Identifying best practice for the supervision of mental health and psychosocial support in humanitarian emergencies: a Delphi study

Áine Travers,Pia Tingsted Blum,Kelly A Mcbride,Frédérique Vallières,Nana Wiedemann,Nadeen Abujaber

doi:10.1186/s13033-022-00515-0

Abstract

BackgroundSupportive supervision has been shown to improve worker resilience and wellbeing, which are particularly important in the context of humanitarian emergency settings. Despite its noted importance however, supervision remains an under-prioritised area in mental health and psychosocial support (MHPSS).MethodThe present study used a Delphi consensus-building methodology to examine levels of agreement among a diverse sample of MHPSS stakeholders (n = 48) on key ideas and concepts relating to supervision in humanitarian settings.ResultsThe majority of statements presented showed a high degree of consensus, with some receiving almost universal agreement, such as the importance of using active listening skills in the supervisory context and the need for supervisors to have access to their own supervisory support. However, disagreement on several points remained. For example, participants disagreed about whether the qualities required to be an effective supervisor can be taught, or whether they are more innate and should be screened for when recruiting supervisors. Gender differences in responses were also analysed, with potential associations between gender and level of agreement emerging in relation to statements about power dynamics, remote supervision, and intervention quality enhancement.ConclusionsThe findings of the present study are discussed in terms of their implications for a forthcoming set of guidelines for supervision of MHPSS in humanitarian settings: The Integrated Model for Supervision (IMS).

Highlights

Populations affected by humanitarian emergencies are at risk of adverse mental health outcomes relating to trauma exposure and ongoing adversity and challenging conditions in the crisis aftermath [6]
The statements were developed through previous phases of research and consultations as part of the ongoing development of the Integrated Model for Supervision (IMS): these phases included (1) a desk review of literature relating to the supervision of mental health and psychosocial support (MHPSS) in humanitarian settings (McBride et al [15]), (2) a series of key informant interviews (Perera et al [17]) and (3) workshop discussions on best practice in supervision for MHPSS in humanitarian settings [12]
The newly worded item appeared to create some ambiguity about the meaning of the statement, resulting in a final consensus score of 51%. This Delphi study aimed to examine the degree of consensus or disagreement among MHPSS stakeholders on 28 statements relating to the supervision of MHPSS interventions in humanitarian settings, with a view to developing a new set of guidelines for its delivery, entitled the Integrated Model for Supervision (IMS)

Summary

Introduction

Populations affected by humanitarian emergencies are at risk of adverse mental health outcomes relating to trauma exposure and ongoing adversity and challenging conditions in the crisis aftermath [6]. Operating in complex and stressful environments to provide support to those who have experienced significant adversity increases workers’ vulnerability to vicarious trauma, secondary trauma and burnout [1, 5, 19] This vulnerability is further compounded in situations where MHPSS workers are themselves from the communities affected by the humanitarian crisis, since prior exposure to traumatic events is a significant risk factor for the onset of occupational stress responses [10]. Despite its noted importance supervision remains an under-prioritised area in mental health and psychosocial support (MHPSS)

Methods

Results

Discussion

Conclusion