Overview

With funding from USAID’s Center of Excellence in Democracy, Human Rights, and Governance (DRG), CIRGH assists HEARD in its efforts to strengthen the evidence base and accelerate data liberation and evidence use related to community-level mental health and psychosocial support (MHPSS) interventions.

Activities include:

  • Funding studies to understand better the effectiveness and implementation of community-level MHPSS interventions.
  • Supporting a cross-study learning collaborative to facilitate connections and coordination across study teams and between study teams and technical and policy partners at the local, national, regional, and global levels.
  • Establishing an implementation science collaborative network on MHPSS, which is connected to existing MHPSS communities of practice and networks.

IASC Levels of MHPSS Intervention

One of the biggest challenges facing survivors of torture and those living in emergency contexts is the lack of mental health care and psychosocial support. Mental health and psychosocial support interventions (MHPSS) are defined as “any type of local or outside support that aims to protect or promote psychosocial wellbeing and/or prevent or treat mental disorders.” (IASC, 2017) MHPSS interventions are commonly used by non-governmental and humanitarian organizations in challenging settings to improve psychosocial wellbeing and mental health. In many settings however, trauma-exposed individuals enter the mental health system through general community- or primary care level services, rather than through interventions explicitly targeting Victims of Torture or other trauma exposed individuals. Therefore, improving access to these services broadly will directly benefit survivors or torture and traumatic events related to war.

IASC Levels

Partnerships

Study Partners

Donor

Technical & Managerial Support

Activities

There are four studies which seek to better understand the effectiveness and implementation of community-level Mental Health and Psychosocial Support (MHPSS) interventions, with an emphasis on the PSS intervention components and impacts.

A fifth, related study is being funded by GIZ and will be implemented by War Child in Jordan. This collection of studies spans seven countries in four regions—South Asia, the Middle East, Central and South America, and Africa.

To learn more about these interventions, visit the Mental Health and Psychosocial Support Knowledge Hub.

Scientific Evaluation of the Psychosocial Impacts of Baby Friendly Spaces in Low-Resource Humanitarian Settings in Bangladesh

Lead Implementation Partner: Action Contre la Faim (ACF)

Lead Research Partner: University of Virginia (UVA) and Johns Hopkins University (JHU)

Study Setting: Bangladesh

Recognizing the critical role of maternal mental health in addressing the health and development of children in emergencies, Action Contre La Faim/Action Against Hunger (ACF) developed the Baby Friendly Spaces (BFS) program. BFS is a holistic, evidenced-based psychosocial support (PSS) program implemented as a part of child malnutrition prevention services that aims to enhance mothers’ wellbeing, internal resources, and child care practices skills in order to create a buffer against the deleterious health and developmental impacts of humanitarian crisis on children. This study will evaluate BFS’s effectiveness for improving conflict-affected mothers’ psychosocial well-being and supporting child development and growth among Rohingya mothers and children living in refugee camps in Cox’s Bazar, Bangladesh.

A mixed-method study evaluating the effectiveness of a community-based PSS intervention for communities affected by torture in Colombia

Lead Implementation Partner: Heartland Alliance International (HAI)

Lead Research Partner: La Universidad de Los Andes

Study Setting: Quibdo, Colombia

Heartland Alliance International (HAI) and La Universidad de Los Andes are investigating the effectiveness of HAI’s community-based psychosocial support (PSS) services program Alianza Con Organizaciones Por lo Emocional2 (ACOPLE) in the Pacific Coast region of Colombia. ACOPLE leverages identified community leaders, called community psychosocial agents (CPAs), who are trained and supervised by psychologists to provide non-specialized community PSS, thereby strengthening social cohesion, coping, and resilience in their own communities. Since 2010, ACOPLE has provided these mental health and PSS services to survivors of torture and trauma, primarily Afro-Colombian populations affected by violence and conflict. In response to feedback from CPAs, HAI recognized the need to adapt the ACOPLE intervention to better fit the evolving needs of participants and include a greater focus on peer support and community problem-solving. The first phase of this work will test feasibility and fidelity of the adapted intervention. After a period of adaptation based on the findings from Phase 1, the effectiveness of the finalized adapted model will be measured using a randomized controlled trial (RCT) methodology. This model could have global relevance in other countries struggling to build the capacities of communities to cope with the mental health needs stemming from ongoing and past conflict as well as systemic crime and violence.

Evaluating the implementation and effectiveness of an integrated psychosocial intervention to reduce psychological distress and intimate partner violence among forced migrants in Ecuador and Panama

Lead Implementation Partner: HIAS, Inc.

Lead Research Partner: Columbia University, University of Copenhagen

Study Setting: Ecuador, Panama

HIAS, an international humanitarian MHPSS implementing agency, in partnership with Columbia University and Johns Hopkins Bloomberg School of Public Health, will adapt, implement, and evaluate an integrated psychosocial intervention to improve psychological wellbeing and reduce intimate partner violence (IPV) among forced migrants in Ecuador and Panama. This work builds upon a prior feasibility trial which tested an integrated IPV and mental health intervention approach, called ‘Nguvu’ – the Swahili term for strength, for acceptability, relevance, and feasibility among Congolese refugees in Tanzania. A key recommendation that emerged from that trial was that integration of psychosocial and community-focused components are needed, which will be a focus of this project. This work will adapt Nguvu from a focused, non-specialized psychological and protection intervention (IASC MHPSS pyramid level 3) into a psychosocial intervention integrated into basic, evidence-based protection services for women in forcibly displaced communities (IASC MHPSS pyramid levels 1-2). Specifically, the project will integrate Psychological First Aid (PFA) to promote mental health and psychosocial wellbeing with Advocacy Counseling to reduce the frequency and severity of IPV. This work will then evaluate 1) the implementation of the integrated psychosocial and protection intervention in four complex, dynamic humanitarian settings and forcibly displaced populations in Ecuador (Guayaquil – urban, Tulcan – a border city) and Panama (Panama City – urban; Panama West – peri-urban) in the context of COVID-19, and 2) the effectiveness of the integrated psychosocial and protection intervention to improve psychosocial wellbeing and reduce IPV through strengthening linkages to community-based supports, health and protection services, and the direct provision of basic psychosocial support among forcibly displaced women in Ecuador and Panama.

Journey of Life Psychosocial Support Intervention for Conflict-Affected Populations in Uganda

Lead Implementation Partner: TPO Uganda

Lead Research Partner: Washington University in St. Louis

Other Partners: Columbia University

Study Setting: Kiryandongo, Uganda

Transcultural Psychosocial Organization (TPO) Uganda and Washington University in St. Louis are investigating the effectiveness and implementation of the Journey of Life (JoL) program in Kiryandongo, Uganda. JoL addresses the ecologies of children and adolescents by working with caregivers, educators and community members to understand the importance of their support in the protection of children. JoL focuses on addressing key preventive and curative measures for mental health and psychosocial outcomes, including improving coping skills, meaning-making, social functioning, and social capital. Previous findings have shown that JoL led to improvements in children’s access to community-based childcare centers, reduction in violence against children, reduction in child labor, and adoption of child protective practices. JoL has been implemented in various African settings; however, it has never been formally assessed in a humanitarian context. The aim of this work is to evaluate the implementation and effectiveness of the JoL intervention with a conflict-affected population living in Kiryandongo, Uganda. This research will help to establish an evidence base for psychosocial programming and community-based child protection mechanisms in humanitarian settings, especially in a context of limited, sustainable resources.

Development and Evaluation of the Nurturing Families Programme in Jordan

Lead Implementation Partner: TBD

Lead Research Partner: War Child Holland

Study Setting: Jordan

Study Overview: The study has a central family intervention component, beginning with assessment with the entire family, whereby their challenges and needs are identified jointly. This includes communication and setting common goals as a family, with some basic parenting strategies introduced to all families. Based on the results, other components of the intervention will be identified. In case of impairing distress of a caregiver, their mental health and alcohol and drug use will be assessed. In case of problematic parenting strategies, we will offer more intensive parenting support. In case of financial distress within a family, there will be referral for services such as financial coping and poverty reduction. If there is violence identified between caregivers, a referral would be made for intimate partner violence. The intervention will be targeted and non-specialist for families experiencing multiple and complex stressors and forms of distress.

Timeline: Phase 1 (Apr-Dec 2020) consists of a qualitative case-formulation approach with 10 families with poor family functioning & 10 families with high family functioning. There will be focus groups, key informant interviews, and participatory workshops, leading to the development of a theory of change in addition to the user-centred co-creation and/or systematic cultural adaptation of intervention materials and measurement tools. Phase 2 (Mar-Jun 2021) will include 10 families, including qualitative and quantitative assessments. Phase 3 (Aug 2021- Aug 2022) will consist of a feasibility study, using mixed methods longitudinal pilot RCT. There will be qualitative interview and qualitative assessments to explore measure properties, indications of effectiveness, and potential mechanisms of change. Phase 4 will focus on disseminating research publications, practice recommendations, and methodological recommendations for mixed methods research on effectiveness evaluation processes in interventions for and with conflict-affected families.

Resources

Visit the Mental Health and Psychosocial Support Knowledge Hub

MHPSS Knowledge Hub

Hosted by the Center for Innovation in Mental Health (CIMH) at the CUNY SPH, the Mental Health and Psychosocial Support (MHPSS) Knowledge Hub provides an in-depth overview of the topic area and specific interventions.

The following resources and reports provide additional information on the frameworks and programs utilized by study partners (click to download):

A Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings

Identifying research priorities for psychosocial support programs in humanitarian settings

What works in psychosocial programming in humanitarian contexts in low- and middle-income countries: a systematic review of the evidence