Intervention : Table of Contents

A Randomised Controlled Trial of the I-Deal Life Skills Intervention with Syrian Refugee Adolescents in Northern Lebanon
Kenneth E Miller, Gabriela V Koppenol-Gonzalez, Ali Jawad, Frederik Steen, Myriam Sassine, Mark J.D Jordans
July-December 2020, 18(2):119-128
DOI:10.4103/INTV.INTV_4_20

Armed conflict and displacement pose threats to children’s mental health and psychosocial wellbeing. We report on the findings of an evaluation of I-Deal, a life skills intervention aimed at fostering resilience among early adolescent refugees. We used a parallel group randomised controlled trial to compare I-Deal to a structured recreational activity group (SRA). 325 adolescents in Akkar, Lebanon, 74% of them Syrian, were randomised to I-Deal or SRA. The primary outcome was psychosocial wellbeing; secondary outcomes included psychological distress, prosocial behaviour, hope, self-esteem and social connectedness. Assessments were conducted at baseline, endline and 3-month follow-up. Due to low reliabilities, only wellbeing, distress and hope were included in the analyses. These outcomes showed similar results: no statistically significant changes over time, no significant differences between groups and no significant interaction between group and time. Our findings do not support the effectiveness of I-Deal. Several factors are considered that may help explain the lack of effect, including the aspects of the intervention design, possible measurement error suggested by low reliabilities on several instruments and a ceiling effect on our primary outcome. A replication using rigorously piloted instruments, the selection of outcomes more specifically tailored to the intervention and a nonactive control condition could help provide definitive evidence regarding the effectiveness of the I-Deal intervention. Key implications for practice

This study contributes to the growing literature on the effectiveness of life skills interventions for refugee adolescents.
The lack of any intervention effects in this study raises important questions about the appropriate focus and role of preventive and promotive interventions with refugee adolescents.
Methodological issues in the study underscore the vital importance of using validated and well piloted measures of appropriately selected intervention outcomes.

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Rohingya mHealth: Investigating Mental Health in Kutupalong Refugee Camp
Lars Rune Christensen, Hasib Ahsan, Subrata Kumar Mandal
July-December 2020, 18(2):99-107
DOI:10.4103/INTV.INTV_10_20

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The Impact of a Livelihood Intervention on Psychosocial Wellbeing and Economic Empowerment in an Ongoing Conflict Setting: The Gaza Strip
Jeyda Hammad, Rachel Tribe
July-December 2020, 18(2):108-118
DOI:10.4103/INTV.INTV_35_19

The literature indicates that poverty and unemployment in conflict-affected areas are major stressors that negatively affect civilian wellbeing and mental health. Restoring livelihoods is expected to have a positive impact on wellbeing (Inter-Agency Standing Committee, 2007). There is a lack of research evaluating livelihood interventions in ongoing conflict settings. This study evaluated an economic empowerment programme (EEP) for seven young Palestinian university graduates experiencing poverty and unemployment (as per the selection criteria for the EEP), living in the Gaza Strip, occupied Palestinian territories. Semi-structured interviews were conducted. Thematic analysis was used. Three themes were identified: (1) economic empowerment, (2) psychological benefits (e.g. hope, confidence and improved morale) and (3) income generation fosters psychosocial empowerment. The evaluation findings indicated that despite the difficult economic conditions in Gaza, the EEP was found to help address psychosocial issues and reduced poverty and unemployment. It enabled participants to meet their own and their family’s basic and crucial needs, thus enabling financial survival and facilitating greater economic security. For some participants, income generation was found to increase agency, independence, social mobility, self-sufficiency and decision-making ability. The findings indicated that economic and psychological benefits were maintained 2 years 5 months after the EPP completion, including 8 months postwar. The analysis revealed that participants conceptualised empowerment as being able to work and having a livelihood and that income generation led to empowerment. The implications of this study and the relevance of the findings to mental health and disaster relief are considered, and further areas of exploration are discussed. Key implications for practice

A stand-alone livelihood intervention promotes psychosocial wellbeing and empowerment.
A local livelihood intervention appears to be viable and sustainable in reducing poverty and unemployment in an ongoing conflict setting including post-war.
Local Palestinian conceptualisations and experiences of empowerment are newly identified.

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Stories from the Field: Mapping Innovation in Mental Health During the COVID-19 Pandemic
Alisa Hamilton, Giovanni Sala, Onaiza Qureshi, Julian Eaton
July-December 2020, 18(2):159-165
DOI:10.4103/INTV.INTV_22_20

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Designing Psychosocial Support for COVID-19 Frontline Responders in Pakistan: A Potentially Scalable Self-Help Plus Blueprint for LMICs
Asma Humayun, Israr ul Haq, Faisal Rashid Khan, Sarah Nasir
July-December 2020, 18(2):150-158
DOI:10.4103/INTV.INTV_21_20

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Relatives of Enforced Disappeared Persons in Mexico: Identifying Mental Health and Psychosocial Support Needs and Exploring Barriers to Care
Geert E Smid, Margriet Blaauw, Lonneke I.M Lenferink
July-December 2020, 18(2):139-149
DOI:10.4103/INTV.INTV_55_19

In the current study, we explored the needs for psychosocial support as well as barriers to care among relatives of enforced disappeared persons in Mexico. Interviews were conducted with 29 relatives of disappeared persons as well as with representatives from seven organisations working with relatives. Needs and barriers to care mentioned by the interviewees were categorised and rated according to the frequency of mentioning. The interviewers, a psychiatrist and a medical doctor, assessed emotional distress. All interviewed relatives reported and showed signs of severe emotional distress. Frequently reported mental health symptoms included suicidal thinking, sleeplessness, anxiety, changes in appetite, intrusive memories, irritability and major role impairments. The most frequently expressed needs for psychosocial support included peer support, support when in contact with law enforcement officers, treatment of mental health conditions, religious support and family support. The most frequently encountered barriers included having a negative opinion about the quality of available services, feelings of judgement from other people (e.g., due to incrimination), lack of available services and not knowing where to get help. These findings emphasise the need to provide practical and informational support to relatives of disappeared persons as well as to provide emotional support during the entire search process for their missing relative, and beyond. Key implications for practice

There is an urgent need to provide practical and informational support to relatives of disappeared persons as well as to provide emotional and family support during the entire process of searching for the missing relative, including during contact with the law, searching, reconnection, and/or before, during and after exhumations and handing over of the remains.
Psychosocial support providers should focus on living with uncertainty and refrain from pressure for closure as well as from imposing hope as a moral imperative.
Mental health care professionals need to provide adequate treatment for common mental health conditions, including depression and posttraumatic stress disorder, within a supportive context.

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Ubwiyunge Mubikorwa (reconciliation in action): Development and Field Piloting of Action-Based Psychosocial Reconciliation Approach in post-Gacaca Rwanda
Masahiro Minami
July-December 2020, 18(2):129-138
DOI:10.4103/INTV.INTV_5_20

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From a Refugee Camp in Ethiopia as a Social Worker to Working with Refugees as an Expert Psychotherapist in Ethiopia: A Story of a South Sudanese Canadian Immigrant
Nhial Korow Wicleek
July-December 2020, 18(2):172-175
DOI:10.4103/INTV.INTV_20_20

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Systems Under Strain
Wendy Ager
July-December 2020, 18(2):97-98
DOI:10.4103/INTV.INTV_43_20

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“More Alike Than Unalike?” A Personal Reflection on Working to Support the Mental Health and Wellbeing of Unaccompanied Refugee Minors in Greece
Maria Gialama, Sinead McGilloway
July-December 2020, 18(2):166-171
DOI:10.4103/INTV.INTV_19_20

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Common Global Challenges and Common Stressors of Humanitarian Field Workers Related to the COVID-19 Outbreak
Boris Budosan
July-December 2020, 18(2):176-181
DOI:10.4103/INTV.INTV_11_20

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Call for United Nations and World Health Organization to Tackle COVID-19 Pandemic in the Conflict-Affected Parts of Libya
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
July-December 2020, 18(2):182-183
DOI:10.4103/INTV.INTV_6_20

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