Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC

W.A. Tol, A. Ager, C. Bizouerne, R. Bryant, R. El Chammay, R. Colebunders, C. García-Moreno, S.U. Hamdani, L.E. James, S.C.J. Jansen, M.R. Leku, S. Likindikoki, C. Panter-Brick, M. Pluess, C. Robinson, L. Ruttenberg, K. Savage, C. Welton-Mitchell, B.J. Hall, M. Harper ShehadehA. Harmer, M. van Ommeren

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2020, The Author(s).Major knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC’s research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).
Original languageEnglish
Article number71
JournalConflict and Health
Volume14
Issue number1
DOIs
Publication statusPublished - 1 Dec 2020
Externally publishedYes

Funding

Third, there remains a knowledge gap regarding how to effectively build on local existing supports, such as religious and traditional healing and community-level social support systems, but also including professionally high-level functioning local NGOs, research teams and governing bodies. Most of the studies in the R2HC MHPSS portfolio have pragmatically adapted and evaluated interventions developed outside of the context in which they are applied. There is a tension between the need for interventions that can be rapidly adapted and deployed in new humanitarian crises, and the preference to build humanitarian programming on locally available resources that support mental health and psychosocial wellbeing. More research is needed that assesses the effectiveness of locally available and used supports, and the best processes to engage with these supports []. For example, the studies aimed at integrating mental health considerations in disaster preparedness in Haiti and Nepal build on local support practices by: encouraging community members to provide peer support to neighbors with mental health concerns; encouraging mental health-specific help-seeking with both informal and formal support networks; and recognizing the role of culturally-specific beliefs and practices. Similarly, the work of Living Peace, a local non-governmental organization working to reduce gender-based violence in Eastern DRC is collaborating with scholars from neighboring Rwanda. The Living Peace intervention works with community volunteers who are trained to guide groups of (perceived to be) violent men through 15-week group sessions attended by 15 men. The project builds on locally existing solutions and aims to evaluate its impact to identify strengths and weaknesses that can help to further improve the intervention. In both the disaster preparedness and Living Peace research projects (as well as several others), the development of initial research partnerships was supported by seed funding, so that the initial research questions were jointly developed. In Haiti, for example, the intervention curriculum built on an earlier intervention which was jointly developed with survivors of the 2010 earthquake, and included coping mechanisms drawing on local belief systems, stories, songs, dance and humor. This paper focuses on the portfolio of MHPSS research funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) program, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by Wellcome, and the UK government’s Foreign, Commonwealth and Development Office and the National Institute for Health Research. R2HC’s funding is not specific to MHPSS, but this has emerged as a key focus of funding across several research calls. The broader funding landscape for MHPSS research includes initiatives focused on global mental health interventions (i.e., not specific to humanitarian settings, such as Grand Challenges Canada Global Mental Health), as well as funding from donors with broader humanitarian, health, humanities and social sciences, global health, and mental health mandates (see e.g. the International Alliance of Mental Health Research Funders: https://iamhrf.org/ ).

FundersFunder number
disaster preparedness and Living Peace
Wellcome Trust
National Institute for Health Research

    Fingerprint

    Dive into the research topics of 'Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC'. Together they form a unique fingerprint.

    Cite this