Impact of the Healing in Harmony program on women's mental health in a rural area in South Kivu province, Democratic Republic of Congo

Abstract

Background To assess whether Healing in Harmony (HiH), a form of music therapy, improved women's mental health following conflict-related trauma and sexual violence in the Democratic Republic of Congo. Methods This study used a step-wedged design and included 167 women, who completed up to two pre-tests, a post-test, and up to two follow-up interviews at 3 and 6 months after completing the program. The Hopkins Symptoms Checklist was used to measure anxiety and depression. The Harvard Trauma Questionnaire was used to measure post-traumatic stress disorder (PTSD). Generalized estimating equations with unstructured covariance were used to estimate mean change in mental health scores and relative risks (RRs) for screening positive. Results Prior to starting the HiH program, 73.9, 84.2, and 68.5% screened positive with median scores being 2.20, 2.70, and 2.06 for depression, anxiety, and PTSD, respectively. The RR for screening positive declined significantly (RR = 0.49 for depression, 0.61 for anxiety, and 0.54 for PTSD) and mean scores declined significantly by −0.54, −0.67, and −0.53 points, respectively, from the pre- to the post-test, declines that were sustained at the 3-month and 6-month follow-up interviews. Conclusion The HiH program was associated with significant improvement in women's mental health that was sustained up to 6 months post completion of the program despite instability in the region and evidence of continued experience of conflict-related trauma during the study. These data support the value of providing psychological care in the context of ongoing humanitarian crises.

Mental health outcomes, literacy and service provision in low- and middle-income settings: a systematic review of the Democratic Republic of the Congo

“…Brief trauma-focused therapy appears to be effective in reducing symptoms among young people exposed to armed conflict in DRC, Iraq and the Occupied Palestinian Territory 19 . Moreover, a 12-week music session and community engagement programme led by a psychologist and music producer were associated with significant improvement in women’s mental health, which was sustained up to 6 months post-completion of the programme, despite instability in the region and evidence of continued experience of conflict-related trauma 24 .…”

“… Cikuru, J. 2021 24 South Kivu, DRC. 167 women aged 15–69 years Impact of music therapy group on women’s mental health.…”

“…Several designs were used including descriptive, correlational, causal-comparative/quasi-experimental, and experimental research. Randomized controlled trials and step-wedged design were used where participants were pre-tested and post-tested 3 and 6 months later 24 , and 8 months later 23 . Eighteen studies were cross-sectional and descriptive.…”

“…Most studies assessed depression ( n = 19), anxiety (n = 15), and PTSD ( n = 14) symptoms of their participants. For anxiety and depression, the Hopkins Symptoms Checklist (HSCL-25) was the most common measure 24 , 31 . One recent study used both Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) to assess the prevalence of depression and anxiety during the pandemic COVID-19 32 .…”

Reconstructing theory in mental health and psychosocial support and peacebuilding: Towards an integrated model for psychosocial peacebuilding

“…While clinical services remain essential for severe or specific needs, the Inter‐Agency Standing Committee (IASC) guidelines for MHPSS predominately promote basic service provision and non‐specialised community‐based support (Haroz et al, 2020). This is organised within a scaled ‘intervention pyramid’, with approaches as diverse as structured user‐guided Self‐Help Plus (Acarturk et al, 2022), music therapy (Cikuru et al, 2021), and Community‐based Sociotherapy (Dekker, 2018).…”