ETHNOGRAPHY

A TOOL FOR IDENTIFYING COMMUNITY PROTECTIVE

FACTORS AND ACTIVITIES THAT FOSTER
PSYCHOSOCIAL WELL BEING

Joseph O. Prewitt Diaz, Ph.D.

Visiting Professor of Psychology
Disaster Mental Health Graduate Program
University of Indonesia
Jakarta, Indonesia

23 November 2008
Abstract

The last fifteen years have witnessed major disaster in South east Asia, the United States

and most recently Haiti and Chile. There is a need to identify methods to ascertain the

psychosocial needs of disaster affected people. Ethnography, the recording of life as it

occurs is a real time assessment tool. This paper describes a methodology used initially in

India, and is presented here as a possible tool to involve the disaster affected person in

identifying their problems, proposing solutions, and monitoring and evaluating the results

over time. The role and tools used by the researcher are described
Introduction

During the last fifteen years over one hundred Red Cross National Societies have

taken on the challenge of developing a Psychosocial support program to prepare

communities to face a crisis, emergency or a disaster and maintain a certain sense of

Psychosocial balance among the survivors. The program is oriented to provide

Psychosocial support during the acute phase of a crisis, emergency, or disaster during the

rehabilitation and reconstruction phases of the stressful life event.

To determine the effectiveness of the program stakeholders in general and donors

in particular have requested that the Red Cross Societies develop ways in which to

identify the protective factors in the target communities, determine the activities that the

community deems proper to achieve psychosocial well being, develop programs,

monitors the ongoing progress of the program, and conducts an evaluation process to

draw lessons from the interventions. The tool that has been proposed is ethnographic field

studies (Prewitt Diaz, Trotter & Rivera, 1989; Prewitt Diaz, 1996). The ethnographies

will be used to seek qualitative information from the target communities, and will report

the stories shared by the survivors about achieving psychosocial well being.

The American Red Cross (2006) developed a tool that provides for quantitative

reporting every quarter based on detailed implementation plans. This tool provides a way

to use the community in identifying lessons to be learned or the possibility of identifying

activities that we should learn and we haven’t. One-way in which a systematic record

can be documented is through ethnography. Ethnography as an alternative method to

elicit data from disaster affected people has been extensively used to gather qualitative

information in real time by direct observation, interviews, focused groups, and recording

the stories of disaster affected community as they are taking place.

Ethnography as a Scientific Method

Ethnography is a scientific method of recording people’s beliefs, behavior, and

culture directly from life (Prewitt Diaz, Trotter, & Rivera, 2002). It is a highly intimate

process. Werner and Schoepfle (1987) describe ethnography as a full or partial

description of the activities of a group; in this case, cultural patterns of survivors and

evidence of how resilience behaviors have helped the survivor to bounce back and

develop an outlook for future life by identifying activities that enhance the psychosocial

well being of the community.

Ethnographers become a part of the communities they study. They spend weeks

getting to know people, and months observing behavior, asking questions, and getting in-

depth interviews about various subjects. Ethnographers spend time recording direct

naturalistic observations of people’s behavior. They spend even more time interviewing

“key informants”, people in the community who are knowledgeable about the group’s

customs, habits and work. They learn what the community members consider to be

proper behavior and the proper way to do important tasks. Ethnographers ask in-depth

questions of large numbers of information over a significant length of time to be

confident that the answers they are receiving are true and not merely what those being

interviewed think they want to hear. One of the objectives of ethnographic research is to

learn so much about the lifestyles of the people under study that ethnographers can

participate in community events without making mistakes (Goodenough, 1980).

 Ethnographers use pseudonyms for both the individuals interviewed and for the

various States and communities in which the interviews take place. To avoid

compromising the informants, information identifying particular people and places will

not used. The information collected by the ethnographers follow the standard procedures

of the American Anthropological Association and the American Psychosocial

Association. In India the American Red Cross received approval from the Ethics and

Research Board of the Government of India to conduct ethnographic field studies in

Gujarat and Orissa during 2002-2004.

The Structure of the ARC Psychosocial Support Program

The purpose of the Psychosocial Support program (PSP) is to promote positive

adaptation post-disaster and to assist target communities to identify protective factors and

activities that will increase the psychosocial well-being. The PSP program has developed

structured activities in target schools and communities conducted by trained teachers,

mental health workers and trained community facilitators (Prewitt Diaz & Dayal 2008).

These activities consist of general psycho-educational and support-oriented activities

designed to increase the understanding of the long-term consequences of loss, to

normalize and validate stress-related experiences and reactions, and to provide skills that

will enhance psychosocial well being. These activities can take place in varied settings,

are immediate, experiential and simple. Persons with minimal amount of training and

supervision can administer the activities. The activities involve children, teachers, Red
Cross volunteers, parents, community members in general, and government

administrators.

Ethnographic Studies in PSP programs

The ethnographic data supporting the Psychosocial Support program objectives has been

divided into two linked, but separate parts: (1) programmatic ethnography and (2)

focused ethnography.

I. The Programmatic Ethnography

The programmatic ethnography will study the capacity building process for Red

Cross volunteers, teachers and community facilitators. This part of the study looked at the

systematization of materials into a structured program: the Gujarat project, the staff

development process, supervision and follow up activities. Two States (Gujarat, Orissa)

participated in the first phase. The Indian Red Cross Psychosocial Support Program was

developed in these States of India. The programmatic ethnography sought to identify

school and community activities that helped to identify protective factors and ways to

increase psychosocial well-being. The findings from the programmatic ethnography were

summarized in a report prepared for the Indian Red Cross Society (Prewitt Diaz,

Ramalingam, 2004).

The programmatic ethnography sought to identify ideal intervention models

community resilience markers, and ways for the community to enhance the psychosocial

well-being. It also attempted to identify profiles of ideal community facilitator and Red

Cross volunteer’s attributes and skills for Psychosocial support activities in schools and
communities. In the process, the ethnographers scientifically confirmed the need for

interventions in the geographical area or communitites where the crisis, emergency or

disaster has occurred, which were immediate, experiential and simple. The ethnographers

documented some of the characteristics of the program that made it both desirable and

unique among other psychosocial support programs in India. The data from the

programmatic ethnography was used to develop much of the direction for the field

ethnographies conducted with community members, community volunteers, Red Cross

volunteers and the local and state branch personnel.

II. The Focused Ethnographies

After analyzing the programmatic data for the preliminary refinement of

development of training materials, the ethnographers began a focused ethnography of the

beliefs, behaviors, and attitudes of community members, teachers and Red Cross

volunteers, related to resiliency markers, crisis planning, and developing activities in the

target communities and schools that would foster psychosocial well being. This part of

the ethnographic research included direct observation, interviews, and analysis of the

behavior of several groups, to include Red Cross volunteers, community volunteers,

teachers’ and crisis intervention specialists, in the communities, the schools, and during

and after a crisis intervention activity. After learning what the Red Cross volunteers did

during their capacity building activities, the ethnographers participated in simulations,

and actual responses, the ethnographers actually served as assistants to the Crisis

Intervention teams. The ethnographer became as knowledgeable about Red Cross

volunteer and crisis intervention personnel lifestyles, as the volunteers themselves, due to

the number of questions they asked and the number of recorded observations they made.

The purpose of the focused study was to identify protective factors and key

variables that either supported or impeded psychosocial well being. The PSP field

focused ethnography, for the first time, conducted the necessary form of research to

identify what are the community perceptions about their own psychosocial well being.

The focused ethnography specifically looked at the (1) general conditions of the

community, (2) parents and their relationship to children and to each other, (3) children

and adolescents and how they see their world, and (4) determined the services available.

The data gathered by the ethnography provided the program planners and the

Indial Red Cross Society a view of key crisis intervention volunteer’s issues from the

perspective of the service providers and of the persons that received the services. This

balanced approach is critical for a realistic view of a PSP program and for rational policy

development.
 III. Location of the Ethnographies

The programmatic ethnography was conducted in the state of Andhra Pradesh,

Gujarat, Orissa and Tamil Nadu. The ethnographers observed the interactions of Red

Cross crisis intervention personnel with state officials, local school district personnel, and

Red Cross and community volunteers, as well as teachers in their areas. This phase of the

project lasted for approximately three months and produced essential data on the types of

community activities and resilience projects that exist, the models used for administrative

organization, ideal profiles of Crisis Intervention Specialists, norms or profiles of rules

and regulations critical to the psychosocial support program, as well as an ideal profile of

a Red Cross volunteer involved in Psychosocial support programs in communities and

schools.
Following the review of existing records, the ethnographers spent six months of focused

field experience with teachers, community facilitators, Red Cross volunteers and their

families. These in-depth studies depended on the establishment of a high level of trust

between the ethnographers and their informants. Significant time was spent in Gujarat

and Orissa. The first field sites for the focused ethnography were target schools and

villages. These were all villages where substantial numbers of disaster affected people

were relocated near the location of their new homes. The ethnographers spent from 12

weeks in Bhuj, Gujarat and Puri, Orissa, then shifted their studies to the villages along

the coast south of Puri, Orissa and in Gujarat went to villages and schools in Anjar.

IV. Methods used to collect data

Three classic ethnographic methods were used during the ethnographic fieldwork

conducted for the Psychosocial Support program. These methods were 1) naturalistic and

participant observation, 2) life histories and 3) semi-structured interviews.

The participant observation phase of the ethnographies included such diverse activities as

spending days with Red Cross volunteers, community facilitators and teachers, living in

community facilitator’s households, participating in community training sessions, and

attending meetings and resilience activities in all the villages in each participating State.

This form of participant observation provided the environmental framework for

understanding the relationships between community facilitators developing resilience

enhancing activities in their communities and the government institutions they encounter

in places where they lived and worked.

The semi-structured interview phase was interwoven with the participant

observation. Semi-structured interviews are those in which a specific set of open-ended

questions are asked, but where the interviewer took advantage of volunteered information

to ask additional questions which were generated by the interview itself. During the semi-
structured interview phase of the project, formal, prearranged interviews with and about

family members were tape recorded and transcribed. These semi-structured interviews

with Red Cross volunteers and community facilitators in their homes, on the road, and at

work produced hundreds of hours of answers to important questions.

Opportunistic interviews that were not pre-arranged but focused on one of the

topics under study were also recorded. The opportunistic interview not only provided

answers to the questions that ethnographers believed to be important, it also uncovered

issues that the informants believed to be important. Since the purpose of the current

evaluation was to discover how the protective factors and resilience markers have

impacted the target villages and schools, semi-structured interviews avoided the problem

typical of social science survey research: getting accurate answers to the wrong

questions. A strength of this approach was that ethnographers were still able to get the

answers to questions that the psychosocial delegate felt were important.

Collecting life histories was the third major component of the research effort. Life

histories are descriptions, in the “key informants” own words, of the every day processes

and the major events in the lives of people in a community. The numerous life histories

collected by the psychosocial support program provided a critical framework for

understanding the lifestyles and the life events that are important to different groups in

the community.

The total ethnographic data set was the result of more than 1,000 hours of

participant observation, semi-structured interviews and life histories. The ethnographers

lived with families for weeks at a time, recording most of what they saw and heard. They

set up interviews, conducted training sessions and participated in community

assessments, attended meetings with emergency management personnel, and observed

children as they conducted the risk assessment and prepared their school crisis response

plan, in the schools, the villages and at home.

V. Stages of the Ethnographic Research

Typically, ethnographic research has five stages: (1) entry into the community; (2) initial

observations and interviews; (3) information review and confirmation; (4) increasingly

intensive and focused interviews on selected topics; and (5) exit from the community

(See Figure above). In all cases these are cyclical, not linear processes. At any given

time, the ethnographer is not only collecting new information but also reviewing field

notes and going back to key informants to confirm, modify, or reject their interpretations

of what is occurring. Even the process of entering and leaving is not a linear one.

Ethnographers continually meet potential informants, and for each new person there is a

repetitive process of explaining who you are, what you are doing, and what will happen

to the information you are collecting. Leaving a community is not simple either. The very

nature of ethnography causes the researchers to bond with the people they are studying.

These bonds, like all friendships, are not easily severed. Most ethnographers develop life-

long relationships with key informants.

The following summarizes the processes used by the ethnographers to collect data for the

project (See Figure above).

1. Community Entry

One problem that ethnographers were trained to solve was explaining to people what he

or she were doing in the community, why he or she were collecting information, and
what he or she were going to do with the information. In this psychosocial support

program activity, the ethnographers identified a community facilitator who could

introduce the ethnographer to a small circle of friends and acquaintances. Since that

Psychosocial support program had already established contacts with individuals in the

communities, these networks were used for initial interviews, and for observation. Since

everyone knows many other people, the ethnographers worked their way through social

groups, finding more and more people to talk to, and being allowed into more and more

homes and work sites. This process took considerable time since virtually no one was

willing to talk in depth about his or her disaster reactions and subsequent experiences on

the first visit. Time, familiarity and “going with the flow” were needed until enough

rapport was established so that the ethnographer could take out a notebook, turn on a tape

recorder, or videotape the interview.

Once the primary barriers were down, the ethnographer was able to return and

gather much more information from the informants. The ethnographer was trusted, and

people were excited that their views would be recorded and heard by the people who

support, create, and run the psychosocial support programs. This is a common reaction to

ethnography. People are often pleased that an ethnographer who cares enough to ask

them about their lives. This reaction often changes their reaction from indifference or

hostility to openness and cooperation. Once trust is established, information pours out.

Once community leaders were convinced that the ethnography could be

beneficial, they would often take on the role of explaining why the researcher was present

and why it would be a good idea for people to cooperate. While it often took time for

people to become comfortable enough to talk honestly, the general reception of the

ethnographers was positive.

 2. Cyclical Observations and Interviews

After contacts had been established, and confidence in the ethnographers was

developed, the data went from a trickle to a flood. The most intense cyclical part of the

evaluation had begun. The ethnographers gathered initial data, asked for confirmation,

discovered areas that needed to be visited in depth, and began the intensive data review

process.

Naturalistic participant Observation

Participant observation is the foundation of ethnographic research (Bernard,

1988). In this project, each ethnographer spent hundreds of hours directly observing what

the community members did and said during their daily lives, while they worked, and

when they interacted with other members of society. These observations were recorded in

detail as a part of the ethnographer’s field notes; the raw data recorded directly during the

research process. The notes were then reviewed and analyzed for regular patterns, as a

part of the total ethnographic assessment.

Ethnographers in their field notes record two types of observations. One is

contextual observations. The other is direct observation and recording of key behavior.

Contextual observations explain either the physical or the social context of any

conversation or interview. Without this type of anchoring observations, it would be much

easier to take what the Red Cross volunteers and community facilitators say out of

context. The second form of observation was a recording of either physical surroundings,
such as the vivid description of housing, the community, and people at risk, or recordings

of observations of people’s behavior.

Interviews

Ethnographic researchers spend much time “hanging around” in situations where

they were able to observe important behavior and interview people doing the things about

which the ethnographer was interested in learning. They also set up formal interview

sessions with people whom they knew well enough to be confident that rich, accurate

information would be provided. Two types of interviewing, opportunistic interviews and

formal interviews, form the basis for the data collected in the ethnography.

Opportunistic Interviews

In some types of research, accidental encounters with people who could provide

vital information are not considered part of the data collection process. However, in

ethnographic research, these encounters are recorded. The purpose is to build up as broad

and deep a base of descriptive information as possible, to make sure that no leads to

important areas of information are lost, and to help confirm that the themes that the

ethnographer describes are as accurate and representative as possible.

Formal Interviews and key Informants

In-depth interviews are the backbone of ethnographic research. Project ethnographers

arrived at their first field site with questions and areas for recorded observations that had

been created by members of the project advisory board, project staff and the ethnography
group. They pursued these questions while remaining open to issues of importance to

their informants, issues which might have been overlooked by the experts.

It is common for ethnographers to record dozens of conversations with the same

informants. Some are broad explorations of the areas of culture under study. Others are

confirmations or re-examinations of earlier statements. The latter serve to clarify or check

accuracy and validity of information. Interviews with key informants span months as

more and more information is collected, recorded and confirmed.

Ethnographers commonly conduct semi-structured rather than unstructured or fully

structured interviews. While the ethnographer has a series of pre-written questions to be

asked, the questions are open-ended. Open-ended questions allow informants maximum

leeway in the topic of discussion. Moreover, the ethnographer has the option of asking

additional questions during the interview that help clarify answers.

Under certain circumstances project ethnographers allowed the interviews to go off in

unexpected directions to explore interesting or promising answers to their questions. The

answers ethnographers received from initial questions sometimes indicated they were

asking the wrong question, or asking the right question in the wrong way. In some cases,

informants simply could not answer the question as it was asked; and in other cases, they

provided the interviewers with a better question.

Many interviews were recorded verbatim using a tape recorder. Others were recorded by

jotting down notes during the interview. Still others were written by the ethnographer
after the interview. The reasons for these different approaches are simple. People willing

to give information are sometimes unwilling to do so with a tape recorder running or

when someone is taking notes. In such cases, notes jotted down after the fact are better

than losing the information altogether. The ideal is to get the most accurate verbatim

recording possible, but other forms of data collection provide useful information as well.

Both types of interviews may occur with the same informant and are useful for double

checking information collected from others or for capturing additional details.

Comparison of these types of interviews reveals differences in informants. Some provide

wonderful detail. Others must be guided. Some informants require probing questions for

the ethnographer to find out what they are really saying and what the information means.

A strength of ethnographic interviews is that while they allow people to make their own

uninterrupted statements, they also allow active intervention on the part of the

interviewer to extract the basic information needed in the ethnography.

Group Interviews

Ethnographers often use a variation of the semiformal interview, the group interview.

Many ethnographic interviews are conducted in natural settings (people’s homes, in the

neighborhood, and at school). The ethnographer is rarely alone with an informant, so

many interviews turn into group interviews, whether or not they started out that way.

Group interviews allow informants to express themselves in a comfortable setting. They

also enable ethnographers to explore diversity of opinion, as well as consensus. People

interject their views into the interview, even though they are not the primary informant. If
they agree with the informant, they provide additional confirmation about the subject. If

they disagree, they provide important information about the intercultural diversity

surrounding that subject.

The answers show the complexity and depth of issues that villages, schools, and Red

Cross volunteers face, as well as the assumptions that they take into account in making

key life decisions. Sometimes, it takes several interviews to clarify a fairly simple

subject.

Information Interpretations of the Data

One important interview technique ethnographer’s use is to have informants interpret

their own behavior, ideals, and beliefs or the behavior of other people.

Confirmations and Re-interviewing

Another crucial interview technique is to return to informants to re-ask important

questions and to confirm earlier statements. A characteristic of ethnographic interviews is

the ability of the ethnographer to follow up on questions over a long period of time.

Sometimes in the press of the interview, the ethnographer misses something important, or

later discovers that he or she should have asked for clarification. Ethnographic

interviewing is designed to overcome the weaknesses of one-time interviews. Field notes

are read on a daily basis, and notes made to return to an informant for further information

as soon as possible (Goodenough, 1980).

Life History Collection

A life history is a record, in the informant’s own words, that recounts an important part of

his or her life story. A complete life history is rare, because it takes many interviews and

recountings of events on the part of informants as well as intensive analysis on the part of

the ethnographer to assure that all of the key events in the informant’s life have been

recorded. Most ethnographers collect focused life histories instead; histories of special

events or narrowly defined areas of an informant’s life.

Focused life history accounts are very valuable for two reason: they reveal what events an

informant thinks are crucial to his or her personal development; they provide a context

that helps in the interpretation of beliefs, attitudes, and current behavior. The

ethnographers collected life histories that gave important insights into why migrants

joined the migrant lifestyle and what events structured their migrations.

Life histories have historical events, but informants tend to jump forward and backward

in time with confusing results if there are no follow-up interviews to eliminate the

problems this creates. Life histories often have many themes and information based on

beliefs and attitudes interspersed in the historical account. This juxtaposition is very

useful. During the analysis stage of the research, these data can be related to key events,

themes, and processes in migrants’ lives. These provide information that is especially

useful in matching policy analysis and policy development to the reality of migrant life.
 Data Analysis, Summary, and Write Up

One of the greatest strengths of ethnography is the identification of repetitive information

that best describes the way most people think, believe, and behave. Once sufficient field

data are collected, ethnographers search the data for themes, commonly held beliefs,

similarities of behavior, and common ways of expressing ideas.

In ethnography, multiple examples of all-important findings from the study were

scattered throughout the data. The process of data analysis required the

ethnographers to identify themes and patterns, as well as variations on them.

When a theme became apparent, it was presented back to key informants for

confirmation.

Ethnography offers the opportunity to discover shared cultural beliefs and ideas

expressed in the words of a representative individual. A particular quote is a composite of

dozens-even hundreds-of similar quotes.

Summary

The observations and interviews collected by the ethnographic field study covered a wide

variety of topics. After studying the answers and piecing together the observations from

all of the States, three areas emerge that are critical to understanding the process of

providing psychosocial support services long time to community facilitators, teachers and

Red Cross volunteers in the target communities and schools. (1)The recognition of

protective behaviors that facilitated survival and positive adjustment, (2) the role of
knowledge about Psychosocial response to a crisis, practices that allowed the behaviors

to be practiced and attitude change, the benefits in engaging in preparedness activities in

the community and schools as a tool of emotional growth, and a sense of security.

FIELD WORK DATA GATHERING PROCEDURES

WHEN WHAT HOW
Consultation with NHQ
STEP 1 Selection of Locations
Consultation with State
Branch

Program Staff
STEP 2 Selection of subjects:
Survivors
-Gender
Red Cross Volunteers
-Age
-Survivors status Community Volunteers
Teachers

STEP 3 Method used to collect Community entry

data: Cyclical observations -Opportunistic
and interviews interview
-Naturalistic and
Participants observation: -Formal interviews
participant observation
-Direct observation - Group interviews
-Life histories
-Contextual observation -Informal
-Semi-structured interpretations of
interviews Life history collection data
Data analysis -Confirmation and
Summary Write-up re-interviewing
Community exit
REFERENCES

Agar, M. H. (1987). Speaking of Ethnography. Beverly Hills, CA: Sage Publications, Inc.

Adler, P.A. & Adler, P. (1987). Membership Roles in Field Research. Beverly Hills, CA:
Sage Publications, Inc.

Bernard, H. R. (1988). Research Methods in Cultural Anthropology. Beverly Hills, CA:

Sage Publications, Inc.

Goodenough, W. H. (1980). Ethnographic Field Techniques. In H. C. Triandis & J. W.

Berry (Eds.), Handbook of Cross-Cultural Psychology: Methodology (Vol. 2). Boston,
MA: Allyn and Bacon, Inc.

Reed, M. (1987). The State of the Art: What we have learned from the programmatic
Ethnography. Harrisburg, PA: Pennsylvania Department of Education, Division of
Migrant Education.

Trotter, R.T., Wood, A., Gutierrez Mayka, M., Felegy, M. & Reed, M. C. (198710. An
Ethnography of Migrant Farmworkers’ Educational Opportunities. Harrisburg, PA:
Pennsylvania Department of Education.

Werner, O. & Schoepfle, G.M. (1987). Systematic Fieldwork: Foundation of

Ethnography. (Vol. 1). Beverly Hills, CA: Sage Publications, Inc.
Werner, O. & Schoepfle, G.M. (1987). Systematic Ethnographic Analysis and data
Management. (Vol. 2). Beverly Hills, CA: Sage Publications, Inc.

Agar, Michael H. (1980) The Professional Stranger: An Informal Introduction to

Ethnography, Academic Press

Fetterman, David (1998) Ethnography Step by Step, 2nd edition, Sage

Hammersley, Martyn and Atkinson, P (1983) Ethnography: Principles in Practice, 2nd

edition, London: Tavistock
 APPENDIX A

Psychosocial Checklist

Descriptor Stimulus Question

Notes
General
Conditions
in the
community

Families are living together.

Privacy in the shelter for the family and family members is available.

Community conducts activities to help children with difficulties.

The community can identify three strategies to deal with Psychosocial distress.

The community has identified resilience factors that have helped them survive.

The community has a strategy to recover from the tsunami.

Social organization promotes social well-being through information, cultural and

recreational activities.

Measures have been taken to improve the living conditions of children and their
families.

There are persons in the community that provide regular activities for children
(informal education, play and recreation).

Parents

Parents are facing stress that is affecting their well-being and how they care for
the children.

Parents want to participate in self-care activities.

Parents seek support for stressing difficulties.

Parents learn how to reduce the stress level in their children

Parents and children participate in stress reducing creative and expressive

activities.

Children

Children are provided with adequate nurture and care at home.

 Children are provided with adequate nurture and care in school.

Culturally appropriate ways are used to promote expressive activities and play.

Culturally appropriate ways are used to promote creative activities.

Children who are alone are cared for in the community and school.
Service

Children participate in development enhancing activities to re-establish a sense

of place.

Social services are available for internally displaced persons.

Children experiencing Psychosocial distress are identified and supported in formal

and informal schooling.

Training and support to provide psychosocial support is provided to teachers and

other school personnel.

Children and adolescents are taught methods of self-care.