SeriesMental health and psychosocial support in humanitarian settings: linking practice and research
Section snippets
MHPSS practices
To assess which MHPSS practices are common, we reviewed documents disseminated on the internet, within organisations, or to donors, to identify reports of implemented programmes (webappendix p 3). We selected countries that had had a humanitarian crisis (including natural or technological disasters, and armed conflicts) between Jan 1, 2007, and Sept 20, 2010, using four databases: the Uppsala Conflict Data Program,19, 20, 21 the annual Conflict Barometer,22, 23, 24 the Central Emergency Relief
Financial tracking
We searched the Financial Tracking Service and Creditor Reporting System databases, in accordance with the approach used in other financial tracking efforts (for global health,29 reproductive health in conflict-affected settings,30 and maternal, newborn, and child health31). The databases provide specific codes for some health specialties (eg, reproductive health) but not for mental health. Using the list of countries affected by humanitarian crises identified in the grey literature review, we
The evidence for MHPSS
To identify studies assessing MHPSS in humanitarian settings, we did a systematic review and meta-analysis separate from our review of the grey literature (panel). Studies were identified in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.46 For the systematic review, randomised controlled trials (RCTs) or controlled clinical trials were included (ie, studies that compared any mental health or psychosocial support practice with either
Study selection
Figure 1 shows the selection criteria for the systematic review and meta-analysis (for selected characteristics of included studies see webappendix pp 8–15). All identified studies were categorised according to intervention goals (figure 2) as described in the intervention pyramid of the IASC MHPSS and Sphere guidelines.73 We did not identify studies that assessed MHPSS at the lowest level of the IASC pyramid—social considerations in basic services and security (eg, promotion of participation
Meta-analysis of RCTs
In total, 13 studies met the inclusion criteria: six in children and adolescents, and seven in adults (figure 1). The studies in children and adolescents focused mainly on two school-based interventions (ERASE Stress62 and the classroom-based intervention57, 58, 59, 60) that had PTSD as one of the primary outcomes. Other studies were of a parenting intervention and basic medical support for young children in Bosnia and Herzegovina (including both outcomes for parents and children)56 and
Conclusion
The main strength of this review is that it provides a comprehensive overview of implemented practice, funding, and synthesis of evidence for psychological interventions with rigorous standards of systematic review and meta-analysis. Our findings had the following limitations. First, our grey literature search included only reports in English. Second, the financial tracking might provide an incomplete account of funding for MHPSS. No dedicated code for MHPSS funding exists in the relevant
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