The increasingly widespread nature of this

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affected other priorities, such as food, security and physical health. The increasingly widespread nature of this understanding is perhaps reflected in media reports of the current Syrian refugee crisis, which have focused heavily on the MHPSS needs of refugees and IDPs fleeing violence. 37 28 Ager (1993); Agger (2002). 29 Harrell-Bond (1988); Ratnavale (1981). 30 Mollica & Jalbert (1989); Mollica, Donelan, Tor, et. al. (1993); Mollica, McInnes, Poole & Tor (1998). 31 Agger (2002). 32 Agger & Mimica (1996). 33 IOM (2000). 34 Kostelny & Wessells (2005); Silove & Zwi (2005). 35 Wessells (2009). 36 Wessells & van Ommeren (2008). 37 For example, “Tortured, traumatised, scarred: the children caught up in Syria’s war,” The Guardian, September 24 2012, at ; “Rape is shredding Syria’s social fabric,” cnn.com , December 5 2012, at ; “Syria: Refugees’ trauma,” BBC Health Check, Dec 24 2012. 21 A Global Review
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Conceptual developments Alongside the increase in MHPSS activities within humanitarian response, theoretical and conceptual work in the field advanced understanding of the impact of conflict and displacement on individuals and communities. These efforts fed into principles that now form the basis of the IASC Guidelines, and have informed policy and practice in the field. An early discussion of the impact of the refugee experience on mental health is Ager’s 1993 paper discussion of stressors and ameliorative factors impacting refugees’ mental health across different phases of displacement: pre-flight, flight, reception and resettlement. 38 Ager’s analysis focused on the balance between recognition of the negative mental health impacts of stressors, and the strengths and resiliency of individuals and communities in the face of such stressors, recommending a focus on rebuilding and strengthening social networks. The Psychosocial Working Group [PWG], a collaboration between academic institutions and humanitarian agencies established in 2000, worked toward developing and improving consensus on goals and best practice in the field. For example, the PWG developed a conceptual framework, defining psychosocial well-being with respect to three domains – human capacity, social ecology, and culture and values, all of which can be influenced by the experience of conflict and displacement. Events and conditions wrought by conflict and displacement may challenge these domains, while available economic, environmental and physical resources can be marshalled to address these challenges. 39 This drive towards a common framework of understanding for the field of MHPSS has now culminated in the IASC Guidelines, described below. Core principles included in the PWG Conceptual Framework and working papers – including commitment to human rights in MHPSS work, participation, do no harm, and building on existing resources – were disseminated in various ways, including publications in journals such as The Lancet and Intervention , 40 and were included among the core principles in the IASC Guidelines.
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