Report on – 33rd IC Resolution 2: Addressing mental health and psychosocial needs of people affected by armed conflicts, natural disasters and other emergencies (33IC/19/R2) – Danish Red Cross

Has your State/National Society/Institution incorporated the commitments contained in this resolution into the relevant strategic or operational plans?

The commitments are incorporated into:
Strategy
Policy
Operational plan
Legislation (e.g. Law, Regulation, Statutes, Rules of Procedure etc.)

At the International, Regional, National, Local level

Explanation:

The commitments are incorporated into the strategies guiding the work in both the international and the national department. Both departments have MHPSS advisors embedded at HQ level and advisors sitting at local level overseeing quality of the implemented activities. At international level DRC support around 20 partners to deliver MHPSS services and to institutionalise MHPSS (NSD).DRC has also supported several of its partners and the IFRC RO Africa to develop operational frameworks based on the Resolution.

The IFRC PS Centre, which Danish Red Cross has hosted since 1993, celebrates it’s 30th anniversary in June 2024. The hosting of the IFRC PS Centre and DRCs commitment to MHPSS granted DRC an instrumental role of the formulation and adaptation of the Resolution 2 in 2019 and in the development of the Roadmap supporting the roll out of the Resolution 2. DRC confirmed its commitments through participation in the governance of the MHPSS roadmap and involvement in several Working Groups established to implement the Roadmap Priority Action Areas. Through the Roadmap and the working groups the attention to MHPSS has increased.

In February 2024, the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Committee of the Red Cross (ICRC), and the Danish Red Cross (DRC) signed a Partnership Agreement outlining the framework for the establishment, functions, and management of the RCRC Movement Hub for Mental Health and Psychosocial Support (MHPSS). The current IFRC Reference Centre for Psychosocial Support will transition into the RCRC Movement MHPSS Hub, which is expected to be operational by January 1, 2025. DRC is instrumental in the transformation process and will continue to host the new International MHPSS Movement Hub – and thereby once again reaffirming DRCs commitment to the global MHPSS agenda.

MHPSS in the DRC National department was scaled up during Covid-19 and because of the Ukraine refugee response. A dedicated MHPSS advisor position was established at the National Department recognizing the needs for consolidating and harmonizing the response at national level.
In 2021 a national strategi against loneliness was developed together with civil society partners and ministries highlighting the need for MHPSS. The need for MHPSS is also reflected in the Danish Red Cross National strategy (2024) with a focus on:
– Volunteer based (psychosocial support) activities in welfare institutions and care facilities
– Running care facilities for especially vulnerable groups
– Having (psychosocial support) activities for vulnerable groups in all branches
– Increasing MHPSS in emergencies activities at a national level
There has been an increased focus on MHPSS capacity building including psychological first aid. National department has 25 staff trained as PFA trainers and 15 volunteers trained as dedicated CB-MHPSS trainers.
Approximately 15.000 volunteers are supporting community based MHPSS activities at local level as well approximately 100 staff at HQ level.
22 staff have been trained as psychosocial support team leaders in emergencies.

Has your State/National Society/Institution been working with other partners to implement the commitments contained in this resolution?

Partner with:
National Red Cross or Red Crescent Society in your country
Government and/or public authorities
ICRC/IFRC
Other National Red Cross or Red Crescent Societies
Humanitarian and development partners (e.g. UN, NGOs etc.)
Academia

Examples of cooperation:

International Level
From 2020 – 2023, DRC has supported its partners to deliver MHPSS to more than 2 million people through its bilateral and multilateral support. In addition, DRC has increased its MHPSS human resources. Around 50.000 volunteers and staff have been trained to deliver MHPSS, and across HQ and country level DRC has 15 staff dedicated to work on MHPSS.

During Covid, DRC seconded 4 MHPSS specialists to the global Covid-19 response and 2 MHPSS specialists/coordinators to the IFRC secretariat in Geneva. In addition, DRC seconded a MHPSS coordinator and a MHPSS advisor to IFRC RO in Budapest to support the Ukraine Response. MHPSS specialists have also been deployed at country level to provide guidance and advise during larger emergencies such as Cyclon Freddy in Malawi and the earthquake in Syria, as well as during conflicts in Ukriane, oPt/Gaza, Myanmar, Sudan and Ethiopia responding to the MHPSS needs in close collaboration with RCRC partners and external MHPSS actors (like Dignity and Save the Children).
Throughout 2023-2024 Danish RC has supported 8 partner NSs to develop MHPSS operational frameworks and plans resulting in Bangaldesh, Nepal, Ethiopia, Kenya, Mali, Niger, and Somalia (Somaliland and Puntland) having their own operational plans and frameworks for MHPSS. In addition, Danish RC co-chaired with IFRC and South Africa RC the first regional MHPSS meeting for the African Communities of Practices in 2024. AT this workshop a regional MHPSS framework was developed operationalizing the commitments from the Resolution 2. In Mali, Danish Red Cross has supported its partner, MRCS, to engage with its Ministry of Health on the development of a “National Mental Health and Psyshcosocial Support Policy and Strategic Plan”.

Since 2019, Danish Red Cross and Save the Children Denmark has co-chaired the CSO network for MHPSS actors in Denmark. Together with Dignity the co-chairs succeeed in their advocacy with the MFA to get MHPSS included in the Danish MFA development strategy 2022-2025.

In 2022 DRC, Save the Children Denmark and the Danish MFA co-hosted the first ever Nordic Conference on MHPSS in fragile and humanitarian settings. The conference was organized together with the Danish CSO MHPSS network. More than 60 actors across governments, civil society, UN agencies, academia, private foundations, institutional and government donors and youth organisations particiapted in the conference. The actors shared and exchanged ideas, formed partnerships and inspired new ways of working to achieve their common goals and leveraging their shared values as a region. The conference led to the development of the Copenhagen Declaration and establishment of a Nordic MHPSS network showing the commitment amongst Nordic Actors to address MHPSS needs in armed conflicts and other situations of violence, natural disaster and other emergencies which recognise that people of all ages and gender identities living in fragile and humanitarian settings are directly exposed to violence, including sexual and gender-based violence (SGBV), loss and other distressing circumstances and suffer indirect effects, such as the disruption of access to services, protection and support systems that individuals, families, communities and societies depend on, which are further exacerbated by structural inequality, poverty, oppression and discrimination. https://www.rodekors.dk/sites/rodekors.dk/files/2022-10/final%202022%20CPH%20Declaration%20on%20MHPSS.pdf

NATIONALLY
Danish Red Cross are supporting ministry of health in revising guidelines for MHPSS in emergencies for municipalities and advocating for a greater role for civil society and Danish Red Cross in emergency responses.
DRC are a member of the ABC network (Act, Belong, Commit) focusing on mental health initiatives across municipalities and civil society.
Over the past years, Red Cross in Denmark volunteers have provided care and reassurance to patients and their families in hospitals across the country. These supporters offer both guidance and psychosocial support in wards and outpatient clinics. Additionally, beyond our traditional patient support, the Red Cross has deployed patient supporters in three psychiatric departments in Region South, with plans to expand this in the coming years. In the past years, approximately 900 volunteer patient supporters every year provided assistance and support more than 750,000 times, a significant increase over the past years. The Red Cross is present with patient supporters in 27 of the country’s 67 hospitals, representing 40% of the hospitals in Denmark.
The Red Cross in Denmark and the Senior Citizens Association work closely together to make the wake service nationwide, ensuring no one dies alone if they do not wish to. In the oast years, more than 1,700 dying individuals received help and support from the Red Cross in Denmark wake service. The Red Cross in Denmark is active in more than 60 of the country’s 98 municipalities and engaged 1,500 volunteers. These volunteers typically keep wake in nursing homes, as well as in private homes and hospitals.
The Red Cross in Denmark also collaborates with hospitals for early intervention for vulnerable pregnant women and new families. For instance, we have a forward-deployed initiative at North Zealand Hospital and Amager-Hvidovre Hospital, where we work closely with midwives for the screening and referral of families to our initiative ‘A Good Start’. Presence at hospitals ensures continuity in cooperation and builds bridges between the healthcare system and the Red Cross. This collaboration signifies a new development in recognizing the importance and significant role of civil society in ensuring early preventive efforts for vulnerable families outside the hospitals themselves. Several hospitals, including Slagelse and Roskilde Hospital, have shown interest in adopting similar services.
The Red Cross in Denmark collaborates with language schools across the country. In 25 out of 41 branches with language training, there is local cooperation with the language school, where volunteer language trainers help students with Danish on a weekly basis. This takes place either as a supplement to the teaching or in a voluntary language café on the premises after classes. Many branches use the cooperation with language schools to refer new participants to the local language training programs. In addition to physical language training, the Red Cross in Denmark also offers digital training through digital learning platform, which significantly took off in 2022/2023, with the platform being used by users in 95 municipalities, conducting over 20,000 language conversations in the past three years, now averaging over 1,000 conversations per month.
The Red Cross in Denmark is also involved in Family Houses, a new focus in municipal family work, collaborating in some areas to systematically integrate Red Cross family activities as part of municipal services for families.
The Red Cross’ prison and release program encompasses a wide range of initiatives, from traditional prison visit services, communal activities, first aid courses, daily life skills training, aftercare support during the transition upon release, and special support for young detainees. Both aftercare initiatives and support for young people have expanded to more locations over the past years, driven by high demand from the Prison and Probation Service. In total, more than 1,000 participants every year receives support through the Prison and Release Program.
Health clinics are the Red Cross in Denmark’s offer to undocumented migrants who do not have the same access to the Danish healthcare system as the rest of the population. The clinics treats approximately 2,700 patients every year. The clinic in Copenhagen have seen an increase in patient visits from EU citizens, a slightly different target group. Red Cross in Denmark continuously adapt the clinic offerings to best meet the needs of the patient groups. In 2023 the Red Cross in Denmark opened its 4th health clinic in Aalborg.
Over the past years, 3 Red Cross care centers for sick homeless people have been operating, funded through public funds: Eirsgaard Care Center in Copenhagen, funded by Region Hovedstaden; Pitstop Care Center in Aarhus, funded by Aarhus Municipality; and Svalegangen Care Center in Middelfart, funded by Region Syddanmark. Work is underway to establish an additional three care centers.
Together with another national organization, Kirkens Korshær, the Red Cross in Denmark has submitted a bid to operate a nursing home for socially vulnerable individuals in Aarhus Municipality and are in the process of planning. The nursing home expects to become operational in 2025.
The Red Cross in Demark is widely present with family interventions across the country: volunteer family friends are in 67 municipalities, Job and Education mentors in 41 municipalities, and Family Networks in 55 municipalities. In the past years, we focused on expanding all activities across the five regions, working towards full national coverage. Approximately 3,500 participants (children and parents) received support through family interventions every year, provided by nearly 2,000 volunteers.
‘A Good Start in Life’ has been implemented in 14 branches, covering approximately 27 municipalities.. Midwives are central partners in referring vulnerable pregnant women and new families. Therefore, the initiative is organized around the geographical birth intake areas of hospitals, and we collaborate across Red Cross branches, so one branch has activity leaders and volunteers and families in other branches’ areas/municipalities.
Through our efforts for women and children affected by sexual and genderbased violence, we supported 1,000 participants every year in the past years. The support network, where Red cross in Denmark provides aftercare following a stay in a crisis center, operates in 31 municipalities, with a focus on continued expansion and methodological development in the volunteer effort. The initiative ‘From House to Home’ experiences high demand from women seeking support to establish their new homes after leaving a crisis center; currently, this initiative is in 10 municipalities.
The Red Cross’ integration efforts have never had as many participants as now; in 2023, we reached over 12,000 refugees with our activities, which takes place almost nationwide. Red Cross branches’ integration initiatives are present in 73 municipalities, including “Friends Showing the Way”, social cafés, and language and counseling services. Red Cross in Denmark continues to see many Ukrainian refugees in our activities, with their needs now being more long-term, showing a strong interest in learning Danish and obtaining permanent employment, unlike seasonal work and temporary jobs. The temporary nature of residence permits given to Ukrainians and other refugees in the country greatly affects their well-being, a focus in both advocacy and volunteer training.
Preventing and alleviating loneliness among adults is a major and important activity area for the Red Cross in Denmark. Here, Red Cross in Denamark help in 1:1 activities and social communities, offering services such as the visiting service, support for relatives, knitters, and other social groups. The total number of participants increased by more than 10% from 2022, encompassing over 13,000 participants in 2023. The largest increase is seen in the diverse local social communities, which are thriving again after a challenging time with the pandemic.
In the support activity for people with mental illness, is now offered in 15 municipalities, with 28 Red Cross branches involved. Psychosocial support for people with mental illness have been established in 21 branches. The ambition remains to continue expanding, and after struggling with the stigmatized topic of mental illness, we now experience high demand from both municipal partners and participants, successfully recruiting volunteers.
Over the past years, the Red Cross in Denmark has focused on ensuring both local and national authorities are aware of the Red Cross’ competencies as a psychosocial emergency responder in acute crisis. The Red Cross in Denmark has participated in debates, network meetings, and exercises. We advocate for politicians to support strengthening of the role of civil society in emergency responses, integrate civil society’s psychosocial emergency response into the national emergency plan, establish a social emergency response for the most vulnerable groups, and create a national information bureau.
Operationally, the focus has been on strengthening and developing our capacity, ensuring we have the relevant and sufficient resources to respond to local and national incidents. Locally, in collaboration between branches, local authorities, and the national office, we tested three pilots on how a local emergency response collaboration could unfold. Learnings from these pilots have been partially implemented in materials for the organization, including two videos developed for authorities and volunteers. Additionally, this year, we participated again in a major emergency event in close collaboration with the authorities. In the fall, we assisted the authorities in evacuating Danes from Gaza. Red Cross psychosocial team leaders received evacuees in close cooperation with the embassy in Cairo, providing crisis support and social assistance, and accompanying them back to Denmark. In several cases, we also connected with the local municipality and local Red Cross efforts.
In our Corona response support for and cooperation with authorities have been a significant part of our efforts. We established a Corona hotline at the National Office, which was part of the joint authority hotline, providing vital information and assistance. Our health professionals, including first aiders, also supported this hotline, ensuring comprehensive health advice was available.
We offered psychosocial support and training for employees working on the Corona hotline, ensuring they were well-prepared to handle challenging situations. Additionally, through Victim Counseling, we provided specialized psychosocial support for particularly difficult calls, a service that remains active. In the Capital Region, we implemented security-enhancing measures at test centers to ensure a safe environment. Nationwide, we introduced an accompaniment service for vulnerable and at-risk citizens, assisting them to and from vaccination sites and providing a sense of security. At the vaccination sites, in collaboration with municipalities and regions, we further ensured the safety of these vulnerable groups. In Høje Taastrup, we conducted a door-to-door campaign to support the vaccination effort, providing information and reassurance to residents. At Region Zealand’s vaccination center in Næstved, our first aiders served as observation guards, monitoring all citizens after their vaccinations. We also vaccinated and tested migrants through our own health clinics, in agreement with health authorities, a service that continues to be active.
Through TalkTogether, a digital visit service, we combated loneliness, while the digital activity for language lessons provided Danish language training.
During the Easter of 2020, Danish RC delivered special packages to inmates and women’s crisis centers, showing humanity during the isolation period. We supported vulnerable families through the Family Friends at a Distance initiative. Additionally, we transitioned our activities from physical to digital meetings, ensuring continuity of service. We held public meetings to fight loneliness, organizing 14 meetings in 11 cities, culminating in a joint conference to share experiences and strategies.
There has also been a general focus on capacity building in psychological first aid and basic the psychosocial support to volunteers in all Red Cross activities. For the first aid response teams, psychological first aid training has been made mandatory to ensure that Red Cross first aid response teams can provide psychological support in addition to physical first aid. The focus has also been on ensuring a nationwide presence, so the Red Cross can continue to offer first aid response across the country.
Since 2019, the Red Cross has published several teaching materials for Danish schools and high schools / colleges with a focus on mental health & psychosocial wellbeing, including:
https://www.rodekors.dk/skole/livsmestring (mental health / target groups: schools / high schools (“ungdomsuddannelser”)
https://www.rodekors.dk/skole/os-fra-6b-0 (Loneliness / target groups: schools (grundskole)
https://www.rodekors.dk/skole/corona (mental health post corona / target groups: schools (grundskole)
https://www.rodekors.dk/skole/ensomhed-og-faellesskab (Loneliness / Loneliness ungdomsuddannelser/samfundsfag)
https://www.rodekors.dk/skole/bag-skyerne (Grief /mental health / target groups: schools (grundskole)

Have you encountered any challenges in implementing the commitments contained in this resolution?

With challenges on:
Human resources
Funding constraints
Competing priorities
Lack of capacity and/or support (technical, financial, or other)

Details about challenges:

The main challenges with implementing/ensuring the commitment on MHPSS remain funding and human resources allowing for sustainable and long-term interventions.

Funding for MHPSS continues to be project specific and short-sighted, challenging the consistency and quality of the implemented activities.
In addition, Danish RC face challenges with recruiting and sustaining volunteers with relevant competences to deliver MHPSS services across the above-mentioned spectrum of activities.
Danish RC notice an increasing interest in short term volunteering on an ad hoc basis, which challenges the need for more consistent and long-term interventions.

As a result of complicated digital systems and admin structures, Danish RC is facing a high turn-over of branch volunteers team leaders. In order to continue delivering quality MHPSS services there is a need for ensuring more admin and technical support to the respective branch volunteer team leaders to protect them from burn out.

Have the commitments contained in this resolution had an impact on the work and direction of your State/National Society/Institution?

Type of Impact:
Cooperation between Government/public authorities and National Society has been strengthened
Programming and operations have become more effective and efficient
Innovative tools/methodologies have been developed and are utilized
Partnerships with other humanitarian actors have been created or enhanced
Increase in mobilization of resources
Training and capacity of staff and volunteers has increased (for National Societies)

Details about the impact:

For Danish RC MHPSS has been given high priority for more than 30 years, the same number of years as the Danish RC has hosted the PS Centre. The Danish RC has hosted the IFRC PS Centre since 1993 reaffirming DRCs commitment to MHPSS. The PS Centre will celebrate is 30-year anniversary in June 2024. The hosting of the PS Centre and DRCs commitment to MHPSS also granted DRC an instrumental role of the formulation and adaptation of the Resolution 2 in 2019 and in the development of the Roadmap supporting the roll out of the Resolution 2. DRC confirmed its commitments through participation in the governance of the MHPSS roadmap and involvement in several Working Groups established to implement the Roadmap Priority Action Areas. The implementation of the Roadmap is coming to an end at the IC34.

In February 2024, the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Committee of the Red Cross (ICRC), and the Danish Red Cross (DRC) signed a Partnership Agreement outlining the framework for the establishment, functions, and management of the RCRC Movement Hub for Mental Health and Psychosocial Support (MHPSS). The current IFRC Reference Centre for Psychosocial Support will transition into the RCRC Movement MHPSS Hub, which is expected to be operational by January 1, 2025. DRC is supporting the transformation process and will continue to host the new International MHPSS Movement Hub – and thereby once again reaffirming DRCs commitment to the global MHPSS agenda.

DRC continue its focus on building buy-in from partners on the importance of MHPSS as an integrated part of all interventions, build consensus of the approaches used in the RCRC Movement and strengthen partner capacities to deliver quality MHPSS interventions.
The Movement MHPSS resolution/policy has been used to guide and support partner NSs to develop MHPSS operational frameworks and plans. In addition, Danish RC has supported regional MHPSS network meetings with the aim to develop regional MHPSS frameworks.

Over the past 5 years, the approach has been further systematized and harmonized across national and international department with dedicated technical roles from coordinator role to advisors and specialist across interventions/programmes. In addition, increased focus has been given to ensure MHPSS in emergencies both nationally and internationally.

The strategic focus on MHPSS in Danish RC has led to increased recognition and several consultations on MHPSS interventions with relevant MHPSS partners at national and internal level. In addition, Danish RC is being called upon as experts to discuss MHPSS in the public media.

Since 2019, Danish Red Cross has co-chaired with Save the Children Demark the CSO network for MHPSS actors in Denmark including Dignity. Together these partners succeeed in ensuring MHPSS was mentioned in the Danish MFA development strategy 2022-2025.

Have the commitments contained in this resolution had an impact on the communities that your State/National Society/Institution serves?

Description of the impact:

Overall, the identified changes fall into three categories: (a) Changes in behaviour, actions and practices of individual service users or service providers i.e., medical staff, social workers etc.; (b) Changes to informal or formal networks; and (c) Change in practices of authorities and/or changes to legislation.

Based on desk reviews and case studies, the vast majority of Danish RC contribution to mental health and psychosocial wellbeing at international level are of structural character, e.g. changes to law, policies, practices and community norms. DRC is contributing to change at governance level, with impressive results, such as the legislative change that ensures remuneration of community health promoters in Kenya.

At national level, changes are linked to increased well-being of participants in the MHPSS activities for the following specific target groups; vulnerable families, ex-detainees and refugees and migrants.

A study conducted by Danish RC international department in early 2024 finds that change depends on the specific context and situation. However, the study does identify a number of factors that enable or hinder change, which seems to transcend context and situation. These factors are: (a) volunteer network; (b) linking community members in groups of “similar”; (c) community engagement through strongly positioned NS; (d) coordination and collaboration with authorities; (e) integrated approach beyond health and MHPSS; (f) targeted approach to reach all community members. The study finds that the many of the identified changes are considered sustainable with possibility of replication without DRC’s or its partners’ involvement. These types of sustainable changes are linked to enhanced knowledge, skills and abilities among community members, health care staff and volunteers as well as community-led networks and formal structures. Examples exist of these changes being replicated by community members and health care staff without support from DRC and its partners. These changes can and do continue to benefit communities beyond the end of the DRC-supported intervention. The study also found examples of continued support to ensure sustainable of the identified change as well as replication and scaling by authorities after a successful handover. This was achieved through continuous engagement, coordination and collaboration with authorities, often by using the impressive results of the project as a way to gain their interest and support.