Evidence-informed Mental Health and Psychosocial Support (MHPSS) Guidelines: Are They Any Good and Where DoThey Lead Us When Disaster Strikes?

Abstract

Introduction:Disasters and humanitarian crises can have a tremendous impact on the mental health and psychosocial well-being of affected populations. Reliable and practical evidence-informed mental health and psychosocial support (MHPSS) guidelines are indispensable for policy and practice to address the mental health impact. Our objective was to review the quality of available guidelines and to explore similarities and differences in content.Method:The review was conducted in two steps. Firstly, MHPSS guidelines, frameworks, manuals and toolkits were selected via a systematic literature review as well as a search in the grey literature. A total of 13 MHPSS guidelines were assessed independently by 3–5 raters using the Appraisal of Guidelines for Research and Evaluation–Health Systems (AGREE-HS) instrument. Secondly, we analyzed the content of the highest-ranking guidelines.Results:Guideline quality scores varied substantially, ranging between 21.3 and 67.6 (range 0–100, M= 45.4), with four guidelines scoring above midpoint (50). Overall, guidelines scored highest (on a 1–7 scale) on topic (M = 5.3) and recommendations (M = 4.2), while implementability (M = 2.7) is arguably the area where most of the progress is to be made. The four guidelines proved largely similar, overlapping or at least complementary in their MHPSS definitions, stated purpose of the guidelines, user and target groups, terminology, and models used. Many recommended MHPSS measures and interventions were found in all of the guidelines and could be categorized. The guidelines stress the importance of monitoring needs and problems, evaluating the effect of service delivery, deliberate implementation and preparation, and investments in proper conditions and effective coordination across professions, agencies, and sectors.Conclusion:The MHPSS knowledge base embedded in guidelines is rich and contains invaluable content for disaster risk reduction. Although application contexts differ geographically, available guidelines should allow policymakers and practitioners globally to plan, implement, and evaluate MHPSS actions.