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Stress and staff welfare: The psychological risks aid workers can't afford to ignore

Psychological well-being is a crucial yet under-discussed issue affecting a huge proportion of aid workers. But it’s also an important and under-recognised risk for organisations. Imogen Wall explains why ILS is launching new online courses on this vital topic.

Exactly two hours after Hurricane Tomas left Haitian waters in early November 2010, I collapsed in my office. It was a genuinely peculiar experience. One minute I was debriefing my boss in our UN shipping container, the next I was sprawled on the floor. I also felt sick. My first thought was actually that I had cholera – we were in the middle of a huge outbreak. But I didn’t.

To be fair to my organisation, (UNOCHA), they pulled me out for an immediate week’s R&R in New York. My line managers could not have been kinder. But months later, symptoms of what turned out to be severe burnout kicked in. I went from being a UN spokesperson to someone who couldn’t read a page of a novel and retain any idea of what had happened at the end. I picked arguments, and struggled to sleep.

It was a long road to recovery – along which I discovered that my experience was alarmingly common. In 2015, 79% of aid workers surveyed by the Guardian newspaper said they had experienced mental health issues – and 93% believed these to be directly related to their profession. Deeply committed to our work, pushed to the limits by the needs on the ground (and our organisations), often without loved ones, facing insecure employment and even more insecure environments, it’s not really surprising that our mental ill health levels are on a par with other first responders such as paramedics. It’s also deeply dangerous. Psychological ill-health is painful and distressing, and can be life-changing or even life ending for individuals. But it’s also a real risk for teams, and organisations.

Chronic stress, all too common in our sector, damages our minds as well as our bodies. It literally shuts down cognitive capacity, affecting our ability to assess risk and make decisions. This is how brains work, nothing to do with whether or not we are intrinsically good at our job.

The results can be hugely damaging for individuals and agencies – something ILS staff have seen over and over. Unwell staff members who go AWOL, have panic attacks, fail to follow protocol or pick fights with colleagues – there are so many stories. Such incidents divert resources and attention, often at critical times, putting additional pressure on already stretched teams, as well as being hugely distressing for the staff member concerned.

Then there are those whose productivity nosedives or who just leave their jobs (the Guardian research said 63% of those who’d experienced mental health issues believe them to have impacted their professional performance). Yet speaking up before things reach this point, and asking for support, is something few humanitarians feel confident to do. For too many, tell your organisation you’re struggling, and you risk being judged a ‘bad humanitarian’ – or even being let go. As one friend told a journalist, “When I finally submitted my resignation, citing fear of severe burnout, I was simply told I was “clearly not committed” to the work. The irony is that being open about psychological wellbeing actually helps everyone. I know one colleague who pulled himself out of CAR after realising that his risk assessment capacity had deteriorated to the point where he was jumping checkpoints, thus putting his colleagues at risk. That may well have saved lives.

Another colleague cites the case of his agency deploying staff members across the West Bank and Jerusalem. After the initial briefing for deployed staff, at which the importance of foregoing alcohol was emphasised, one staff member admitted to a history of problematic drinking. Consequently, he thought it would be unwise for him to take a post in an alcohol free area. “I actually thought that was amazingly honest and responsible and helpful for all of us,” his supervisor says now. “Him speaking up helped us mitigate a major reputational risk”.

Of course being open about a struggle is also a critical first step to accessing help. But it is also by far the best way to identify problems before they become acute. There is so much teams and organisations can do – practical steps, researched by world class bodies like the Headington Institute – to support staff mental health. Buddy systems, for example. Employee assistance programmes are another. Introducing stress management strategies for teams is a third. And of course, training staff to spot the signs and symptoms of distress, and in the proven approaches for mitigating and managing the impact of stress in what is and always will be a complex and challenging sector.

There is definitely hope, especially now. The COVID-19 crisis has highlighted mental health issues– and how they impact everyone, from the most remote field posts to life in locked down HQs. Agencies are also stepping up: promoting employee assistance programmes, organising staff mental health training. It’s so important: I was lucky enough to be able to afford time off and a therapist. Many of us aren’t.

It’s long overdue. And a big reason why I now teach psychological well being and stress management for aid worker and why I’m so pleased that ILS and I have been able to collaborate to build psychological risk management into the core of what ILS does, including designing and launching a whole new standalone course. In three hours, we’ll walk you through the physiology of stress, conditions like PTS, PTSD, burnout and vicarious trauma, and the practical, protective steps you and your organisation can take to mitigate risks and create a psychologically resilient and support environment for everyone. It’s everything I and others on the ILS team have learned the hard way. We hope, by integrating it into our work, that we can help others take an easier road.

Imogen Wall is a mental health trainer and consultant specialising in safeguarding, staff welfare and crisis management with extensive experience in the humanitarian sector. If you are interested in learning more about how to support your staff with their wellbeing, please have a look at the and get in touch with us at