Littérature scientifique sur le sujet « MHPSS Intervention »

BackgroundOver 240 million children live in countries affected by conflict or fragility, and such settings are known to be linked to increased psychological distress and risk of mental disorders. While guidelines are in place, high-quality evidence to inform mental health and psychosocial support (MHPSS) interventions in conflict settings is lacking. This systematic review aimed to synthesise existing information on the delivery, coverage and effectiveness of MHPSS for conflict-affected women and children in low-income and middle-income countries (LMICs).MethodsWe searched Medline, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO)databases for indexed literature published from January 1990 to March 2018. Grey literature was searched on the websites of 10 major humanitarian organisations. Eligible publications reported on an MHPSS intervention delivered to conflict-affected women or children in LMICs. We extracted and synthesised information on intervention delivery characteristics, including delivery site and personnel involved, as well as delivery barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data.ResultsThe search yielded 37 854 unique records, of which 157 were included in the review. Most publications were situated in Sub-Saharan Africa (n=65) and Middle East and North Africa (n=36), and many reported on observational research studies (n=57) or were non-research reports (n=53). Almost half described MHPSS interventions targeted at children and adolescents (n=68). Psychosocial support was the most frequently reported intervention delivered, followed by training interventions and screening for referral or treatment. Only 19 publications reported on MHPSS intervention coverage or effectiveness.DiscussionDespite the growing literature, more efforts are needed to further establish and better document MHPSS intervention research and practice in conflict settings. Multisectoral collaboration and better use of existing social support networks are encouraged to increase reach and sustainability of MHPSS interventions.PROSPERO registration numberCRD42019125221.

The mental health burden of displaced communities is enormous and ever-increasing. Community-based Mental Health and Psychosocial Support (CB-MHPSS) interventions are seen as vital in addressing this challenge, and they have been lauded as being integral in the overall multi-level Mental Health and Psychosocial Support Intervention approach in humanitarian settings. This article assumes that CB-MHPSS innately require a participatory approach to truly benefit the targeted population. It explores important benefits and challenges of using a participatory approach with CB-MHPSS interventions, as well as identifying key considerations in their design and implementation. A literature review of the PubMed database, Web of Science, The Cochrane Library of Systematic Reviews, and defined ‘grey literature’ identified 42 relevant articles. Thematic analysis identified dilemmas raised by many of the authors, including: the disconnect between using a participatory community-based approach and evidence-based medicine; using locally derived versus standardised measures; incorporating local mental health expressions and idioms into the intervention versus using standardised diagnostic classifications; empowering communities versus falling into the hands of local power dynamics and agendas; and trying to allow for sufficient time to develop relationships and build trust with the targeted community. The findings can serve to encourage reflexivity and critical thinking in the design and implementation of future CB-MHPSS interventions, which will be required to develop robust evidence that supports CB-MHPSS interventions in displaced communities.

Child soldiers represent a challenging population for mental health and psychosocial support (MHPSS), as we have little evidence regarding their needs or the efficacy of interventions. Despite an increasing breadth of MHPSS interventions for children affected by war, very few are supported by evidence (Jordans et al, 2009). In a recent decade-long conflict, Maoists and the government of Nepal conscripted thousands of children to serve as soldiers, sentries, spies, cooks and porters. After the war ended in 2006, we began a project incorporating research into the development of interventions for former child soldiers. Through this work, conducted with Transcultural Psychosocial Organization (TPO) Nepal, we identified four key principles to guide research and intervention with child soldiers (Fig. 1). We present these principles as location- and context-specific examples of the growing effort to develop guidelines and recommendations for research and intervention in acute post-conflict settings (Inter-Agency Standing Committee, 2007; Allden et al, 2009).

Recently, discussions have considered how mental health and psychosocial support (MHPSS) can build upon local resilience in war-affected settings. To contribute to the knowledge in this field, the paper explored the gap between MHPSS and local communities in terms of perceived mental health problems and healing processes, and how the gap could be filled. Qualitative research was conducted in northern Rwanda with 43 participants between 2015 and 2016. Findings revealed how three particular gaps can isolate MHPSS recipients in their local community. First, whereas MHPSS applies bio-psychological frameworks to post-genocide mental health, community conceptualisations emphasise social aspects of suffering. Second, unlike MHPSS which encourages ‘talking’ about trauma, ‘practicing’ mutual support plays a major role in the community healing process. Third, MHPSS focuses on one part of the community (those who share the same background) and facilitates their healing in intervention groups. However, healing in natural communities continues in everyday life, through mutual support among different people. Despite these gaps, MHPSS recipients can be (re)integrated into the community through sharing suffering narratives and sharing life with other community members. The paper highlights the ways in which MHPSS could inclusively support different social groups in the overall geographical community, allowing members to preserve the existing reciprocity and recover collective life through their own initiatives.

Background: Psychosocial research in humanitarian settings has been historically dominated by a focus on distress and disorder. As such, there is a need to establish the validity of instruments for a broad range of psychosocial outcomes, particularly among highly affected and under-represented populations. The current study describes the adaptation and testing of multiple psychosocial instruments among displaced Rohingya mothers in Bangladesh. Methods: We used baseline data from 600 mothers of malnourished children aged 2 and under enrolled in an intervention study in Cox’s Bazar, Bangladesh. Instruments assessed distress (International Depression Symptom Scale [IDSS] and Kessler-6 [K-6]); functional impairment (World Health Organization Disability Assessment Schedule [WHODAS]); subjective wellbeing (global Satisfaction With Life [SWL] and Personal Wellbeing Index [PWI]; and, coping (Brief COPE and locally developed coping items). Instruments were piloted and refined, then used for data collection by Bangladeshi-Rohingya interviewer pairs. We conducted exploratory factor analysis, evaluated internal consistency, examined construct validity through correlation with other scales, and used regression models to explore demographic factors associated with psychosocial health. Results: Both the WHODAS and coping items fit 2-factor models; other scales were unidimensional. Cronbach’s alphas ranged from .76 to .90 for the refined scales. With the exception of coping, scale correlations supported construct validity; separate measures of the same construct were highly correlated, distress and impairment were moderately correlated, and both were inversely correlated with wellbeing. Correlates of poorer psychosocial health included relative socioeconomic disadvantage, current pregnancy, and being unmarried. Conclusions: Most of the standard psychosocial assessment tools performed adequately, but they did not appear to fully capture local experiences and included items of little local relevance. Findings highlight the need for further mixed methods research to develop a rich battery of instruments with cross-cultural validity, particularly for positive outcomes such as coping which was particularly challenging to assess.

Introduction: Substance Use Disorders (SUDs) are among the most stigmatized mental health condition in Pakistan’s health care system. Stigma serves as a chief barrier to successful treatment engagement including seeking, sustaining participation or receiving quality care by health care professionals. Purpose: The present study aimed to investigate the mediating role of stigmatizing attitudes in explaining the relationship between perceived aetiology and therapeutic attitudes. Method: Correlational research design and purposive sampling strategy were used to collect a sample of 100 MHP’s (N= 100) consisting of n= 36 (M=33.64, SD=8.34) psychiatrists and n= 64 (M=30.38, SD=7.30) psychologist from hospitals, addiction centers and universities. Results: Results indicated that bio-medical causal attributions predicted stigmatizing attitudes (i.e., permissiveness, non-stereotype treatment optimism and treatment intervention); however, only treatment intervention mediated the relationship between bio- medical causal attributions and therapeutic preparedness among MHPs. Similarly, psychosocial causal attributions predicted stigmatizing attitudes (i.e., non-stereotype and non-moralism), however neither of them mediated the relationship between psycho- social causal attributions and therapeutic preparedness among MHPs. Conclusion: The study highlights the importance of combined aetiological information in anti-stigma interventions, advance training, and informed curriculum to reduce stigma and increase therapeutic preparedness. Keywords: Perceived Aetiology, Therapeutic Attitudes, Stigmatizing Attitudes, Substance Use Disorders

Most interventions for mental health and psychosocial support (MHPSS) have been developed in contexts and with populations that differ significantly from the realities of migration. There is an urgent need for MHPSS in transit; however, transit-specific aspects of MHPSS provision are often neglected due to the inherent challenges transit poses to traditional conceptualizations of practice. The Delphi method, which consisted of three iterative rounds of surveys, was applied with the goal of identifying challenges to and adaptations of MHPSS in the transit context. Twenty-six MHPSS providers working with refugees in 10 European transit countries participated; 69% of participants completed all three survey rounds. There was consensus that a flexible model of MHPSS, which can balance low intensity interventions and specialized care, is needed. Agreement was high for practice-related and sociopolitical factors impacting MHPSS in transit; however, the mandate of MHPSS providers working in the transit context achieved the lowest consensus and is yet to be defined. There is a need to rethink MHPSS in the refugee transit context. Providing MHPSS to refugees on the move has specificities, most of which are related to the instability and uncertainty of the context. Future directions for improving mental health protection for refugees, asylum seekers, and migrants in transit are highlighted.

Aims.To discuss the potential usefulness of a public health approach for ‘mental health and psychosocial support’ (MHPSS) interventions in humanitarian settings.Methods.Building on public mental health terminology in accordance with recent literature on this topic and considering existing international consensus guidelines on MHPSS interventions in humanitarian settings, this paper reflects on the relevance of the language of promotion and prevention for supporting the rationale, design and evaluation of interventions, with a particular focus on populations affected by disasters and conflicts in low- and middle-income countries.Results.A public mental health approach and associated terminology can form a useful framework in the design and evaluation of MHPSS interventions, and may contribute to reducing a divisive split between ‘mental health’ and ‘psychosocial’ practice in the humanitarian field. Many of the most commonly implemented MHPSS interventions in humanitarian settings can be described in terms of promotion and prevention terminology.Conclusions.The use of a common terminology across health, protection, education, nutrition and other relevant sectors providing humanitarian interventions has the potential to allow for integration of MHPSS activities in one overall framework, with diverse humanitarian practitioners working to achieve a common goal.

Abstract Background Exposure to conflict, violence and forced displacement can increase poor mental health among affected populations. Our aim was to examine evidence on the burden of mental disorders and access to and effectiveness of mental health and psychosocial support (MHPSS) services in Syria and among Syrian refugees in neighboring countries. Methods A systematic review was done following systematic review criteria. Twelve bibliographic databases and additional gray literature sources were searched for quantitative and qualitative studies. Descriptive analysis and quality assessment were conducted. Results Twenty-eight eligible studies were identified, of which two were with conflict-affected populations within Syria. Levels of post-traumatic stress disorder ranged from 16 to 84%, depression from 11 to 49%, and anxiety disorder from 49 to 55%. Common risk factors were exposures to trauma and having a personal or family history of mental disorder. Financial and socio-cultural barriers were identified as the main obstacles to accessing MHPSS care. Evaluations of MHPSS services, albeit from predominantly nonrandomised designs, reported positive treatment outcomes. Conclusions The MHPSS burden was high, but with considerable variation between studies. There are key evidence gaps on: MHPSS burden and interventions—particularly for those living within Syria; access and barriers to care; and implementation and evaluation of MHPSS interventions.

ObjectiveThe aim of this review is to elucidate the characteristics of school-based mental health and psychosocial support (MHPSS) interventions in humanitarian contexts and the hypothesised mechanisms by which they influence well-being or learning outcomes.MethodsWe conducted a realist review and searched PubMed, Embase, Global Health, CINAHL, PsychInfo, PILOTS and grey literature through January 2022. Eligible studies included children age 6–12 years, were conducted in humanitarian contexts in low-income or middle-income countries, and focused on universal MPHSS prevention in an educational setting, using any study design. Data were extracted and analysed using narrative synthesis and realist analysis techniques to create ‘context–mechanism–outcome’ configurations that were iteratively developed to modify, refine and substantiate programme theories.ResultsTwenty-seven articles, representing 19 studies, were included in the review. We analysed data from 26 articles. Eleven evidenced-informed programme theories were developed at the levels of the child (n=4), teacher (n=3), caregiver (n=2), school environment (n=1) and school managers/administrators (n=1). At the child level, mechanisms related to strengthening coping skills, emotion regulation, interpersonal relationships led to improved psychosocial well-being or learning outcomes. At the teacher level, coping skills and the provision of support to students were linked to psychosocial well-being and learning outcomes. At the caregiver level, strengthening interpersonal bonds trigger improved psychosocial well-being, and at the school environment level, fostering feelings of security was linked to psychosocial well-being and learning outcomes. We did not find any evidence supporting the programme theory at the school managers/administrators level. We found limited evidence of positive impacts of the included interventions to support these programme theories.ConclusionsThese programme theories are a promising start towards ensuring school-based MHPSS interventions in humanitarian contexts better address the well-being and learning needs of children. Future research is needed to support these programme theories and enhance the evidence base.

This dissertation explored the psychosocial needs and mental health and psychosocial support (MHPSS) interventions of a group of Palestinian children living in the context of armed conflict and political violence. This conventional perspective has also influenced research studies of Palestinian youths. In many countries, for example, popular narratives suggest that children are unable to engage in crucial decisions that impact them. However, we must examine these prevalent narratives and seek alternative qualitative information that challenges preconceived notions about children’s abilities from an empowerment viewpoint (Langhout, 2010). With the present work, we attempted to fill this gap in literature, which has recurrently depicted and assessed children’s psychosocial needs from different perspectives, and focused on the gaps in the MHPSS interventions implemented. Community psychologists have identified numerous stakeholders that influence children’s thinking and behavior, including parents and extended family members, family advocates, teachers, mental health experts, and other adults in children’s lives. These adults are most often questioned in interviews or focus groups, and their responses are usually in response to the researcher’s conceptualization of the problem. On the other hand, children rarely participate in the interview and are not asked to assist in the formulation of the problem definition or near solution. Children’s research is usually done for them, but not with them. (Hart 2013; Langhout & Thomas, 2010). In order to challenge the traditional way of assessing the efficacy of MHPSS interventions in addressing the needs and aspirations of the Palestinian children, this research was designed to provide a more comprehensive and nuanced perspective on the MHPSS interventions in adverse contexts. More specifically, this work has aimed to outline the psychosocial needs of the children and the gaps in the MHPSS interventions that were implemented based on these needs. Within a critical framework, our research design was a qualitative study, with a sample of 131 people, including 60 children; 13 parents; 24 teachers; and 34 school counselors, principles, NGOs & INGOs workers, decision makers, expert researchers, expert in the field of mental health. The different qualitative methods adopted have allowed us to approach and explore the phenomena in two different aspects, reaching a more comprehensive understanding to the MHPSS interventions in addressing the needs and aspirations of the Palestinian children. Through the first part of exploration, we assessed the children’s psychosocial needs of the Palestinian children from different perspectives. This analysis confirmed that children’s needs must be assessed by different influences in children’s lives to have a comprehensive perspective on the psychosocial needs of the Palestinian children. Secondly, the efficacy of MHPSS interventions on children’s needs were explored in two ways. The first method included interviews with school staff, expert researchers, experts in the fields of mental health, service providers, workers in NGOs and INGOs, and decision makers. The second method included critically analyzing relevant guidance from 9 annual reports, 11 strategical plans, and 3 guidelines. The resources of the documents came from several local NGOs, INGOs, and ministries. Collectively, this exploration revealed various kinds of interventions, the most recommended interventions, why children need interventions, and gaps in MHPSS interventions. The conceptual network built from our data highlighted gaps between the different perspectives of the children’s needs. Also, gaps in MHPSS interventions were pointed out by the field workers, and there seem to be gaps in these interventions for meeting the needs and aspirations of the Palestinian children.
This dissertation explored the psychosocial needs and mental health and psychosocial support (MHPSS) interventions of a group of Palestinian children living in the context of armed conflict and political violence. This conventional perspective has also influenced research studies of Palestinian youths. In many countries, for example, popular narratives suggest that children are unable to engage in crucial decisions that impact them. However, we must examine these prevalent narratives and seek alternative qualitative information that challenges preconceived notions about children’s abilities from an empowerment viewpoint (Langhout, 2010). With the present work, we attempted to fill this gap in literature, which has recurrently depicted and assessed children’s psychosocial needs from different perspectives, and focused on the gaps in the MHPSS interventions implemented. Community psychologists have identified numerous stakeholders that influence children’s thinking and behavior, including parents and extended family members, family advocates, teachers, mental health experts, and other adults in children’s lives. These adults are most often questioned in interviews or focus groups, and their responses are usually in response to the researcher’s conceptualization of the problem. On the other hand, children rarely participate in the interview and are not asked to assist in the formulation of the problem definition or near solution. Children’s research is usually done for them, but not with them. (Hart 2013; Langhout & Thomas, 2010). In order to challenge the traditional way of assessing the efficacy of MHPSS interventions in addressing the needs and aspirations of the Palestinian children, this research was designed to provide a more comprehensive and nuanced perspective on the MHPSS interventions in adverse contexts. More specifically, this work has aimed to outline the psychosocial needs of the children and the gaps in the MHPSS interventions that were implemented based on these needs. Within a critical framework, our research design was a qualitative study, with a sample of 131 people, including 60 children; 13 parents; 24 teachers; and 34 school counselors, principles, NGOs & INGOs workers, decision makers, expert researchers, expert in the field of mental health. The different qualitative methods adopted have allowed us to approach and explore the phenomena in two different aspects, reaching a more comprehensive understanding to the MHPSS interventions in addressing the needs and aspirations of the Palestinian children. Through the first part of exploration, we assessed the children’s psychosocial needs of the Palestinian children from different perspectives. This analysis confirmed that children’s needs must be assessed by different influences in children’s lives to have a comprehensive perspective on the psychosocial needs of the Palestinian children. Secondly, the efficacy of MHPSS interventions on children’s needs were explored in two ways. The first method included interviews with school staff, expert researchers, experts in the fields of mental health, service providers, workers in NGOs and INGOs, and decision makers. The second method included critically analyzing relevant guidance from 9 annual reports, 11 strategical plans, and 3 guidelines. The resources of the documents came from several local NGOs, INGOs, and ministries. Collectively, this exploration revealed various kinds of interventions, the most recommended interventions, why children need interventions, and gaps in MHPSS interventions. The conceptual network built from our data highlighted gaps between the different perspectives of the children’s needs. Also, gaps in MHPSS interventions were pointed out by the field workers, and there seem to be gaps in these interventions for meeting the needs and aspirations of the Palestinian children.

Abstract There is much to learn about how immigrants describe their experiences of faith in the counselling context while negotiating meaningful relationships with mental health professionals (MHPs). Here, MHPs refer to individuals in the helping profession who provide services to immigrant clients such as social workers, psychologists, clinicians, practitioners, and counsellors. For the purpose of this presentation, immigrants are viewed as persons relocating to a host country for the purpose of resettlement for a better life (Perruchoud & Redpath-Cross, 2011). In this context, faith describes one’s committed spiritual and religious belief system. Although, it is important to the wellbeing of many immigrant clients, some MHPs struggle to integrate religious faith into the counselling process. According to Plumb (2011), these challenges might be a result of limited training in the area of faith as well as lack of confidence, competence, and comfort related to faith-based practices (Plumb, 2011). These professionals also appear to lack the knowledge and skill set needed to adapt culturally appropriate faith-based interventions in their work with immigrant clients (Dixon, 2015). Many immigrants rely on such faith-based interventions as a source of internal strength and comfort to manage social inequities like racism and discrimination. As such, MHPs have a responsibility to accommodate, recognize, and consider the importance of faith-based practices and interventions when providing counselling services to diverse immigrant client populations. Therefore, the aim of this live virtual presentation session is to engage in reflective discussions with attendees that highlight the role of faith within the therapeutic relationship. The co-presenters will provide useful faith-based interventions for attendees to consider when working with immigrant clients. We will also create a culturally safe environment for attendees to discuss practical ways that they have incorporated faith-based interventions in their counselling practices. Key words: Immigrants, Faith, Faith-Based Interventions, Mental Health Professionals