@article{ref1,
title="A call for greater conceptual clarity in the field of mental health and psychosocial support in humanitarian settings",
journal="Epidemiology and psychiatric sciences",
year="2021",
author="Galappatti, A. and Miller, K. E. and Tol, W. A. and Jordans, M. J. D.",
volume="30",
number="",
pages="e5-e5",
abstract="AIMS: 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. <br><br>METHODS: 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. <br><br>RESULTS: 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. <br><br>CONCLUSIONS: 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.<p /> <p>Language: en</p>",
language="en",
issn="2045-7960",
doi="10.1017/S2045796020001110",
url="http://dx.doi.org/10.1017/S2045796020001110"
}