to be followed and enforced.
- Consultant (Indonesia)

Gaps include: - Staff wellness not being systematically and appropriately supported (ie at all stages of the assignment cycle and by all relevant stakeholders such as aid workers themselves, managers, organisations). - Staff support needs to be more inclusive of national staff, currently there is inequity here. Improvements would include more standardised organisational prioritisation of psychosocial support issues and wider access to supporting resources. This would be supported by increased donor accountability requirements of staff care, enabling greater systematisation and resourcing of support.
- Director, Foundation (Australia)

Not enough comprehensive and high quality training/supervision prior, during and post deployment.
- Consultant Psychologist, Foundation (Australia)

Seeking help seen as sign of weakness and failure.
- Health delegate, Red Cross and Red Crescent Movement (Myanmar)

For local organizations that lack staff and funding, there is overwhelming pressure to do more than what can be managed, individually and collectively. The awareness raising on the equal importance of psycho-social-spiritual spheres is important to advocate and support in concrete terms. Also, the clashing worldviews between north and south NGOs in terms of cultural understanding of local contexts which is key in the formulation of psychological health assistance.
- Humanitarian Trainer (Philippines)

I dont think top management is provided with tools, other than common sense or personal technics, to address staff wellness. But I guess it also depends on organizations.
- Head of mission, International NGO (OPT)

Lack of space in the sector to comfortably acknowledge these as issues. Culture of shame attached to experiencing mental health issues, or even to acknowledge high levels of stress as damaging for individuals and organisations. Pervasive lack of prioritisation of staff welfare (national and international) and lack of institutional support for this.
- Coordinator, International NGO (Ukraine)

Gaps and issues: With so many emergencies happening now, staff is going from one emergency to the other, often organisations don't have job security in these posts and are often short term, for which many rely on that income and job so they go from one to the other, often because of short term contracts, there is no medical support or other between contracts, for example someone coming with PTSD after contract ended. Other agencies will issue SSAs (consultancy contracts) for short deployments, to save money and admin, which means sending staff with no insurance or right for leave or R&R to conflict or severely affected disaster areas. Huge gap on contract modalities, which often organisations abuse on the expense of staff wellness. For worst ""emergency staff"" is expected to not complain because we have chosen this field of work for which we should be expected to have instability and no personal life or job security. This constant back to back deployments often doesn't allowed for staff to see when is needed to stop or when is no longer healthy or if there are signs of PTSD, Some of them fall onto this super hero mentality that if you leave, the world won't be saved and that is a very dangerous position to be in because it doesn't allowed for staff to take self care. Another gap is that many organizations working in emergencies do not have the specialized human resource teams for emergencies, who know, or are expected to know how to deal with staffing in emergencies, which is very different to managing staff in other contexts. This often results in poor management of decisions, bad admin procedures, etc. And while a staff can be in the middle of a conflict or earthquake response, the least you need is to be dealing with HR and fighting for your rights or small things that just create an extra stress and burden which eventually also will reflect on performance. What can be done? Improve contract modalities to provide more care and stability for emergency staff so you invest in the staff for continuing responding to emergencies yet not burning him/her out to be of no good use after. This is something which also needs to be in the awareness of donors, because the funding drives a lot of these short contracts and lack of commitment on the staff from the organisations. Create better feedback mechanisms which staff in the field can use and ensure confidentiality for staff to report cases of psychological or sexual harassment or situations which are putting the staff under stress or at risk. Improve accountability mechanisms for reporting and investigating sexual harassment in the work place particularly for national staff who often speak less or none about it due to repercussions on their jobs.
- Regional advisor, UN Agency (Thailand)

If possible, some sort of uniform standards could be elaborated as to the physical and psychological preparation of humanitarian staff - in connection with the type of mission.
- University Professor (Portugal)

Some agencies do not address the possible psychological effect on staff when deployed to field operations.
- Independent Consultant

Macho culture of not willing to admit to being affected by certain situations.
- Deployment Officer, International NGO (United Kingdom)

One gap would be field staff that have been in the field 3+ years. Giving them longer breaks or a personal debrief or such. Country Directors, Deputy Country Directors and upper management needing training and/or debriefing/counsel. Most would not be open to it.
- Senior manager, International NGO (United States)

Many organizations don't have policies in place.
- Medical officer, Governmental agency (United States)

The spiritual dimension of health and well-being receives little attention
- Psychologist (Switzerland)

Preparation for the reality of the situation to be encountered including the facing the disaster victims
- Medical Advisor, Red Cross and Red Crescent Movement

It is not prioritized enough among certain NGOs as it is not seen to impact the effectiveness of the operations. The NGOs are often too focused on delivering services to beneficiaries and do not enough pay attention (and therefore invest resources) into proper management systems and accountability of managers.
- Country Director, International NGO (Iran)

The entire culture needs to change! Debriefings and monitoring staff health before, during and after missions should not be a box ticking exercise but a priority for managers. Staff themselves need support in understanding what they can do for themselves - self-care that goes beyond simply talking to friends and family or 'taking a break'.
- PhD Candidate (United Kingdom)