In 2001 Save the Children and UNICEF launched new programmes in Afghanistan. The emphasis was not on mental health service delivery, but on a community-based psychosocial support strategy. The article discussed the principles of the work undertaken by the two agencies. It also explores both these research and project planning which was carried out in Kabul between 2001 and 2002.

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In this paper the possibilities are explored for integrating Western individualistic models of assessment and intervention in clinical psychology and psychotherapy into work in areas of armed conflict where the culture is predominantly collectivistic. Sri Lanka is used as a case study to provide examples and illustrate how such integration might take place. Directions for training in assessment, intervention, programme evaluation, research, teaching, and supervision are discussed.

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Little is known about the usefulness of psychiatric concepts and psychotherapeutic approaches for refugees who have experienced severe traumatic events and continue to live in stressful and potentially dangerous conditions in refugee settlements. The central goal of the Nakivale Camp Mental Health Project is to establish the usefulness of shortterm treatment approaches when applied by local paramedical personnel in a disaster region. In a randomized controlled clinical trial, the efficacy of Narrative Exposure Therapy (NET) vis-à-vis Supportive Counselling has been tested, when applied by trained paramedical personnel from within the same refugee community. Here we demonstrate the feasibility of such an approach and detail the methods and strategy for it. The project also included an epidemiological survey to ascertain the prevalence of PTSD among refugee adolescents and adults alike. Consistent with other investigations, the demographic survey revealed a high prevalence of chronic PTSD ranging from 31.1% in the Rwandan to 47% in the Somali population; even though traumatic events had on average taken place more than 9 and 11 years earlier in each case respectively. Diagnostic validity was assured using expert clinical interviews. The significant social and work-related dysfunction, a disabling consequence of PTSD, does not only impact on the life of the affected individual. Communities where a significant percentage of members are psychologically affected by past human rights violations, atrocities and war, are held back in their recovery process at many levels. Therefore mental health programmes with workable guidelines on how to treat posttraumatic symptoms, based on solid scientific research with proven effectiveness and feasibility, in particular cultural settings, must become a humanitarian priority.

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This article describes clinical supervision of counsellors as a structured process that encompasses emotional support, education and monitoring of professional performance. It is based on the experiences of the authors while supervising counsellors with limited professional education in areas of armed conflict.

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If access to appropriate mental health services is not to be limited to peopl’s ability to speak a dominant or host language used by mental health providers, an interpreter or bicultural worker will be required. This article makes suggestions for good practice in working with interpreters either in situations of ongoing-armed conflict or with asylum seekers refugees and internally displaced people who have fled from areas of armed conflict.

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This article describes a study of the prevalence of psychiatric disorders among the clients of a community mental health service in the Kakuma refugee camp in Kenya. It is based on the case logbook maintained by the nurse-manager over a period of three years. Post-traumatic stress disorder was the most common diagnosis. Findings suggest that it is feasible to establish a low-cost community mental health service in refugee camps in low-income countries such as Kenya. Such a service is likely to attract an immediate and growing demand for assistance.

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