Mental Health And Psychosocial Support Services Research Articles

Making psychosocial support programmes in emergencies inclusive: lessons learned from interventions in Rohingya camps

This personal reflection describes how Humanity and Inclusion (HI) has implemented inclusive modalities of intervention since the Rohingya influx in Bangladesh in 2017. We focus on how to improve the cultural acceptance of mental health and psychosocial support (MHPSS) services in this context. We explore the issue of stigma towards users of mental health services and misconceptions about this kind of service within the Rohingya community. This article provides an overview of HI’s programme, describing how it was adapted to address barriers and better contribute to the right to health of vulnerable populations. During the influx period, operating through mobile teams was found to be one of the best ways to respond to increasing needs. However, as the months unfolded and needs changed, a key modality of this intervention was community self-support based on peer-to-peer activities. Without advocating for replication of this specific case study, this field report documents ongoing practice in an emergency context and shows how professionalism and creativity are entangled in making MHPSS services really inclusive.

Challenges and opportunities for Rohingya mental health and psychosocial support programming

Mental health and psychosocial support (MHPSS) for Rohingya refugees in Bangladesh has been acknowledged as an important component of the humanitarian response. Despite this recognition, MHPSS programmes are still facing many challenges. These challenges are related to the care delivery systems, to factors in the affected community or to the humanitarian emergency context. Examples of these challenges include language barriers, monsoon-related events, coordination of MHPSS services and community perceptions of mental health and mental health services. Drawing from local, regional and global experiences, we recommend practical solutions to overcome these challenges and improve the outcome of the MHPSS response to the Rohingya refugee crisis.

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment.

BackgroundSince December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom are presently in refugee settlements located throughout Uganda. Existing literature suggests that refugees are at increased risk for a range of mental health and psychosocial problems. There is international consensus on the importance of needs and resource assessments to inform potential mental health and psychosocial support (MHPSS) interventions.MethodsWe conducted a MHPSS needs and resource assessment in Rhino Camp refugee settlement in northern Uganda, between June and August 2014. We followed World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45).ResultsData from the HIS indicated that visits to health centers in refugee settlements attributable to psychotic disorders, severe emotional disorders, and other psychological complaints increased following the refugee influx between 2013 and 2014, but overall help-seeking from health centers was low compared to estimates from epidemiological studies. In semi-structured interviews the three highest ranked mental health and psychosocial problems included “overthinking”, ethnic conflict, and child abuse. Other concerns included family separation, drug abuse, poverty, and unaccompanied minors. The 4Ws assessment revealed that there were very limited MHPSS services available in Rhino Camp.ConclusionsThe types of MHPSS problems among South Sudanese refugees in northern Uganda are diverse and the burden appears to be considerable, yet there are currently few available services. The assessment indicates the need for a range of services addressing social concerns as well as varied types of mental conditions. The idiom of “overthinking” may form a useful starting point for intervention development and mental health communication.

Mental health and psychosocial wellbeing of Syrians affected by armed conflict.

This paper is based on a report commissioned by the United Nations High Commissioner for Refugees, which aims to provide information on cultural aspects of mental health and psychosocial wellbeing relevant to care and support for Syrians affected by the crisis. This paper aims to inform mental health and psychosocial support (MHPSS) staff of the mental health and psychosocial wellbeing issues facing Syrians who are internally displaced and Syrian refugees. We conducted a systematic literature search designed to capture clinical, social science and general literature examining the mental health of the Syrian population. The main medical, psychological and social sciences databases (e.g. Medline, PubMed, PsycInfo) were searched (until July 2015) in Arabic, English and French language sources. This search was supplemented with web-based searches in Arabic, English and French media, and in assessment reports and evaluations, by nongovernmental organisations, intergovernmental organisations and agencies of the United Nations. This search strategy should not be taken as a comprehensive review of all issues related to MHPSS of Syrians as some unpublished reports and evaluations were not reviewed. Conflict affected Syrians may experience a wide range of mental health problems including (1) exacerbations of pre-existing mental disorders; (2) new problems caused by conflict related violence, displacement and multiple losses; as well as (3) issues related to adaptation to the post-emergency context, for example living conditions in the countries of refuge. Some populations are particularly vulnerable such as men and women survivors of sexual or gender based violence, children who have experienced violence and exploitation and Syrians who are lesbian, gay, bisexual, transgender or intersex. Several factors influence access to MHPSS services including language barriers, stigma associated with seeking mental health care and the power dynamics of the helping relationship. Trust and collaboration can be maximised by ensuring a culturally safe environment, respectful of diversity and based on mutual respect, in which the perspectives of clients and their families can be carefully explored. Sociocultural knowledge and cultural competency can improve the design and delivery of interventions to promote mental health and psychosocial wellbeing of Syrians affected by armed conflict and displacement, both within Syria and in countries hosting refugees from Syria.