This field report from Nepal highlights the importance of mental health and psychosocial support in ensuring justice for survivors of sexual violence and abuse. It solidifies how psychosocial support can help to improve the low rate of reporting of sexual violence and lead to higher rates of convictions of perpetrators. The Centre for Victims of Torture Nepal has supported more than 150 survivors of torture, conflict and rape to receive justice in the courts through a holistic approach with mental health and psychosocial support at its core. The organisation is presently pursuing four new cases of child sexual abuse, occurring after the 25 April 2015 earthquake, with a similar approach. Challenges remain in providing justice to survivors of violence, but supporting the survivors through a mental health and psychosocial support lens helps to mitigate these challenges, as highlighted by this case study.

This personal reflection describes how the nongovernmental organisation, TPO Uganda, tried to expand an existing programme providing psychosocial support to survivors of sexual gender based violence in refugee camps in Adjumani District to Bidibidi in Yumbe District, Uganda with an enormous group of new refugees from South Sudan. It describes the kind of (sexual) gender based violence the refugee girls and women experience, how staff try to find these women and provide support through using cognitive behavioural treatment therapy for trauma intervention. The author gives voice to the women who went through this intervention and shows the challenges staff experience in supporting new resettlements of more than 200,000 people since opening in August 2016.

Global mental health work is an emerging specialisation that focuses on serving culturally diverse populations around the world. International mental health providers often work in the settings with complex needs where they are confronted with mass trauma and human suffering. This places special demands on making independent, responsible, competent and ethical decisions in often unique circumstances. Exposure to both the incomprehensible failure of humanity and the incredible resilience of impacted populations forces professionals to re-examine their convictions and beliefs. This, in turn, opens an opportunity for profound existential discoveries about the world, their profession and themselves. This paper argues that humanitarian principles and strategic guidelines for psychosocial intervention provides the conceptual framework and operational guidance for mental health specialists to navigate ethical and moral conundrums in response to pressing humanitarian psychosocial needs, and to do this in a moral, professional, consistent and collaborative way. Further, serving vulnerable populations calls for higher standards of self-awareness and self-care ( Williams, 2012 ), with safety an imperative and burnout prevention key to professional competencies.

Evidence shows an increased risk of psychological distress and mental health problems in refugee populations. Despite this, refugees often display the ability to continue to function, to recover and live meaningful and productive lives. Parents’ mental health and coping style is significant to the mental health and wellbeing of their children. The aim of this study was to explore the coping mechanisms utilised by displaced Syrian refugees who care for children. Twenty-seven mothers and two professional aid workers in refugee camps and humanitarian contexts in Turkey and Syria participated in interviews or focus groups. Data were analysed using thematic analysis. Data were structured into three themes: adaptation to a new norm, such as acceptance, normalisation and gratitude; reaching out for support, such as in aiding problem solving and gaining support; keeping mentally strong using faith to soothe pain and to motivate to parent well. A number of themes associated with Syrian refugee coping during pre-resettlement were identified. These themes may be translated into strategies to improve culturally appropriate psychosocial interventions in such settings.

While the need for psychotherapeutic services for refugees is well documented, little is known about the acceptability and validity of these approaches, especially from refugee and staff perspectives. Qualitative studies of user experience provide critical insight into the utility of current service approaches, and is both clinically and ethically indicated. Therefore, a systematic review of client and provider experiences of psychotherapeutic services is presented (11 studies), combining thematic synthesis and meta-ethnographic approaches. Key concepts to achieving acceptable care were: mutual understanding, addressing complex needs, discussing trauma and cultural competence. Each concept was enabled, or hindered, by a set of related themes. Results found that while practical assistance and advocacy are important to refugee clients, these aspects of care should remain rooted in therapeutic processes of mutual understanding, narrative continuity and self-empowerment through self-efficacy. Further, more ethically rigorous research is still needed in this critical area.

This article describes an approach to training mental health and psychosocial support workers in post disaster areas and areas of armed conflict in single session counselling, also known as Single Session Therapy. This field report also adds further information to earlier publications on the reasons for practicing Single Session Therapy. The training here described offers the participants a systematic approach, as well as a theoretical explanation of the interdependency of three core activities of a Single Session Therapy therapist: offering recognition, psycho-education and reframing. Single Session Therapy is not only helpful for mental health and psychosocial support workers as it can be effective in restarting the development of people who have become stuck in their problems. Practicing the approach also helps workers make the best of desperate situations and enable them to continue when surrounded by hopelessness. Thus, providing training in Single Session Therapy can also work as a form of staff care.

The author describes his experience as a psychiatrist in a large psychiatric hospital near Colombo, the capital of Sri Lanka. While there, he attempted to transform the wards under his supervision into patient friendly spaces through empowering both patients and staff members. This personal reflection shows that sometimes it can be wise not to have a plan, but to make use of opportunities as they arise.