A closer look at evaluation challenges in post-disaster mental health and psychosocial support
Abstract as pdf
Corresponding Author:
Michel Dückers
Nivel Netherlands
m.duckers@nivel.nl
Author(s):
Background
Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, collaborating organizations manage to provide a range of support activities under the umbrella of a coherent, high-quality mental health and psychosocial support (MHPSS) programme. Objective of this contribution is to present (1) findings from a comparative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings; and (2) a synthesis of lessons and areas of attention we can learn from recent MHPSS evaluations.
Methods
The contribution is based on a combination of two studies. The first study used a theoretical framework to statistically test hypothesized relations between quality components of MHPSS programmes. The data on 40 MHPSS programmes mostly implemented in European disaster settings, was collected during the EU project “Operationalizing Psychosocial Support in Crisis” (OPSIC) (Dückers et al. 2018). The second one is a conceptual study based on a review of recent MHPSS evaluations and a summary of relevant conclusions and lessons (Dückers 2021).
Results
Several models were tested and compared in the first study. Programme coordinators were generally positive about their programmes in terms of general evaluation criteria and the realization of essential psychosocial principles. The analysis showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor coordinator perceptions concerning psychosocial principles and evaluation criteria. The second study reveals recurring shortcoming in the way MHPSS is evaluated and helps to distinguish several focal areas, evaluation criteria and contextual aspects to consider when planning and conducting evaluation research in a disaster setting.
Discussion
MHPSS evaluations need to look beyond (clinical) outcomes and apply a broader concept of the quality of mental health intervention. Moreover, evaluations need to capture the intervention context, otherwise it is tremendously difficult − not to say impossible − to make progress in formulating context-specific guidance and evidence-informed scale-up. The context might vary along the timeline of a particular event, but it remains a product of a locally unique interplay between exposure, history and culture.
Focus on human needs: Understanding good and bad practices in public health crises