Community strengthening and mental health system linking after flooding in two informal human settlements in Peru: a model for small-scale disaster response

Abstract

BackgroundMental health is an important factor in responding to natural disasters. Observations of unmet mental health needs motivated the subsequent development of a community-based mental health intervention following one such disaster affecting Peru in 2017.MethodsTwo informal human settlements on the outskirts of Lima were selected for a mental health intervention that included: (1) screening for depression and domestic violence, (2) children's activities to strengthen social and emotional skills and diminish stress, (3) participatory theater activities to support conflict resolution and community resilience, and (4) community health worker (CHW) accompaniment to government health services.ResultsA total of 129 people were screened across both conditions, of whom 12/116 (10%) presented with depression and 21/58 (36%) reported domestic violence. 27 unique individuals were identified with at least one problem. Thirteen people (48%) initially accepted CHW accompaniment to government-provided services.ConclusionsThis intervention provides a model for a small-scale response to disasters that can effectively and acceptably identify individuals in need of mental health services and link them to a health system that may otherwise remain inaccessible.

Salud mental en situaciones de desastres

“…La gravedad y probabilidad de aparición dependerá de la presencia de un trastorno afectivo previo al desastre. En un estudio se encontró que, en una muestra de 129 personas víctimas del fenómeno El Niño en el 2017, un 10 % presentaron depresión (21) .…”

Creative practice as a tool to build resilience to natural hazards in the Global South

“…Third, art and creativity can be used as an active process (where new material is created during the research) with the goal of instigating action or behavioural change in the participants in a broader sense. This is, for example, studied in education (Bequette, 2007;Silo and Khudu-Petersen, 2016;Cramer et al, 2017) and health (Schmid, 2006). In these cases, researchers often have a more active role in guiding the process, sometimes in collaboration with artist(s).…”

“…There are some examples where results are reported. In Contreras et al (2018), theatre-based workshops were a significant success, encouraging almost half of the participants to seek out government-provided health services after a disaster. However, a comparison with a control case, in which other, non-creative methods were used or in which no activity was done at all, is hardly ever done.…”

Engagement in linkage to mental health care program in the Rockaways after Hurricane Sandy

“…When mental health in a postdisaster context is addressed, interventions tend to be short term and use psychological first aid, psychological debriefing, or crisis counseling to address acute mental health concerns and such interventions often lack empirical evaluation (North & Pfeffernaum, ). Few existing interventions focus on long‐term mental health care, and of those interventions that do (Contreras et al., ; Hamblen et al., ), engagement in those programs has not been evaluated. As such, this present study aimed to evaluate Project Restoration's Linkage to Care (L2C) program's success in linking individuals with mental health care and to better understand the participant characteristics associated with acceptance of and attendance at mental health treatment in the wake of Hurricane Sandy.…”