Self-help or silenced voices? An ethnographically informed warning

Torre, Costanza

doi:10.1016/s2214-109x(20)30106-6

Cited by 5 publications

(3 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While inclusion of cultural idioms of distress is important to understand culturally relevant outcomes, it is also important to concurrently homogenize the use of validated survey instruments to address common outcomes across studies. In addition, given the variety of interventions currently being implemented in humanitarian settings, it would be beneficial to have guidelines regarding fidelity monitoring, and areas for porosity to ensure contextually relevant adaptations ( Torre, 2020 ).…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Future studies could test pathways through variables such as employment, social discrimination, and other sources of distress to better understand risk and protection from mental health issues. Given the impeded social support systems during displacement, interventions that strengthen family and community support systems, as well as social and economic empowerment and protection, are critical to the mental health of urban refugee youth (Lahiri et al, 2017; Logie et al, 2020; Reed et al, 2012; Torre, 2020). Given the differential pathways to CMD symptoms, future research may consider more gender-responsive and locally grounded questions that consider sociocultural and structural challenges faced by urban refugees (Freedman, 2010).…”

Section: Discussionmentioning

confidence: 99%

Trauma exposure, social functioning, and common mental health disorders in Somali refugee male and female youth: An SEM analysis

Swan

2021

Int J Soc Psychiatry

View full text Add to dashboard Cite

Background: Refugee youth often face numerous adversities before and during forced migration. Although experiences vary across settings and subpopulations, common mental disorders are prevalent among refugee youth who are displaced in low- and middle-income countries. It is important to examine how risk factors are intricately linked and contribute to common mental health issues to inform clinical practice and social policy. Aims: This study aims to test the pathways from risk factors previously identified as determinants of Somali refugee youth mental health (i.e. trauma exposure, substance use, social functioning, aggression) to symptoms of PTSD, depression, anxiety, and somatic pains. Method: We collected survey data in 2013, using snowball sampling to recruit Somali refugee youth (15–35 years old) living in Eastleigh, Kenya. We ran three structural equation models to assess paths from trauma exposure to mental health symptoms, through psychosocial factors including substance use, aggression, and functional impairment. We first conducted this analysis with a mixed-gender sample ( N = 305) and then assessed gender differences by running one model for male participants ( n = 124) and another for female participants ( n = 181). Results: In the mixed-gender sample, trauma exposure directly predicted substance use and both directly and indirectly predicted aggression, functional impairment, and mental health symptoms. Substance use directly predicted aggression and functional impairment, and substance use both directly and indirectly predicted mental health symptoms. The split-gender models revealed gender differences, with only functional impairment directly predicting mental health symptoms in the male sample and with many significant direct and indirect pathways in the female sample. Conclusions: This study shows the role of trauma exposure, substance use, aggression, and social functioning in determining mental health outcomes among refugee youth and how CMD symptoms are differently manifested across genders in this population.

show abstract

“…This is compounded by a general lack of consensus on MHPSS best practices (Bangpan, Dickson, Felix, & Chiumento, 2017), including the means in which to promote longer‐term social change (Ager, 2021). For example, even evidence‐based interventions such as Self‐Help Plus (Tol et al, 2020) have been questioned for their lack of cross‐cultural applicability, top‐down implementation, and perceived propensity to de‐socialise mental distress (Torre, 2020). This is compounded by similar critiques of peacebuilding, including calls for an increased focus on the social and structural determinants of violent conflict, as well more local ownership (Mac Ginty, 2008).…”

Section: Introduction: the Need For Psychosocial Peacebuildingmentioning

confidence: 99%

Reconstructing theory in mental health and psychosocial support and peacebuilding: Towards an integrated model for psychosocial peacebuilding

Frasco,

Sherr,

Burgess

2024

Community & Applied Soc Psy

View full text Add to dashboard Cite

Despite wide agreement among practitioners on the need for integration, mental health and peacebuilding practice remain siloed in conflict‐affected contexts. Yet before the integration of these two fields should occur, a revaluation of existing practice is needed. Within the field of mental health and psychosocial support (MHPSS), critics have long questioned dominant assumptions and treatment models, raising concerns about top‐down implementation, Western‐centric approaches, and a lack of community leadership. These criticisms are largely echoed within peacebuilding literature. Furthermore, both fields underappreciate the overlap between their practices. For example, the relationship between the structural drivers of poor mental health or the social‐psychological drivers underpinning peacebuilding. Accordingly, this article seeks to contribute to the development of a novel, integrated approach to MHPSS and peacebuilding—or ‘psychosocial peacebuilding’. In doing so, we address dominant critiques of both fields, before discussing the relevance of critical (community) psychology as an ideal means in which to bridge a theoretical and practical gap between fields. Using quality peace as a guiding normative theory, we will also reinforce the argument that working to address mental health concerns is essential to creating peace in post‐conflict contexts. It concludes by exploring potential avenues for further research. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

show abstract

Self-help or silenced voices? An ethnographically informed warning

Cited by 5 publications

References 2 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

Trauma exposure, social functioning, and common mental health disorders in Somali refugee male and female youth: An SEM analysis

Reconstructing theory in mental health and psychosocial support and peacebuilding: Towards an integrated model for psychosocial peacebuilding

Contact Info

Product

Resources

About