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In 2017, nearly 140 aid and humanitarian workers were killed while helping those in need. This figure is up 30% from 2016, reflecting the heightened intensity and severity of violent conflicts during the past year. It also represents a steep rise in aid worker deaths among national staff, who often lead the riskiest operations in the most insecure areas.

From large-scale emergencies in the Democratic Republic of Congo to massive refugee crises in Myanmar, aid workers are responding to situations where they’re routinely exposed to traumatic situations.

On World Humanitarian Day on 19 August, the humanitarian community recognised those who have lost and continue to risk their lives providing life-saving support. Yet we are only just starting to acknowledge the mental health of aid workers as a pertinent and pressing issue.

Mental health matters

Work stress and limited time for self-care are major causes of depression, burnout and anxiety among aid workers. A prevailing culture of silence, feelings of guilt and perceived stigma result in many continuing their work without seeking treatment. Combined with poor understanding of the issue and limited funding, these are significant roadblocks to addressing mental health issues.

Too often, appropriate and culturally-sensitive support systems are lacking, especially for national staff. A recent study found that only 20% of aid workers felt they had been offered adequate mental health and psychosocial support. For the millions of people who volunteer in humanitarian emergencies, mental health issues are even more pressing.

A recent Humanitarian Practice Network publication revealed that volunteers responding to an earthquake in Indonesia suffered from mental health issues for months following the disaster. Volunteer drivers providing support in the West Africa Ebola response reported suffering more post-traumatic distress than burial teams. This relates to the perception that burial teams are safer thanks to their protective clothing and receive more recognition.

Breaking the silence

At an ODI public event that the Humanitarian Policy Group convened to mark World Humanitarian Day, experts sought to break the silence around mental health. During discussions, the word ‘burnout’ emerged repeatedly.

In Gaza and the West Bank, international staff are often mobilised from one deployment to another without a break. The ‘always-on’ environment leaves them feeling obliged to answer emails outside of working hours instead of resting. According to Michael Bociukiw, this has created a ‘mental health crisis in the aid industry’.

Jaz O’Hara, founder of the Worldwide Tribe, described how volunteers in the Calais ‘jungle’ camp were not prepared for the level and intimacy of exposure to refugees’ trauma. Over time, volunteers burnt out and began leaving the camp.

Volunteers are not just frontline workers. They’re also often members of affected communities who experience the same risks and challenges as the people they’re trying to help. Despite this, volunteers are expected to work long hours under strenuous conditions with unclear job descriptions. They also lack access to official support systems.

Promoting action for aid workers

Fortunately mental health support for aid workers has improved. What’s more, the aid industry is increasingly finding ways to ensure that their staff stay healthy. However progress has not been quick enough, or gone far enough. Contrary to popular belief, it’s easy to implement simple and cost-effective preventative actions to promote staff and volunteer wellbeing before, during and after assignments.

Introducing regular team meetings and ensuring clear supervision can help identify the signs and symptoms of stress early on. Providing training to aid workers and their managers can also help. For severe cases, a referral system should be offered, with staff trained in specialised care.

For Cecilie Dinesen, advisor at the International Federation of Red Cross and Red Crescent Societies’ Reference Centre for Psychosocial Support, managers – at all levels – must acknowledge the problem. Mental health needs management support. It also needs to be in budgets and induction programmes. Furthermore, mental health needs to feature in aid agencies’ duty of care to staff. An increasing volume of material is available to support managers in this, including a psychosocial support toolkit for volunteers.

The call to action is unequivocal, and aid agencies need to listen and take responsibility. Besides the toll that mental health issues take on staff, aid agencies suffer when burnout takes hold and turnover is high. It’s in their best interest to facilitate a shift away from the ‘machismo’ culture of aid work to awareness and acknowledgement of mental health issues.

It’s time for the humanitarian community to do more for its people, and contest the image that ‘all is well’. If aid workers don’t have others helping them, how can they help anyone else?

Merryn Lagaida is a Communications Officer (Digital Lead) at ODI.