IASC Guidelines, psychological first aid and case management

Explanation : The base concerns the whole population (basic services and security, provided in a dignified way), then community and family supports, then focused, non-specialised supports for a smaller group, and at the top specialised services for a small proportion of people.

Explanation : The third layer covers individual, family or group interventions delivered by trained and supervised non-specialists. Specialised services are provided by mental health professionals.

Explanation : PFA is based on Look, Listen and Link. It is neither a diagnosis nor a treatment, and does not require the person to recount the event.

Explanation : Available evidence shows no benefit from single-session psychological debriefing, which may even be harmful; WHO does not recommend it. PFA supports people without forcing them to relive the event.

Explanation : 84 / 3 = 28 cases per case manager. Requirement: 84 / 20 = 4.2, rounded up to the next whole number, i.e. 5 case managers. With 4 case managers, each would have 21 cases, above the standard.

Explanation : 2 + 2 + 1 + 3 + 2 + 1 + 2 + 1 + 0 = 14, in the 10-14 band (moderate). The PHQ-9 is a screening tool: it points towards a clinical assessment and does not make a diagnosis.

Explanation : Any positive answer to this item requires an immediate risk assessment. Talking directly about suicide does not increase the risk. Confidentiality may be breached in the event of imminent danger, according to the protocol, but not systematically.

Explanation : The mhGAP-HIG provides first-line clinical management protocols for priority conditions. PFA is not a clinical tool and the DSM-5 is a diagnostic classification.

Explanation : The six principles are: human rights and equity; participation; do no harm; building on available resources and capacities; integrated support systems; and multi-layered supports. On the contrary, the guidelines favour non-medicalised responses for the majority.

Explanation : Most early reactions are normal responses to an abnormal event and ease as safety and support are restored. Pathologising should be avoided, while identifying people whose difficulties persist or worsen.

Explanation : 64,000 × 0.05 = 3,200 people. This figure is used to size specialised services (consultations, medication, referral); 320 would correspond to 0.5%.

Explanation : 180 / 12 = 15 groups; 15 × 2 = 30 co-facilitation slots. The same facilitator can run several groups, depending on their workload and the supervision available.

Explanation : Vicarious trauma results from repeated exposure to other people's traumatic accounts. Regular supervision, limiting caseloads and staff care measures are the main ways of preventing it.

Explanation : PM+ combines stress management, problem solving, behavioural activation and strengthening social support. It is designed to be delivered by non-specialists, under supervision.

Explanation : The limits of confidentiality (risk to life, legal obligation, certain child protection cases) must be explained from the first interview. Reports to donors use anonymised data.

Explanation : The term covers both psychosocial support and mental health care, delivered by actors with different profiles. It reflects the integrated, multi-sectoral approach of the guidelines.

Explanation : Completion: 78 / 120 = 65%; dropout: 42 / 120 = 35%. 54% comes from dividing by the wrong denominator (42 / 78).

Explanation : Available time: 40 × 0.5 = 20 hours; supervision: 14 × 1 = 14 hours; 14 / 20 = 70%. It is feasible, but little time remains for other tasks (training, complex cases, reporting).

Explanation : The survivor-centred approach is based on safety, confidentiality, respect and non-discrimination; for a minor, the best interests of the child are added. She is referred to GBV and child protection services, without investigating or organising mediation.

Explanation : The MHPSS 4Ws tool classifies activities according to common categories and makes it possible to identify gaps and duplications in the response. The food consumption score belongs to food security.