This paper describes the use of a mixed methods design to develop the Sri Lankan Children's Daily Stressor Scale (CDSS). It briefly describes its use in a study assessing the relative contribution of daily stressors on the one hand, and war and disaster exposure on the other, to young people's mental health and psychosocial wellbeing. The authors discuss the neglect of daily stressors; the stressful social and material conditions of everyday life in settings of armed conflict and natural disaster and offer a rationale for the importance of assessing daily stressors when seeking to understand and address mental health and psychosocial needs of conflict and disaster affected youth. A central focus of the paper is on the unique value of a mixed methods approach to contextually sound measure development.

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The success of interventions to address psychosocial issues depends on effectively identifying areas in which assistance is needed, and measuring whether the intervention is providing that assistance. This study evaluates one attempt to develop a locally meaningful assessment of emotional wellbeing (the Kakuma Emotional Wellbeing Interview or KEWI) using both quantitative and qualitative methods. The KEWI was found to have good reliability and validity according to a quantitative study, but a qualitative study highlighted some challenges. The findings of this research illustrate the importance of basing an assessment of psychosocial wellbeing on the aspects of people's lives that are particularly salient to that population, and of finding a way of taking into account the circumstances in which people are actually living. If useful and accurate information is to be obtained, there is a need for real community involvement in the planning and construction of an assessment tool, as well as in the decision-making process regarding how the assessment information is to be used. In addition, a good understanding of the norms and expectations of the population in which the instrument is to be used is necessary, both for the construction of the instrument and the interpretation of results.

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Designing and implementing psychosocial intervention programmes in post conflict settings requires a breadth of knowledge of the context, circumstances, and needs of vulnerable social groups. However, mixed methods research focusing on which groups are vulnerable, and their specific psychosocial needs, is rarely conducted. This study uses historical policy discourse analysis to identify the origins of contemporary social categories related to vulnerability in Nepal, specifically caste. The policy analysis is employed to interpret cross-sectional epidemiological findings from a sample of 316 adults. Analyses test the relationship between caste and psychological morbidity, assessed with the General Health Questionnaire (GHQ-12), including potential mediators. Low caste (Dalit/Nepali) groups were found to have a 53,3 percent prevalence of psychological morbidity compared with 28,2 percent prevalence among other caste and ethnic groups (odds ratio 2,91, 95% confidence interval 1,71–4,96). Income and stressful life events partially mediate the relationship between caste and psychological morbidity. These findings are interpreted in relation to themes from the policy analysis including restrictions in social interactions, access to resources, social control and punishment, social mobility and gender relations. The study concludes with recommendations for addressing the needs of vulnerable social groups in post conflict settings.

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This paper outlines a methodology for the development of culturally sensitive measures of war problems (including psychological and behavioural problems) and wellbeing for use among refugees affected by the recently concluded civil war in Sri Lanka. These measures were derived from qualitative data collected from individuals living in areas affected by the civil war. The authors utilised a qualitative data analysis methodology, involving both open coding and thematic analysis. Examples of frequently coded nodes and questionnaire items that were developed from them are presented, and next steps (validation of the measures) are discussed.

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The capacity of the pre disaster mental health system in Pakistan was weak, and the earthquake affected areas in the North-West Frontier Province (NWFP) of Pakistan were among the most underserved areas in the country in terms of adequate mental health services. The natural disaster exposed the weaknesses in the mental health delivery system in most of these areas. This paper describes a mixed methods field based assessment to design a mental health intervention in the earthquake affected district of Mansehra of NWFP. The assessment had two objectives: 1) to get a more complete and comprehensive understanding of mental health issues and priorities in this earthquake-affected district; and 2) to help in selecting and designing mental health intervention for the earthquake affected population. Both qualitative and quantitative data were collected. Qualitative data collection methods included open-ended semi structured key informant interviews, structured focus groups, and unstructured participant observation. Quantitative data collection methods included a community survey and a multiple choice mental health knowledge test. Equal priority was given to quantitative and qualitative data collection and analysis. Both types of data were analysed separately and integrated in the final results of the assessment. The results showed that a mental health training for both primary health care staff and community volunteers was a feasible and high priority intervention to improve the mental health of the earthquake affected population in the Mansehra District. The assessment helped in selection of topics for training interventions.

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