Supporting mental health in conflict-affected settings

Abstract

Global mental health is a rapidly changing landscape; scientific and technological innovations and the leveraging of naturally occurring social networks have broadened the reach of psychological and psychosocial supports in conflict-affected settings. As methodological approaches have advanced, so too has a focus on monitoring and evaluation of the effectiveness of these programs. This chapter will review the literature on psychological and psychosocial interventions in conflict-affected settings with three distinct aims. First, a review of the research literature will focus on promising innovations that have improved the reach and context-responsiveness of psychological supports in conflict-affected settings. Next, the chapter will address key gaps and pressing empirical and theoretical questions, including the lack of guiding theoretical “uplinks” of individual interventions in their relationships to broader community-level interventions. By linking individual interventions to community interventions, challenges emerge, such as lack of cohesiveness and integration of psychological supports in conflict-affected settings; tensions between psychological and psychosocial frameworks for care and the consequent implications for violence prevention; and difficulties regarding iatrogenic effects in the transactional effects of interventions across systems. Finally, the chapter will conclude by reflecting upon the unique challenges of implementing effective psychological supports in conflict-affected settings, including social norms around psychological care, government intrusion and lack of privacy, and problems in implementing randomized controlled trial (RCT) designs in these contexts.