Reducing Psychological Distress and Intimate Partner Violence Among Forced Migrants 

To improve psychological well-being and reduce intimate partner violence (IPV) among forced migrants in Ecuador and Panama, HIAS, an international humanitarian mental health and psychosocial support (MHPSS) implementing agency, in partnership with Columbia University and Johns Hopkins Bloomberg School of Public Health, adapted, implemented, and evaluated an integrated psychosocial intervention. Mental health and psychosocial problems affecting migrant women are inextricable from other multisectoral priorities such as safety, security, meeting basic needs, protection from violence, and discrimination and xenophobia. Thus, a multisectoral approach to MHPSS policy is critical for impact and sustainability.   

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Feedback from the participants in the Entre Nosotros program in Ecuador

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Feedback from the participants in the Entre Nosotros program in Panama

Problem: Panamá hosts refugees and migrants from the Northern Triangle (Guatemala, Honduras, El Salvador), Nicaragua, Colombia, and Venezuela, among other countries. Ecuador has long been a host country for displaced persons from Colombia and, more recently, Venezuela. Migrants in these contexts face mental health and psychosocial problems, protection risks, and disrupted social and community support systems. Gaps in the provision of psychosocial services, despite the high prevalence of psychosocial problems and threats to the safety and well-being of refugees and migrants, persist in both countries and have been exacerbated by the COVID-19 pandemic.

Question: This work adapted Nguvu, an integrated IPV and mental health intervention, from a focused, non-specialized psychological and protection intervention into a psychosocial intervention integrated into basic, evidence-based protection services for women in forcibly displaced communities. The intervention, Entre Nosotras, was designed to address salient psychosocial needs of migrant women in these communities, namely psychological distress, lack of social support and isolation, xenophobia and discrimination, and safety and protection concerns.

Design & Methods: Entre Nosotras is a five-session intervention implemented by HIAS in 11 communities in Ecuador and Panamá. It combined elements of psychoeducation, problem solving, stress management/coping, safety planning, and mobilizing social support and resources. Entre Nosotras was delivered by pairs of trained community members to groups of 6-10 women. The study evaluated the feasibility of delivering the standard and enhanced version of the intervention in the study communities using a cluster randomized comparative effectiveness feasibility trial. Each of the communities were randomly allocated to receive the standard or the enhanced version of Entre Nosotras. 225 women were enrolled and evaluated for their psychosocial wellbeing, psychological distress, social support, coping strategies, and functioning pre-intervention, post-intervention, and five weeks after the intervention had been completed using existing survey tools.

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  • Psychological distress, depression, xenophobia and discrimination, and gender-based violence are important psychosocial problems facing migrant women in Ecuador and Panamá. 
  • It is feasible to integrate community-based participatory methodologies to design and deliver psychosocial interventions that align with the needs and preferences of populations in humanitarian settings 
  • Non-specialists can deliver a group psychosocial intervention to community members with high fidelity and competency. 
  • Mental health and psychosocial problems affecting migrant women are inextricable from other multisectoral priorities such as safety, security, meeting basic needs, protection from violence, and discrimination and xenophobia. Thus, a multisectoral approach to MHPSS policy is critical for impact and sustainability.

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Policy & Practice Achievements

HIAS implemented a cross-divisional Global Learning Group, comprised of program staff, strategy and measurement staff, and public affairs and advocacy staff, to work toward:
Evidence-Based Practice | Thought Leadership | Policy Influence | Research Capacity 

Resources 

Evaluating the feasibility of a group psychosocial intervention for migrant and host community women in Ecuador and Panamá: protocol for a multi-site feasibility cluster trial – Pilot and Feasibility Studies (2022)