Challenges to Access to Mental Health Services in War-Affected Areas
Many children in war-affected settings with a need for psychological treatment don’t have access to mental health services. Humanitarian health organisations working in these settings tend to be confronted with many obstacles, including lack of funding to set up new mental health services, difficulties in recruiting qualified local staff, and restricted access of the refugee population to primary health care centres. These challenges are difficult to address with conventional mental health services, which tend to be provided by mental health specialists in centralised primary health care centres. In order to overcome these hurdles, this project will adapt and evaluate the existing transdiagnostic psychological treatment programme CETA (Common Elements Treatment Approach) for the delivery by trained lay counsellors over phone. If found to be effective, telephone-delivered CETA (t-CETA) will facilitate the provision of psychological intervention for children in humanitarian emergency and other low-resource settings with limited access to mental health services.
Delivering Psychological Therapy Remotely
Psychologists from Queen Mary University of London, American University of Beirut, Médecins du Monde and John Hopkins University, have created a free online resource for mental health services looking to deliver psychological therapy remotely to children amid the current Covid-19 pandemic.
Queen Mary University, American University of Beirut, and John Hopkins University co-author a guidance document
The guidance document draws on the researchers’ experience adapting an existing psychological treatment to phone delivery for Syrian refugee children living in Lebanon, which they are currently investigating as part of a clinical research study.
Whilst the resource is especially relevant for those working in refugee or other low resource settings, the researchers suggest this guidance can be adopted by children’s mental health services worldwide who are now transitioning to online or phone delivery due to Covid-19.
While some existing psychological therapies have been specifically developed for phone delivery, most of the current mental health treatments for children have been designed for face-to-face and in-person delivery and have not undergone the specific adaptation and evaluation processes for delivery over the phone or via video calls.
The resource covers topics such as developing safety protocols and managing risk over the phone, adapting therapy to maintain child engagement and tips to manage specific practical and treatment-related challenges that can arise during therapy.
Whilst the guidance proposes a number of specific solutions to support mental health services transitioning to remote delivery, the researchers outline that is important for each service to adapt these to create protocols appropriate for their specific setting, population, and type of therapy.