Healing through sharing

Mirghani, Zahra

doi:10.1097/wtf.0000000000000006

Cited by 12 publications

(2 citation statements)

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“…This lack of discussion around compensation and mental health support for lay providers echoes findings in global mental health literature regarding the use of task-shifting interventions ( Hoeft et al, 2018 ; Shahmalak et al, 2019 ; Singla et al, 2017 ). In fact, supplemental studies show that when international actors merge with local organizations, they often disrupt indigenous mechanisms for mitigating the risk of vicarious trauma ( Hassan, 2013 ; Ismael, 2013 ; Mirghani, 2013 ). This issue is further exacerbated by lack of sustainable funding for the implementation of task-shifting interventions, within humanitarian settings and globally ( Singla et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Task-shifting for refugee mental health and psychosocial support: A scoping review of services in humanitarian settings through the lens of RE-AIM

Cohen

Yaeger

2021

Implementation Research and Practice

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Background: Decades of war, famines, natural disasters, and political upheaval have led to the largest number of displaced persons in human history. The refugee experience is fraught with obstacles from preflight to resettlement, leading to high rates of mental distress including post-traumatic stress disorder, depression, and anxiety. However, there is a paucity of mental health services for refugees in transit. To meet the needs of this vulnerable population, researchers are experimenting with teaching lay community members basic tools for the delivery of mental health and psychosocial support services (MHPSS). However, there are research gaps about the use of implementation science to inform the delivery of applicable interventions, especially within low resource settings, and even less in the humanitarian context. Methods: This review utilizes an implementation science framework (RE-AIM) to assess the reach, effectiveness, adoption, implementation, and maintenance of these interventions. Studies included varying interventions and modes of delivery within refugee camp and urban settings. A comprehensive search strategy led to the inclusion and analysis of 11 unique studies. Results: While current research documents adaptation strategies, feasibility, and fidelity checks through routine monitoring, there is still a dearth of evidence regarding capacity building of lay providers in humanitarian settings. Barriers to this data collection include a lack of homogeneity in outcomes across studies, and a lack of comprehensive adaptation strategies which account for culture norms in the implementation of interventions. Furthermore, current funding prioritizes short-term solutions for individuals who meet criteria for mental illnesses and therefore leaves gaps in sustainability, and more inclusive programming for psychosocial services for individuals who do not meet threshold criteria. Conclusion: Findings contribute to the literature about task-shifting for MHPSS in humanitarian contexts, especially illuminating gaps in knowledge about the lay counselor experiences of these interventions. Plain language summary: There is a growing number of refugees forced to make homes in temporary camps or urban centers as they await resettlement, a process that can last decades. These refugees are at risk of serious mental health outcomes due to ongoing stress and trauma. One strategy commonly used in global mental health is the training of lay providers to deliver basic mental health and psychosocial programming to communities. While this tactic is currently being tested in refugee settings, there is limited evidence about the implementation of this strategy. The following scoping review aims to assess the implementation of task-shifting interventions within refugee settings, through the use of a robust implementation science framework.

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Section: Discussionmentioning

confidence: 99%

Task-shifting for refugee mental health and psychosocial support: A scoping review of services in humanitarian settings through the lens of RE-AIM

Cohen

Yaeger

2021

Implementation Research and Practice

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“…Psychosocial interventions come in many forms and scales, and the services provided through these interventions vary from basic relief services (shelter, food and health) that can be provided by the average relief worker and target most of the affected population, to specialized clinical services that target specific cases (IASC, 2007, p. 12) After the invasion of Iraq in 2003, UNHCR started a community outreach initiative in Syria whereby 180 Iraqi refugee volunteers participated in bridging the gap between the organization and the refugees' community through community networking, which provided support to around 6,000 refugees every month (Mirghani, 2013).…”

Section: The Psychosocial Support Approachmentioning

confidence: 99%

Psychosocial support among refugees of conflict in developing countries: a critical literature review

Alfadhli,

Drury

2016

Intervention

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The contemporary refugee crisis: an overview of mental health challenges

2017

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There has been an unprecedented upsurge in the number of refugees worldwide, the majority being located in low-income countries with limited resources in mental health care. This paper considers contemporary issues in the refugee mental health field, including developments in research, conceptual models, social and psychological interventions, and policy. Prevalence data yielded by cross-sectional epidemiological studies do not allow a clear distinction to be made between situational forms of distress and frank mental disorder, a shortcoming that may be addressed by longitudinal studies. An evolving ecological model of research focuses on the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the background disruptions of core psychosocial systems, the scope extending beyond the individual to the conjugal couple and the family. Although brief, structured psychotherapies administered by lay counsellors have been shown to be effective in the short term for a range of traumatic stress responses, questions remain whether these interventions can be sustained in low-resource settings and whether they meet the needs of complex cases. In the ideal circumstance, a comprehensive array of programs should be provided, including social and psychotherapeutic interventions, generic mental health services, rehabilitation, and special programs for vulnerable groups. Sustainability of services, ensuring best practice, evidence-based approaches, and promoting equity of access must remain the goals of future developments, a daunting challenge given that most refugees reside in settings where skills and resources in mental health care are in shortest supply.

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Healing through sharing

Cited by 12 publications

References 0 publications

Task-shifting for refugee mental health and psychosocial support: A scoping review of services in humanitarian settings through the lens of RE-AIM

Task-shifting for refugee mental health and psychosocial support: A scoping review of services in humanitarian settings through the lens of RE-AIM

Psychosocial support among refugees of conflict in developing countries: a critical literature review

The contemporary refugee crisis: an overview of mental health challenges

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