Practice-Driven Evaluation of a Multi-layered Psychosocial Care Package for Children in Areas of Armed Conflict

Abstract

Psychosocial and mental health service delivery frameworks for children in low-income countries are scarce. This paper presents a practice-driven evaluation of a multi-layered community-based care package in Burundi, Indonesia, Sri Lanka and Sudan, through a set of indicators; (a) perceived treatment gains; (b) treatment satisfaction; (c) therapist burden; (d) access to care; (e) care package costs. Across four settings (n = 29,292 children), beneficiaries reported high levels of client satisfaction and moderate post-treatment problem reductions. Service providers reported significant levels of distress related to service delivery. Cost analyses demonstrated mean cost per service user to vary from 3.46 to 17.32 € depending on country and specification of costs. The results suggest a multi-layered psychosocial care package appears feasible and satisfactory in reaching out to substantial populations of distressed children through different levels of care. Future replication should address therapist burden, cost reductions to increase sustainability and increase evidence for treatment efficacy.

Differences in the Association Between Childhood Trauma and BMI in Black and White South African Women

“…These guidelines recommend implementing multilayered packages of services, including preventive and treatment interventions, to take into account the diversity of mental health and psychosocial needs in humanitarian settings. The current study concerns a school-based mental health intervention implemented within a multi-layered package of services [6,7]. Within this package, the school-based intervention was aimed both at reducing psychological symptoms (treatment aim), as well as improving strengths and functioning in children with heightened symptomatology (preventive aim).…”

Interventions for Children Affected by War

“…The first used a comprehensive monitoring and evaluation framework to assess a multilevel, stepped-care package in four war-affected countries (Burundi, Indonesia, Sri Lanka, and Sudan). 78 The community-based package included interventions ranging from population-level psychoeducation to specialized referrals for children in need of psychiatric services. Primary prevention activities included building social support through group activities; a secondary preventive, classroom-based intervention was aimed at children with distress; individual psycho-social counseling was offered to those with more severe problems; and available psychiatric services were mapped to facilitate referrals.…”

Evidence-based mental health and psychosocial support in humanitarian settings: gaps and opportunities

“…Previous such collaborations have, for instance, resulted in improved knowledge on therapist burden, costs associated with care, client satisfaction with interventions, knowledge increase after training, and client flow through programmes 20. Researchers have also focused on strengthening monitoring and evaluation measures (which was considered a key priority in aforementioned consensus-based MHPSS research agenda),21 culturally sensitive measurement of mental health22 23 and functioning 24 25…”