Article type
Abstract
Background: The incidence of events leading to humanitarian emergencies has increased four-fold in the past 25 years (Guha-Sapir D et al. 2015). Humanitarian emergencies can have a direct impact on the psychological well-being and mental health of people affected by humanitarian emergencies. There is a growing need to identify and develop culturally relevant effective Mental Health and Psychosocial Support (MHPSS) programmes deemed to be appropriate in humanitarian crises.
Objectives: To conduct a systematic review to investigate the (un)intend effects of MHPSS programmes on people affected humanitarian emergencies in low- and middle-income countries.
Methods: A comprehensive search of electronic databases and hand searching of grey literature was completed in 2016. We extracted data, assessed risk of bias, and performed a meta-analysis of randomised-controlled trials (RCTs) on the impact of MHPSS programmes on children and young people (CYP) and adults.
Results: We included 46 RCTs (Children n=26; Adults n =20) in the meta-analysis. The findings suggest that MHPSS programmes may be effective in reducing the symptoms of post-traumatic stress disorder (PTSD) for CYP (SMD = -0.46; 95% CI: -0.69 to -0.24) and for adults (SMD = -0.75; 95% CI: -0.997 to -0.5), depression for adults (SMD =-1.18; 95% CI = -1.65 to -0.71). Narrative Exposure Therapy is effective in reducing depression and anxiety symptoms for adults but have no impact on PTSD symptoms on CYP. Psychosocial interventions may lead to an increased level of depression symptoms and decrease pro-social behaviours in CYP. There is evidence to suggest that programme intensity and the follow-up period are associated with the effect of MHPSS programmes on PTSD and depression for CYP.
Conclusions: MHPSS programmes should consider adjusting to the local context and to ensure that they address and meet the needs of populations. Additional consideration should be given the possibility of harm, as there are indications of unintended effects in delivering programmes to children and young people.
Objectives: To conduct a systematic review to investigate the (un)intend effects of MHPSS programmes on people affected humanitarian emergencies in low- and middle-income countries.
Methods: A comprehensive search of electronic databases and hand searching of grey literature was completed in 2016. We extracted data, assessed risk of bias, and performed a meta-analysis of randomised-controlled trials (RCTs) on the impact of MHPSS programmes on children and young people (CYP) and adults.
Results: We included 46 RCTs (Children n=26; Adults n =20) in the meta-analysis. The findings suggest that MHPSS programmes may be effective in reducing the symptoms of post-traumatic stress disorder (PTSD) for CYP (SMD = -0.46; 95% CI: -0.69 to -0.24) and for adults (SMD = -0.75; 95% CI: -0.997 to -0.5), depression for adults (SMD =-1.18; 95% CI = -1.65 to -0.71). Narrative Exposure Therapy is effective in reducing depression and anxiety symptoms for adults but have no impact on PTSD symptoms on CYP. Psychosocial interventions may lead to an increased level of depression symptoms and decrease pro-social behaviours in CYP. There is evidence to suggest that programme intensity and the follow-up period are associated with the effect of MHPSS programmes on PTSD and depression for CYP.
Conclusions: MHPSS programmes should consider adjusting to the local context and to ensure that they address and meet the needs of populations. Additional consideration should be given the possibility of harm, as there are indications of unintended effects in delivering programmes to children and young people.