The impact of Mental Health and Psychosocial Support programmes on children and young people’s mental health in the context of humanitarian emergencies in Low- and Middle-Income Countries: a systematic review and meta-analysis (original) (raw)

2024, Global mental health

Humanitarian emergencies pose a significant global health challenge for children and young people's mental and psychological health. This systematic review investigates the effectiveness of mental health and psychosocial support (MHPSS) programmes delivered to children and young people affected by humanitarian emergencies in low-and middleincome countries (LMICs). Twelve electronic databases, key websites and citation checking were undertaken. Forty-three randomised controlled trials (RCTs) published in English between January 1980 and May 2023 were included in the review. Overall, the findings suggest that cognitive behavioural therapy may improve depression symptoms in children and young people affected by humanitarian emergencies. Narrative exposure therapy may reduce feelings of guilt. However, the impact of the other MHPSS modalities across outcomes is inconsistent. In some contexts, providing psychosocial programmes involving creative activities may increase the symptoms of depression in children and young people. These findings emphasise the need for the development of MHPSS programmes that can safely and effectively address the diverse needs of children and young people living in adversarial environments. Impact statements Mental health and Humanitarian Emergencies are global issues, affecting over 200 million school-aged children and young people, placing them at risk of developing mental health conditions (Wait, 2022; UNICEF, 2023). Mental Health and Psychosocial Support (MHPSS) programmes, aiming to protect, promote, prevent and/or treat mental health conditions, are considered as a key priority by international actors in humanitarian emergencies. In recent years, there have been growing interests to explore the impact of MHPSS on children and young people. Contributing to this effort, we identified 43 randomised controlled trials evaluating different types and modalities of MHPSS on a wide range of outcomes. Overall, MHPSS programmes that explicitly link thoughts, emotions, feelings and behaviour, such as cognitive behavioural programmes, can potentially improve depression symptoms. Additionally, narrative exposure therapy may contribute to the reduction in feelings of guilt. Psychosocial programmes involving creative activities indicate potential unintended effects on depression. However, evidence regarding the impact of other MHPSS modalities remains inconclusive. The lack of clear and consistent findings across MHPSS modalities underscores the importance of gaining an understanding how implementation contexts and socio-cultural dimensions may, directly and indirectly, impact children and young people's mental health and well-being. This systematic review highlights the importance of tailoring MHPSS programmes to diverse needs in order to safely and effectively promote, prevent and treat mental health conditions in children and young people affected by humanitarian crises in low-and middle-income countries.