Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries
Introduction: The International Committee of the Red Cross runs an increasing number of mental health and psychosocial programmes integrated into health facilities in conflict settings across Africa. This study looks at changes in symptoms of psychological distress and impaired functioning among pat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2020.591369/full |
| _version_ | 1818331584262045696 |
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| author | Ida Andersen Ida Andersen Rodolfo Rossi Mamie Nouria Meniko Yabutu Ives Hubloue |
| author_facet | Ida Andersen Ida Andersen Rodolfo Rossi Mamie Nouria Meniko Yabutu Ives Hubloue |
| author_sort | Ida Andersen |
| collection | DOAJ |
| description | Introduction: The International Committee of the Red Cross runs an increasing number of mental health and psychosocial programmes integrated into health facilities in conflict settings across Africa. This study looks at changes in symptoms of psychological distress and impaired functioning among patients supported through such programmes.Material and Methods: Between January and December 2019, 5,527 victims of violence received mental health and psychosocial support in 29 health facilities in Burundi, Central African Republic, Democratic Republic of the Congo, Mali, Nigeria and South Sudan. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention. Logistical regression models were used to measure associations between these symptoms and the other variables.Results: Factors associated with high distress prior to receiving support included age (peaking at 45–54 years), intervening within three months, rape, caretaker neglect, internal displacement, secondary education level and referral pathway. Anxiety levels in particular were higher among victims of violence committed by unknown civilians, the military or armed groups. Low functioning was associated with divorce, grief and violence committed by the military or armed groups. Following the intervention, the vast majority of patients reported reduced psychological distress (97.25% for IES-R and 99.11% for DASS21) and improved daily functioning (93.58%). A linear trend was found between number of individual sessions and reduction in symptoms of distress. Financial losses were associated with less reduction in symptoms of depression and stress.Discussion: To further address the mental health and psychosocial needs of victims of violence, intervening quickly and increasing the number of individual sessions per patient is crucial. This requires proximity—being in the right place at the right time—which is challenging when working in stable health structures. Symptoms of depression should not be overlooked, and financial losses must be addressed in order to holistically meet the needs of victims of violence. |
| first_indexed | 2024-12-13T13:22:10Z |
| format | Article |
| id | doaj.art-d415e2b06750487a840a0a1b043aa60e |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-13T13:22:10Z |
| publishDate | 2020-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-d415e2b06750487a840a0a1b043aa60e2022-12-21T23:44:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652020-12-01810.3389/fpubh.2020.591369591369Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African CountriesIda Andersen0Ida Andersen1Rodolfo Rossi2Mamie Nouria Meniko Yabutu3Ives Hubloue4Health Unit, International Committee of the Red Cross, Geneva, SwitzerlandResearch Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Brussels, BelgiumHealth Unit, International Committee of the Red Cross, Geneva, SwitzerlandHealth Unit, International Committee of the Red Cross, Geneva, SwitzerlandResearch Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Brussels, BelgiumIntroduction: The International Committee of the Red Cross runs an increasing number of mental health and psychosocial programmes integrated into health facilities in conflict settings across Africa. This study looks at changes in symptoms of psychological distress and impaired functioning among patients supported through such programmes.Material and Methods: Between January and December 2019, 5,527 victims of violence received mental health and psychosocial support in 29 health facilities in Burundi, Central African Republic, Democratic Republic of the Congo, Mali, Nigeria and South Sudan. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention. Logistical regression models were used to measure associations between these symptoms and the other variables.Results: Factors associated with high distress prior to receiving support included age (peaking at 45–54 years), intervening within three months, rape, caretaker neglect, internal displacement, secondary education level and referral pathway. Anxiety levels in particular were higher among victims of violence committed by unknown civilians, the military or armed groups. Low functioning was associated with divorce, grief and violence committed by the military or armed groups. Following the intervention, the vast majority of patients reported reduced psychological distress (97.25% for IES-R and 99.11% for DASS21) and improved daily functioning (93.58%). A linear trend was found between number of individual sessions and reduction in symptoms of distress. Financial losses were associated with less reduction in symptoms of depression and stress.Discussion: To further address the mental health and psychosocial needs of victims of violence, intervening quickly and increasing the number of individual sessions per patient is crucial. This requires proximity—being in the right place at the right time—which is challenging when working in stable health structures. Symptoms of depression should not be overlooked, and financial losses must be addressed in order to holistically meet the needs of victims of violence.https://www.frontiersin.org/articles/10.3389/fpubh.2020.591369/fullmental health and psychosocial support (MHPSS)sexual violenceAfricaprimary healthcare (PHC)International Committee of the Red Cross (ICRC)armed conflict |
| spellingShingle | Ida Andersen Ida Andersen Rodolfo Rossi Mamie Nouria Meniko Yabutu Ives Hubloue Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries Frontiers in Public Health mental health and psychosocial support (MHPSS) sexual violence Africa primary healthcare (PHC) International Committee of the Red Cross (ICRC) armed conflict |
| title | Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries |
| title_full | Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries |
| title_fullStr | Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries |
| title_full_unstemmed | Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries |
| title_short | Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries |
| title_sort | integrating mental health and psychosocial support into health facilities in conflict settings a retrospective review from six african countries |
| topic | mental health and psychosocial support (MHPSS) sexual violence Africa primary healthcare (PHC) International Committee of the Red Cross (ICRC) armed conflict |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2020.591369/full |
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