Individuals who experience psychological distress during acute emergencies require timely and effective psychosocial support. This study explores operational and systemic hurdles faced by mental health and psychosocial (MHPSS) practitioners worldwide to inform sustainable, contextually appropriate responses, policy development, and intersectoral collaboration.

This study utilized a mixed-method survey. Participants (N = 45) were MHPSS staff and delegates covering four continents. Quantitative data were gathered through the ranking of operational, health-system, and government-level barriers, while qualitative data from open-ended questions were analyzed using reflexive thematic analysis.

Top-ranked barriers were low awareness of the benefits of MHPSS, lack of prioritization within the health system, and absence of relevant policies for local authorities. Qualitative analyses identified themes including systemic under-prioritization, workforce quality-capacity gaps, and operational access constraints. MHPSS is frequently viewed as non-essential (a “nice-to-have” rather than lifesaving), resulting in delayed funding and fragmented coordination.

The findings aim to inform policy development and intersectoral collaboration. Recognizing MHPSS as a fundamental, lifesaving element of humanitarian efforts is essential to improve response effectiveness and foster long-term resilience. Strengthening understanding and collaboration across sectors can ensure that MHPSS is prioritized alongside physical health, ultimately promoting recovery during emergencies.

Patient satisfaction is an important indicator of mental healthcare quality. The Client Satisfaction Questionnaire-8 (CSQ-8) is widely used, but its psychometric performance and contextual relevance have not been examined in humanitarian settings.

To assess the reliability and validity of the CSQ-8 in a sample of displaced and conflict-affected Syrian mental health and psychosocial support (MHPSS) service users.

Structured telephone interviews were conducted with Syrian MHPSS service users in North-West Syria. Psychometric analysis assessed the internal consistency and construct validity of the CSQ-8. Convergent validity with therapeutic alliance was examined using the Working Alliance Inventory Short Revised. Item comprehension and contextual relevance were examined using open-ended qualitative responses.

Among 337 participants, the CSQ-8 demonstrated strong internal consistency (ω = 0.92), but suboptimal model fit (comparative fit index 0.922; Tucker–Lewis index 0.890; root mean square error of approximation 0.132). Convergent validity with therapeutic alliance confirmed the importance of service user–practitioner relationships to satisfaction. Item 4 (‘Would you recommend the service?’) and item 8 (‘Would you return to the service?’) showed large ceiling effects and weaker psychometric properties. Qualitative data indicated responses to these items were shaped by community stigma, low expectations and a lack of alternative services, rather than satisfaction. A secondary analysis of the CSQ-4 showed good reliability (ω = 0.81) and improved model fit (comparative fit index 0.993; Tucker–Lewis index 0.980; root mean square error of approximation 0.065).

In this humanitarian setting, items about a willingness to recommend and intent to return to a service may lack conceptual validity and should be used cautiously. Shorter forms such as the CSQ-4 may be a useful alternative.

Haiti is experiencing a severe humanitarian crisis characterised by political instability and economic and security hardship. These adversities contribute to significant mental health challenges, which are also exacerbated by poor access to psychological support due to a shortage of specialised professionals. Problem Management Plus (PM+), a scalable and low-intensity intervention developed by the World Health Organization, is based on a task-sharing approach to address the treatment gap by training non-specialist helpers to provide psychosocial support.

This study aimed to explore the implementation process of PM+ in Haiti, focusing on the barriers and facilitators that influenced its delivery. Specifically, the study focused on understanding the contextual factors affecting intervention accessibility, participant experiences and potential adaptations to enhance its effect.

A qualitative study was conducted across three Haitian cities, where trained helpers delivered PM+. Data were collected through the PSYCHLOPS tool with end-users and via cognitive interviews with stakeholders. Thematic analysis was conducted incorporating Lund’s social determinants of mental health model and Bronfenbrenner’s ecological systems theory to interpret findings.

Sixteen end-users and five stakeholders participated in the study. Key barriers to implementation and its success mainly included economic constraints and safety concerns. Facilitating factors included strong community engagement, adaptive implementation strategies (such as flexible scheduling, remote supervision and culturally responsive adjustments), alongside strong organisational support. End-users described substantial difficulties in managing everyday problems and emotional distress, as reported during pre-intervention qualitative assessments.

PM+ appeared feasible in the Haitian context from an implementation perspective; however, its implementability depends on cultural adaptations, economic considerations and sustained support for facilitators. Addressing systemic barriers and integrating task-sharing interventions within existing health structures could enhance the long-term impact.

Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.

This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.

MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.

A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).

This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.

No significant relationships.

When the Interagency Standing Committee (IASC) adopted the composite term mental health and psychosocial support (MHPSS) and published its guidelines for MHPSS in emergency settings in 2007, it aimed to build consensus and strengthen coordination among relevant humanitarian actors. The term MHPSS offered an inclusive tent by welcoming the different terminologies, explanatory models and intervention methods of diverse actors across several humanitarian sectors (e.g., health, protection, education, nutrition). Since its introduction, the term has become well-established within the global humanitarian system. However, it has also been critiqued for papering over substantive differences in the intervention priorities and conceptual frameworks that inform the wide range of interventions described as MHPSS. Our aims are to clarify those conceptual frameworks, to argue for their essential complementarity and to illustrate the perils of failing to adequately consider the causal models and theories of change that underlie our interventions.

We describe the historical backdrop against which the term MHPSS and the IASC guidelines were developed, as well as their impact on improving relations and coordination among different aid sectors. We consider the conceptual fuzziness in the field of MHPSS and the lack of clear articulation of the different conceptual frameworks that guide interventions. We describe the explanatory models and intervention approaches of two primary frameworks within MHPSS, which we label clinical and social-environmental. Using the examples of intimate partner violence and compromised parenting in humanitarian settings, we illustrate the complementarity of these two frameworks, as well as the challenges that can arise when either framework is inappropriately applied.

Clinical interventions prioritise the role of intrapersonal variables, biological and/or psychological, as mediators of change in the treatment of distress. Social-environmental interventions emphasise the role of social determinants of distress and target factors in the social and material environments in order to lower distress and increase resilience in the face of adversity. Both approaches play a critical role in humanitarian settings; however, the rationale for adopting one or the other approach is commonly insufficiently articulated and should be based on a thorough assessment of causal processes at multiple levels of the social ecology.

Greater attention to the ‘why’ of our intervention choices and more explicit articulation of the causal models and theories of change that underlie those decisions (i.e., the ‘how’), may strengthen intervention effects and minimise the risk of applying the inappropriate framework and actions to a particular problem.

This paper reviews the efficacy of a community psychosocial arts program focused on building mental health capacity within post-Ebola Liberia. The aim of this paper was to evaluate the outcome effects of two groups using pre- and post-treatment data. We hypothesized that there would be a difference in symptoms pre- and post-treatment, and the longer program would yield more significant results.

There was a total of 870 child participants. Of 40 sites, 24 were selected for a 5-month treatment (TG1) while the remaining 16 sites received 3 months of treatment (TG2). Paired t tests and a mixed-model analysis of variance (ANOVA) were used to analyse pre- and post-psychological stress symptoms (PSS) for samples from both groups.

Separately, treatment group 1 (TG1) and treatment group 2's (TG2) paired t test yielded significant results (p < 0.001) for the decrease of PSS. The mixed-model ANOVA found that there were significant differences in total pre- and post-test PSS and a significant difference in PSS means over time.

Results indicated that there was a statistically significant decrease in reported symptoms in both treatment groups pre- to post-intervention and a significant difference in total symptoms over time. However, the findings do not indicate that the longer programming was statistically different compared to the shorter programming. The study presented had gaps in data, largely due to limits in research during the crisis. However, this paper provides a unique case study for challenges that can be faced for project evaluation in emergency settings.