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Mental health in humanitarian settings | Collections | MSF Science Portal
Mental health in humanitarian settings

Mental health in humanitarian settings

Complex humanitarian emergencies and other low-resource settings can be exceedingly difficult places to provide quality mental health (MH) care. Yet these environments also often have a high burden of mental health care needs.

This collection presents a set of articles describing how MSF teams have adapted and evaluated ways of bringing clinically impactful MH care to neglected communities and patients—from forcibly displaced populations in northern Nigeria to Syrian refugees in Lebanon and typhoon survivors in the Philippines. It also highlights work on developing new tools for providing clinical supervision and for identifying those patients most in need of care in fragile settings, and on new approaches to delivering MH services during the Covid-19 pandemic.

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World NTD Day

World NTD Day

Neglected tropical diseases (NTDs) impact nearly 1.7 billion people each year, causing serious illness or lifelong disability among many—often leading to stigma and exclusion—and killing an estimated 200,000. The vast majority of sufferers live in the world’s poorest countries.


The World Health Organization’s NTD roadmap 2021-2030 aims to address 20 tropical diseases through prevention, control, elimination, and/or eradication. But despite some progress, reaching all its targets will take better, far more accessible diagnostics and treatments along with more robust strategies, political commitment and resources.


To mark World NTD Day, this collection spotlights work by MSF and collaborators on improving approaches to snakebite envenoming, kala azar and noma. One study presents an innovative artificial intelligence-based snakebite diagnostic tool, while others evaluate shorter, less toxic drug regimens or different models of care. Several commentaries advocate for national/regional strategies adapted to contexts ranging from remote villages to active conflict zones. Another crucial factor is the climate crisis, which is intensifying the transmission and geographic spread of many NTDs.

Combatting antimicrobial resistance

Combatting antimicrobial resistance
Mini-Lab—MSF's simplified bacteriology laboratory for low-resource settings

Mini-Lab—MSF's simplified bacteriology laboratory for low-res...
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Antimicrobial resistance is a growing public health crisis, especially in countries with fragile health systems, population displacement or ongoing conflict. In 2019 antibiotic-resistant bacteria directly caused an estimated 1.27 million deaths, and contributed to 4.95 million deaths, tolls that will continue to increase if no effective action is taken.


MSF’s approach to combatting antimicrobial resistance combines three pillars: infection prevention and control, microbiology and surveillance, and rational use of antibiotics via antibiotic stewardship. Several studies characterize patterns and prevalence of antibiotic resistance among MSF patients, from civilians wounded in Middle East conflicts to hospitalized neonates in Central African Republic and Haiti. New technologies developed by MSF and partners are expanding local capacity for rapid, accurate laboratory diagnosis of infections, so that clinicians can prescribe the right antibiotic for each patient. Other work assesses the practices and challenges related to optimizing rational antibiotic use within health facilities and communities.

If you're interested in learning more about MSF's work in antimicrobial resistance, view the full list of MSF's publications on the topic.

Resistance to antibiotics is a growing public health crisis, especially in countries with fragile health systems and in regions at war. One key limitation in most of these settings is a lack of clinical bacteriology laboratory capacity, which leaves medical providers without ways to accurately diagnose patient infections and to tailor antibiotic treatment accordingly. To help fill this critical gap, MSF and partners have developed the Mini-Lab—a small-scale, standalone lab that is easy to transport, set up and operate by staff after only a short training. Its six modules are stocked with everything needed to diagnose common bloodstream and urinary tract infections and to perform antibiotic sensitivity testing using methods adapted to extremely hot climates and remote settings. With Mini-Lab now being rolled out to selected MSF projects, here we highlight the background to its development and some of the research behind the bacteriological tests it incorporates.
Journal Article
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Research

What matters in mental health care? A co-design approach to developing clinical supervision tools for practitioner competency development

Böhm B, Keane G, Karimet M, Palma M
2022-10-21 • Global Mental Health
2022-10-21 • Global Mental Health
BACKGROUND
Specialised mental health (MH) care providers are often absent or scarcely available in low resource and humanitarian settings (LRHS), making MH training and supervision f...
Journal Article
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Research

Severity, symptomatology, and treatment duration for mental health disorders: a retrospective analysis from a conflict-affected region of northern Nigeria

Torre SM, Carreño C, Sordo L, Llosa AE, Ousley J,  et al.
2022-07-15 • Conflict and Health
2022-07-15 • Conflict and Health
BACKGROUND
Mental health and psychosocial support (MHPSS) programs are essential during humanitarian crises and in conflict settings, like Nigeria’s Borno State. However, research on...
Journal Article
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Research

Shifting to tele‑mental health in humanitarian and crisis settings: an evaluation of Médecins Sans Frontières experience during the COVID‑19 pandemic

Ibragimov K, Palma M, Keane G, Ousley J, Carreño C,  et al.
2022-02-14 • Conflict and Health
2022-02-14 • Conflict and Health
BACKGROUND
'Tele-Mental Health (MH) services' are an increasingly important way to expand care to underserved groups in low-resource settings. In order to continue providing psychiat...
Journal Article
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Commentary

Competency-based mental health supervision: evidence-based tool needs for the humanitarian context

Böhm B, Palma M, Ousley J, Keane G
2021-12-31 • Global Mental Health
2021-12-31 • Global Mental Health
Journal Article
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Letter

How mental health care is changing in Cameroon because of the COVID-19 pandemic

Mviena JLM, Fanne M, Gondo R, Mwamelo AJ, Esso L,  et al.
2020-10-01 • Lancet Psychiatry
2020-10-01 • Lancet Psychiatry
Journal Article
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Research

Development of a patient rated scale for mental health global state for use during humanitarian interventions

Llosa AE, Martinez-Viciana C, Carreño C, Evangelidou S, Casas G,  et al.
2020-09-18 • International Journal of Methods in Psychiatric Research
2020-09-18 • International Journal of Methods in Psychiatric Research
OBJECTIVE
We present the results of a cross-cultural validation of the Mental Health Global State (MHGS) scale for adults and adolescents (<14 years old).

METHODS
We per...
Journal Article
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Review

A systematic review of intimate partner violence interventions focused on improving social support and/ mental health outcomes of survivors

Ogbe E, Harmon S, Van der Bergh R, Degomme O
2020-06-25 • PLOS One
2020-06-25 • PLOS One
BACKGROUND
Intimate partner violence (IPV) is a key public health issue, with a myriad of physical, sexual and emotional consequences for the survivors of violence. Social support ha...
Journal Article
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Research

Perceptions and health-seeking behaviour for mental illness among Syrian refugees and Lebanese community members in Wadi Khaled, North Lebanon: a qualitative study

Al Laham D, Ali E, Mousally K, Nahas N, Alameddine A,  et al.
2020-01-21 • Community Mental Health Journal
2020-01-21 • Community Mental Health Journal
This is a qualitative exploration of the perceptions of mental health (MH) and their influence on health-seeking behaviour among Syrian refugees and the Lebanese population in Wadi Khale...
Journal Article
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Research

Not forgetting severe mental disorders in humanitarian emergencies: a descriptive study from the Philippines

Weintraub AC, Garcia MG, Birri E, Severy N, Ferir MC,  et al.
2016-09-12 • International Health
2016-09-12 • International Health
BACKGROUND
Severe mental disorders are often neglected following a disaster. Based on Médecins Sans Frontières' (MSF) experience of providing mental health (MH) care after the 2013 t...