Title:Strategies to Improve Access to Mental Health and Psychosocial
Support Among Displaced Populations in Ethiopia
Volume: 19
Author(s): M. Claire Greene*, Mara Getz, Eleanor Streicker, Priyam Thind, Eri Tayama, Kinfu Manzura Lafto, Noah Wubishet Ayele, Tinsae Abera Worku, Ryan Carson, Cécile Fanton d'Andon, Tesfahun Yilma, Milton Wainberg, Yaregal Fufa and Tsion Firew*
Affiliation:
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia
University Mailman School of Public Health, 60 Haven Avenue, New York, NY, USA
- Department of Emergency Medicine, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, USA
- Office of the Minister, Ministry of Health of Ethiopia, Addis Ababa, Ethiopia
Keywords:
Mental health, Psychosocial, Displacement, Forced migration, Mental health systems, Ethiopia
Abstract:
Background: In 2021, more than 23 million people were in need of humanitarian
assistance in Ethiopia, including four million internally displaced persons and returnees. Displaced
populations face an elevated risk of mental health and psychosocial problems, yet they
often have limited access to mental health and psychosocial support.
Objective: This study aimed to assess: 1) the mental health and psychosocial needs and resources
among displaced persons in Ethiopia; and 2) examine barriers, and facilitators, and
identify strategies to improve access to culturally appropriate mental health and psychosocial
support in this population and context.
Methods: We conducted a sequential mixed-methods assessment of mental health and psychosocial
needs and resources. First, we conducted 16 key informant interviews with those who
had experience and knowledge regarding the mental health situation of displaced persons in
Ethiopia, including mental health providers and humanitarian practitioners. Second, we conducted
an assessment of available mental health services in 15 internally displaced persons
(IDP) sites in Ethiopia along with 28 key informant interviews in this context to explore some
of the challenges and strategies to improving access to mental health and psychosocial support.
Results: Access to mental health services was limited in IDP sites. Participants identified numerous
barriers to accessing services that ranged from limited supply and fragmentation of
existing mental health services to an incongruence between formal mental health services and
explanatory models of mental illness. Strategies to address these barriers included engagement
of community members and key stakeholders (e.g., traditional and religious healers), improving
mental health literacy, strengthening referral systems and mental health capacity, and improving
coordination and integration of mental health within the national health system.
Conclusion: This study highlights several challenges and opportunities for improving access to
mental health and psychosocial support among displaced persons in Ethiopia. Efforts to bridge
gaps in access to mental health and psychosocial support must consider both systems-level
factors that influence availability as well as community factors influencing perceptions and
acceptability of services within this context.
