Improving adolescent mental health and protection in humanitarian settings

Longitudinal findings from a multi‐arm randomized controlled trial of child‐friendly spaces among South Sudanese refugees in Uganda

Bibliographic Data

ID21344282
AuthorsJanna Metzler (0000-0002-3699-1323, Columbia University Mailman School of Public Health New York NY USA, corresponding author), Terry Saw (Columbia University Mailman School of Public Health New York NY USA), Denis Nono (0000-0002-7021-4368, AfriChild Center for the Study of the African Child Makerere University New York NY USA), Agatha Kadondi (World Vision Uganda Kampala Uganda), Yuan Zhang (0000-0002-0902-9585, Columbia University Mailman School of Public Health New York NY USA), Cheng‐Shiun Leu (0000-0002-0301-8316, Columbia University Mailman School of Public Health New York NY USA), Aimyleen Gabriel (World Vision UK Milton Keynes UK), Kevin Savage (0000-0002-1541-5060, World Vision International Geneva Switzerland), Cassie Landers (Columbia University Mailman School of Public Health New York NY USA)
Year2023
Volume64
Issue6
Pages907-917
Publication date2023-06-01
Open AccessYes
TypeARTICLE
VenueJournal of Child Psychology and Psychiatry (JOURNAL)
Journal identifiersISSN: 0021-9630 • E-ISSN: 1469-7610
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jcpp.13746
PMID36593181
OpenAlexW4313453335
LanguageEN
Citations received3
References cited11

BACKGROUND: The effects of conflict and displacement on adolescent mental health and protection are profound and can have lasting consequences. We aimed to investigate the effectiveness of two group-based psychosocial interventions on mental health and protection of South Sudanese refugee adolescents. METHODS: A randomized controlled trial was done in four villages within the Omugo extension of Rhino Camp refugee settlement in the West Nile region of Uganda. Male and female adolescents (aged 9-14 years) were randomly assigned to attend 12 weeks of either a Standard psychosocial intervention delivered in a child-friendly space (CFS) or a more structured sequential delivery of psychosocial sessions guided by a newly developed Toolkit for Child-Friendly Spaces in Humanitarian Settings. The primary outcomes were psychological distress and resilience 12 months after baseline assessment. The trial is registered with ClinicalTrials.gov, NCT03897894. RESULTS: Between May 28, 2019, and February 20, 2020, 1,280 eligible adolescents were recruited. With 70.2% retention at follow-up, 214 assigned to the Standard, 211 assigned to the Toolkit, and 370 assigned to the waitlist control were included in the intention-to-treat and as-treated analysis. Both the Toolkit and Standard approaches were more effective in reducing psychological distress and perceived protection risks reported by adolescents compared to no intervention. Differential intervention impacts are indicated in subgroup analyses. CONCLUSIONS: The trial found that both psychosocial interventions when implemented in a CFS are well suited as a first-line mental health and violence prevention intervention for adolescent populations exposed to conflict and forced displacement. Where feasible, CFS should be implemented as a primary response strategy soon after displacement to improve psychological health and reduce the risk environment for adolescents

Distress · Intervention (counseling) · Mental health · Psychiatry · Psychological intervention · Psychosocial · Randomized controlled trial · Refugee · Child Abuse and Trauma · Clinical Psychology · Medicine · Migration, Health and Trauma · Posttraumatic Stress Disorder Research · Psychology

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