Browsing by Person "Panter-Brick, Catherine"

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Improving mental health and psychosocial wellbeing in humanitarian settings: Reflections on research funded through R2HC
(BioMed Central, 2020-10-30) Tol, Wietse A.; Ager, Alastair; Bizouerne, Cecile; Bryant, Richard; El Chammay, Rabih; Colebunders, Robert; García-Moreno, Claudia; Hamdani, Syed Usman; James, Leah E.; Jansen, Stefan C. J.; Leku, Marx R.; Likindikoki, Samuel; Panter-Brick, Catherine; Pluess, Michael; Robinson, Courtland; Ruttenberg, Leontien; Savage, Kevin; Welton-Mitchell, Courtney; Hall, Brian J.; Harper Shehadeh, Melissa; Harmer, Anne; van Ommeren, Mark; Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme
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).
Insecurity, distress and mental health: Experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis
(2017-10-02) Panter-Brick, Catherine; Dajani, Rana; Eggerman, Mark; Hermosilla, Sabrina; Sancilio, Amelia; Ager, Alastair
Background: Strengthening the evidence base for humanitarian interventions that provide psychosocial support to war-affected youth is a key priority. We tested the impacts of an 8-week programme of structured activities informed by a profound stress attunement (PSA) framework (Advancing Adolescents), delivered in group-format to 12-18 year-olds in communities heavily affected by the Syrian crisis. We included both Syrian refugee and Jordanian youth. Methods: We followed an experimental design, comparing treatment youth and wait-list controls over two programme implementation cycles, randomizing to study arm in cycle 2 (ClinicalTrials.gov ID: NCT03012451). We measured insecurity, distress, mental health difficulties, prosocial behaviour and post-traumatic stress symptoms at three time-points: baseline (n = 817 youth; 55% Syrian, 43% female), postintervention (n = 463; 54% Syrian, 47% female), and follow-up (n = 212, 58% Syrian, 43% female). Regression models assessed: prospective intervention impacts, adjusting for baseline scores, trauma exposure, age, and gender; differential impacts across levels of trauma exposure and activity-based modality; and sustained recovery 1 year later. We analysed cycle-specific and cycle-pooled data for youth exclusively engaged in Advancing Adolescents and for the intent-to-treat sample. Results: We found medium to small effect sizes for all psychosocial outcomes, namely Human Insecurity (_ = -7.04 (95% CI: -10.90, -3.17), Cohen's d = -0.4), Human Distress (_ = -5.78 (-9.02, -2.54), d = -0.3), and Perceived Stress (_ = -1.92 (-3.05, -0.79), d = -0.3); and two secondary mental health outcomes (AYMH: _ = -3.35 (-4.68, -2.02), d = -0.4; SDQ: _ = -1.46 (-2.42, -0.50), d = -0.2). We found no programme impacts for prosocial behaviour or post-traumatic stress reactions. Beneficial impacts were stronger for youth with exposure to four trauma events or more. While symptoms alleviated for both intervention and control groups over time, there were sustained effects of the intervention on Human Insecurity. Conclusions: Findings strengthen the evidence base for mental health and psychosocial programming for a generation affected by conflict and forced displacement. We discuss implications for programme implementation and evaluation research. 2017 Association for Child and Adolescent Mental Health.
Living with transience in high-risk humanitarian spaces: Gendered experiences of international staff and policy implications for building resilience
(Wiley, 2020-08-10) Strohmeier, Hannah; Panter-Brick, Catherine
Being deployed in crisis zones is perilous business. To-date, little is known regarding how humanitarian workers relate social and professional goals to lived experiences of high-risk environments. In South Sudan, ranked as the most dangerous country for aid workers globally, we interviewed international humanitarian staff (n=20) to examine, using thematic and interpretative phenomenological analysis, their sense of place, wellbeing, and vocation. Subjectivities of humanitarian spaces hinged upon negotiating physical hardships and social relationships: Juba was described both as a "prison" and "party hot spot." For expatriate staff, making sense of spatial, social, and professional transience was sharply gendered and rooted in subjectivities of risk-taking, crisis-managing, and career-building. We highlight two policy measures to address the implications of transience for human wellbeing and organizational effectiveness. Efforts to support teams and structure work environments, altering the humanitarian and vocational bubble, will help build resilience at the heart of humanitarian systems.
Measuring the psychosocial, biological, and cognitive signatures of profound stress in humanitarian settings: Impacts, challenges, and strategies in the field
(BioMed Central, 2020-06-23) Panter-Brick, Catherine; Eggerman, Mark; Ager, Alastair; Hadfield, Kristin; Dajani, Rana; This research was funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme (https://www.elrha.org/project/yale-psychosocial-call2/) for a total GPB 295,131 in 2015–17 (grant #14045). Elrha aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises (elrha.org/r2hc). The R2HC programme is funded equally by the Wellcome Trust and the UK Government.
Background: Evidence of ‘what works’ in humanitarian programming is important for addressing the disruptive consequences of conflict and forced displacement. However, collecting robust scientific evidence, and ensuring contextual relevance, is challenging. We measured the biological, psychosocial, and cognitive impacts of a structured psychosocial intervention, implemented by Mercy Corps with Syrian refugees and Jordanian host-community youth. In this paper, we present a case analysis of this evaluation study and reflect on the scientific contributions of the work, the challenges experienced in its delivery, and the strategies deployed to address them.
Mental health and psychosocial support in humanitarian settings: research priorities for 2021-30.
(2023-04-25) Tol, Wietse A; Le, PhuongThao D; Harrison, Sarah L; Galappatti, Ananda; Annan, Jeannie; Baingana, Florence K; Betancourt, Theresa S; Bizouerne, Cecile; Eaton, Julian; Engels, Michelle; Hijazi, Zeinab; Horn, Rebecca; Jordans, Mark J D; Kohrt, Brandon A; Koyiet, Phiona; Panter-Brick, Catherine; Pluess, Michael; Rahman, Atif; Silove, Derrick; Tomlinson, Mark; Uribe-Restrepo, José Miguel; Ventevogel, Peter; Weissbecker, Inka; Ager, Alastair; van Ommeren, Mark
We describe an effort to develop a consensus-based research agenda for mental health and psychosocial support (MHPSS) interventions in humanitarian settings for 2021-30. By engaging a broad group of stakeholders, we generated research questions through a qualitative study (in Indonesia, Lebanon, and Uganda; n=101), consultations led by humanitarian agencies (n=259), and an expert panel (n=227; 51% female participants and 49% male participants; 84% of participants based in low-income and middle-income countries). The expert panel selected and rated a final list of 20 research questions. After rating, the MHPSS research agenda favoured applied research questions (eg, regarding workforce strengthening and monitoring and evaluation practices). Compared with research priorities for the previous decade, there is a shift towards systems-oriented implementation research (eg, multisectoral integration and ensuring sustainability) rather than efficacy research. Answering these research questions selected and rated by the expert panel will require improved partnerships between researchers, practitioners, policy makers, and communities affected by humanitarian crises, and improved equity in funding for MHPSS research in low-income and middle-income countries. [Abstract copyright: Copyright © 2023 World Health Organization. Published by Elsevier Ltd. All rights reserved. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products, or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.]
Resilience in Context: A Brief and Culturally Grounded Measure for Syrian Refugee and Jordanian Host-Community Adolescents
(Wiley, 2017-06-15) Panter-Brick, Catherine; Hadfield, Kristin; Dajani, Rana; Eggerman, Mark; Ager, Alastair; Ungar, Michael
Validated measures are needed for assessing resilience in conflict settings. An Arabic version of the Child and Youth Resilience Measure (CYRM) was developed and tested in Jordan. Following qualitative work, surveys were implemented with male/female, refugee/nonrefugee samples (N = 603, 11-18 years). Confirmatory factor analyses tested three-factor structures for 28- and 12-item CYRMs and measurement equivalence across groups. CYRM-12 showed measurement reliability and face, content, construct (comparative fit index = .92-.98), and convergent validity. Gender-differentiated item loadings reflected resource access and social responsibilities. Resilience scores were inversely associated with mental health symptoms, and for Syrian refugees were unrelated to lifetime trauma exposure. In assessing individual, family, and community-level dimensions of resilience, the CYRM is a useful measure for research and practice with refugee and host-community youth. 2017 The Society for Research in Child Development, Inc.