The International Organization for Migration (IOM) has been deployed for several years through its Disengagement, Dissociation, Reconciliation and Reintegration (DDRR) Program to support the National Disarmament, Demobilization and Reintegration (DDR) of exassociates of Boko Haram. In Cameroon, this support to the Government is based on national standards/guidelines on Mental Health and Psychosocial Support (MHPSS), in connection with the said process for the benefit of ex-associates of Boko Haram.

Emergency situations (conflicts, natural disasters, shocks, etc.) are significant psychological and social stressors for individuals, families and communities. This affects their mental and psychological well-being and makes them vulnerable to mental health issues.

The prolonged exposure of ex-associates of Boko Haram to conflict and violence, separation from their families and communities, poor living conditions and community stigma directly affect their mental health. They are very often subject to enormous psychological stress and the development of mental health problems, acute stress, bereavement, depression, posttraumatic stress disorder (PTSD), substance use and suicide.

Disarm am ent, Dem obilization and Reintegration (DDR)

It is in view of all this that the MHPSS emerges as a key issue in the DDR process at each of the different phases of Disarmament, Demobilization and Reintegration. In the Disarmament and Demobilization phase, the transition of ex-associates of Boko Haram to civilian life is a stressful experience amplified by the psychological strains experienced during captivity. The abandonment of the status of ex-partner has a psychological impact that leads to a feeling of both loss of one's group and loss of status linked to this male perception of power in the possession and handling of weapons. This can complicate transformation in civilian life.

During the reintegration phase, ex-associates of Boko Haram face mistrust, stigmatization and exclusion from host communities. The latter live in a collective psychosis, one of the consequences of which is the rejection and exclusion of returning ex-associates.

On the other hand, lack of community acceptance, loss of livelihood and lack of educational and employment opportunities contribute to mental health problems. MHPSS interventions thus contribute to improving mental health and reducing the harmful use of psychoactive substances.

Far North Cameroon

In the specific case of the Far North, MHPSS is integrated into the DDR process in several forms, in particular through communication, assistance and capacity-building actions for DDR staff on a range of social and mental health problems, the implementation of activities based on "dramatherapy" aimed at creating "theatrical-therapeutic" performances as psychological treatment to treat ex-associates.

With regard to communication and assistance, the actions are broken down in terms of awareness-raising activities, individual and group psychosocial support, referral of cases at the community level to health facilities for more appropriate care, dissemination of information on available services and referral channels to improve access to and use of mental health services and reduce stigma and negative attitudes towards people with mental disorders.

The implementation of interventions based on dramatherapy translates into alternative approaches such as theatre therapy, art therapy, music therapy and sport that improve the well-being of ex-associates and social cohesion in turn.

In the context of the Far North, the contribution of the Health Committees (Commités de Santé-COSA) in the implementation of MHPSS activities within DDR, training of staff of the National Committee on DDR (CNDDR) on MHPSS, the development of various infrastructures (Water and Sanitation, rehabilitation of CNDDR premises, etc.) and the organization of socio-cultural and artistic activities (theatre, poetry) constitute a definite added value for the success of the process.