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Speaking with colleagues in Myanmar and Gaza, there is an eerie moment when I hear an almost word-for-word phrase: “We can’t give space to our pain.”
That sentence has stayed with me. It reflects not just personal grief, but a systemic failure seen across humanitarian responses around the world – one that echoes far beyond Gaza or Myanmar.
I’ve spent years working with in-field and remote teams integrating mental health and psychosocial support (MHPSS) in humanitarian responses wherever I can – wherever teams welcome it.
Too often, what’s seen as “critical lifesaving” is reduced to a shortlist: medicine, water, food, shelter. MHPSS, protection, education, and even gender considerations are dismissed as optional secondaries. Psychosocial support does not solve systemic crises. But it offers moments of dignity, connection, and regulation that make survival more bearable. That matters, especially when leadership structures have fractured, and human recognition is scarce.
Humanitarian teams and communities support individuals and families under unimaginable conditions. Community members in particular amaze me: working without salaries, shelter, electricity, or rest, while managing their own losses.
But I flinch when I hear people say how resilient humanitarians are. “Resilient” is not a reflection of strength; it’s a placeholder for “no other choice”.
The way humanitarian responses are built and funded rests on a false premise: Affected communities and frontline responders are able to cope without adequate support. But this assumption derails programming and leaves critical needs unmet.
The problem with resilience
Across emergency contexts, the language of resilience is everywhere.
We speak it with admiration. But too often, it becomes an excuse. Not all resilience is created equal: There is a significant distinction between functional and dysfunctional resilience.
Functional resilience emerges when people are supported; dysfunctional resilience is what we ask of them when they are not supported. The latter is used to justify underinvestment in staff care, to celebrate endurance over wellbeing, and to overlook the fact that mental health support is the enigma on the humanitarian priority list – critical, yet consistently underfunded; essential, yet too often ignored.
Mental health is not secondary. Delayed support is denied support. In protracted and complex emergencies, it underpins everything in unexpected ways, from team cohesion to complex integrated needs like protection, health, and nutrition.
In Gaza, Afghanistan, Ukraine, and elsewhere, I have met frontline workers returning to work days after giving birth, because their families depended on their NGO salaries. I have seen remote teams providing peer support while mourning their own relatives. I know professionals who have facilitated psychosocial sessions across borders, who then recognise the surnames of the bereaved.
These stories are not about superhuman strength. They are about surviving because there is no other choice.
That is not resilience. It’s survival and should not be an expectation of frontline responders. The risks posed by this kind of dysfunctional resilience are preventable risks for both staff and programme outputs.
This pattern recurs across emergency responses. MHPSS is frequently integrated later, or only after “urgent” needs become clearly visible. For example, I worked during a large-scale cyclone response, where mental health and psychosocial needs were evident from the first day: Families were separated, people clearing rubble were casually disclosing self-harm and suicidal ideation, and children wandered unattended. Yet, MHPSS was not included in the immediate response. It was only activated several months later after cases were flagged by protection teams as visible symptoms progressed.
In the interim, the burden of addressing these kinds of mental health and psychosocial needs fell to frontline responders from other sectors – many of whom were untrained and overwhelmed. Faced with little support and no clear referral pathways, community members gradually stop disclosing mental health concerns altogether. When no one is listening or able to respond, people stop speaking.
Mental health is not secondary. Delayed support is denied support. In protracted and complex emergencies, it underpins everything in unexpected ways, from team cohesion to complex integrated needs like protection, health, and nutrition. I’ve seen infant nutrition programmes fall short because they first concentrated on teaching mothers experiencing postpartum depression and traumatic births about breastfeeding. But the women also needed help to manage their fear, grief, and disrupted attachment: The risks to infants were not only about gaps in caregiver knowledge and information, but also unacknowledged distress.
Mental health support is not simply a luxury when there is time; it is foundational for the welfare of programmes, for the capacity of responders, and, by extension, for the wellbeing and credibility of the entire humanitarian response.
As humanitarian reform evolves and donors cut budgets, services like MHPSS, staff wellbeing, and child protection are at risk of being quietly and inauthentically “integrated” into other areas of programming without sufficient oversight, funding, or accountability.
When we underinvest in the wellbeing of humanitarians, we erode the integrity of the humanitarian response itself.
The humanitarian sector must reframe how it understands and funds mental health. This is not an optional service or a luxury. It is core to ethical, effective response.
Include MHPSS and team wellbeing in preparedness, and real-time response. Fund and monitor it. Understand what the system demands of its frontline workforce. Resilience is not enough.
