Appraising Evidence-Based Mental Health and Psychosocial Support (MHPSS) Guidelines—PART I: A Systematic Review on Methodological Quality Using AGREE-HS

Abstract

In 2007, the Inter-Agency Standing Committee (IASC) published its guidelines for mental health and psychosocial support (MHPSS) in emergency situations. This was one of the first sets of MHPSS guidelines, developed during the last decades, to aid policymakers and practitioners in the planning and implementation of disaster mental health risk reduction activities. However, the potential merit of MHPSS guidelines for this purpose is poorly understood. The objective of this study is to review available MHPSS guidelines in disaster settings and assess their methodological quality. MHPSS guidelines, frameworks, manuals and toolkits were selected via a systematic literature review as well as a search in the grey literature. A total of 13 MHPSS guidelines were assessed independently by 3–5 raters using the Appraisal of Guidelines for Research and Evaluation–Health Systems (AGREE-HS) instrument. Guideline quality scores varied substantially, ranging between 21.3 and 67.6 (range 0–100, M = 45.4), with four guidelines scoring above midpoint (50). Overall, guidelines scored highest (on a 1–7 scale) on topic (M = 5.3) and recommendations (M = 4.2), while implementability (M = 2.7) is arguably the area where most of the progress is to be made. Ideally, knowledge derived from scientific research aligns with the receptive contexts of policy and practice where risks are identified and mitigated.

A quality assessment of clinical practice guidelines with recommendations for family involvement in the care of individuals diagnosed with schizophrenia, bipolar mood disorder, and major depressive disorder: Critical appraisal utilizing AGREE II

“…An evaluation of the Evidence-Based Mental Health and Psychosocial Support (MHPSS) Guidelines was conducted in 2022 by Hans te Brake and his colleagues using AGREE-HS, a quality assessment tool with five core quality items focusing on (1) topic; (2) participants; (3) methods; (4) recommendations; and (5) implementation ( 52 , 53 ) while we used the version of AGREE II that was updated on December 2018 to evaluate the guidelines. Among most included guidelines, FCCC recommendations for HCPs need considerable improvement regarding their applicability and implementation in practice.…”

Appraising Evidence-Based Mental Health and Psychosocial Support (MHPSS) Guidelines—PART II: A Content Analysis with Implications for Disaster Risk Reduction

“…The study aim is to appraise how DRR can benefit from the content of MHPSS guidelines. For this purpose, we will analyze a set of four guidelines that received the highest methodological quality scores in an accompanying review [40]. We formulated three objectives for our comparative analysis: firstly, to explore basic characteristics of the guidelines such as the intended application context, MHPSS definitions, objectives, and user and target groups; secondly, to disentangle the nature of the guidance by giving an overview of terminology, models, and recommended measures and interventions; and thirdly, to examine to what extent implementation or preparedness conditions are considered.…”

“…The overall quality level of the 13 guidelines varied considerably. The average AGREE-HS score was 45.4, with scores ranging between 21.3 and 67.6 on a scale from 0 to 100 [40]. For the current analysis, we included MHPSS guidelines scoring 50 or higher.…”

“…Additionally, whether distinct or integrated fields, MHPSS and DRR need to formulate evidence-based guidance that is generic and practically applicable at the same time. In the accompanying review of MHPSS guidelines, substantial variation in "implementability" and room for improvement was found between the guidelines [40]. The reality is that the implementation context of MHPSS guidelines is not homogenous.…”

Collecting Evidence and Testimonies of Severe Human Rights Violations – The Importance of the Mind

“…They must be seen as the probably at present most severe challenges to public mental health [5,6]. New and usually interdisciplinary strategies and interventions targeting not only individuals but communities and societies at large, might have to be developed and implemented, usually in the context of the general mental health and psychosocial services (MHPSS) approach [7,8] recommended by the UN and WHO. In spite of the development of a number of international legal and humanitarian treaty systems and instruments in humanitarian and human rights law, and of monitoring institutions such as the office of the UN High Commissioner for Human Rights, of International Criminal courts, and of offices of the UN special rapporteurs on subjects like torture, on the rights of women and children, and on genocide, the impunity of perpetrators is still a major challenge so far not sufficiently addressed in an effective way in national or international courts, except in a few exceptional cases.…”