FY 13: Evaluating a Comprehensive Mental Health and Psychosocial Support Services for Vulnerable Refugees (International Medical Corps)

Bureau of Population, Refugees, and Migration
July 15, 2014


Report

PROJECT OVERVIEW

Refugees are frequently exposed to distressing events prior to, during, and after displacement to host countries and often have multiple and complex needs to access services and opportunities. The past decade has seen an increased awareness of mental health as a global public health issue and has pointed to significant needs for more resources and intervention research. There are a limited number national community mental health centers throughout Jordan, and the number of governmental primary health care staff trained in mental health care is low. PRM funded International Medical Corps (IMC) to assess comprehensive mental health service provision programming aimed at refugees and the vulnerable host population in Jordan.

GOALS AND OBJECTIVES

  • Develop a comprehensive and standardized Mental Health Case Management (MHCM) training package and accompanying monitoring and evaluation tools
  • Evaluate comprehensive mental health services
  • Share project evaluation results with national and global stakeholders and audiences
  • Raising awareness about the potential utility and significance of the mental health case management approach for refugees and other population

Project reports and tools will be disseminated with the goals of informing other organizations (e.g. local and international NGOs) and agencies (e.g. WHO, UNHCR) about the mental health case management approach, which can inform their own work in providing or supporting comprehensive services to refugees and the vulnerable host population.

KEY FINDINGS

IMC developed a unique MHCM model that integrates social work case management with the urgent need to treat mental health conditions. While the individual client’s protection is prioritized, case workers also empower them through their own health care decision-making. The six stages of the management process are: Intake, Assessment, Planning, Referral, Monitoring, and Discharge. These may be implemented through direct services or indirect services- at the case manager’s referral.

The study found that among the adult refugee population the most common mental health diagnoses were related to mood and anxiety, psychosis, acute stress and adjustment, and epilepsy. The sample included both urban and camp refugee populations and it was the latter that showed higher functioning scores after the course of treatment.

IMC found that the stigma surrounding mental health impeded the refugees’ access to healthcare. During interviews families expressed resentment toward survey questions including mental health terminology and the suggestion that a family member would be affected. Interviewers found that some families had even prevented a member from seeking treatment.

RECOMMENDATIONS

  • Allow flexibility and time in comparing different humanitarian aid settings. In this case, the Azraq and Za’atari camps did not function as comparison sites as planned due to changing economic, political, and societal factors;
  • Data collectors must be sensitive and culturally-aware while engaging the community due to the aforementioned mental health stigma in addition to the negative reception of being labeled a “refugee”;
  • Engage community members and leaders in order to design the most respectful research methods and data collections;
  • Create mental healthcare partnerships which are hosted by existing primary healthcare services in order to reduce stigma;
  • Coordinate regularly with academic partners, donors, and in-country team.