{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:08:11Z","timestamp":1788959291206,"version":"build-2803163510"},"reference-count":37,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"unspecified","delay-in-days":70,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","award":["IS-RRT-1015-001"],"award-info":[{"award-number":["IS-RRT-1015-001"]}],"id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,8,5]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Disease outbreaks cause widespread suffering, loss of lives and significantly increase the risk of mental health and psychosocial problems. Although mental health and psychosocial support (MHPSS) plays a critical role in addressing the needs of populations affected by outbreaks, limited efforts have been made to integrate MHPSS into outbreak response mechanisms. In this study, we developed, implemented and evaluated priority MHPSS interventions to examine acceptability, feasibility and perceived benefit of MHPSS interventions as part of outbreak response in Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The interventions were implemented in Bundibugyo district, Western Uganda, from November 2024 to March 2025 and evaluated through a qualitative process evaluation. The interventions targeted primary healthcare workers, frontline responders, community leaders and district health team leaders. Study participants were selected purposively and data were collected through in-depth interviews. We used a thematic analysis combined with inductive and deductive approaches to capture emerging themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We conducted in-depth interviews with 19 purposively selected individuals representing community members, implementers and public health leaders. Participants perceived the interventions to be acceptable due to active engagement with the community leaders, community health workers, district leadership and collaboration with the local media. The findings strongly suggest that the programme was feasible because it was deliberately designed and systematically implemented with a community-driven approach. The feasibility of the programme was reflected across five key constructs: practicality, cultural appropriateness, perceived benefit, sustainability and implementation challenges. Participants reported that the interventions helped address serious mental health concerns, including reducing the risk of self-harm, suicide and stigma, while equipping frontline workers with stress management skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the high level of acceptability and feasibility reported, several challenges may hinder the uptake and scale-up of MHPSS interventions in outbreak-affected communities, particularly stigma and misconceptions surrounding mental health conditions. These challenges highlight the requirement for sustained community engagement and continuous sensitisation efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004637","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:40:33Z","timestamp":1788957633000},"page":"e004637","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Acceptability, feasibility and perceived benefits of integrating mental health and psychosocial support (MHPSS) into disease outbreak response in Western Uganda: a qualitative process evaluation study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3518-9459","authenticated-orcid":false,"given":"Biksegn Asrat","family":"Yirdaw","sequence":"first","affiliation":[{"name":"UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK"},{"name":"Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Kalani","sequence":"additional","affiliation":[{"name":"Division of Mental Health, Ministry of Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Alkasaby","sequence":"additional","affiliation":[{"name":"UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK"},{"name":"Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Health in Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4913-8505","authenticated-orcid":false,"given":"Yang","family":"Zhao","sequence":"additional","affiliation":[{"name":"UK Public Health Rapid Support Team (UK-PHRST), Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Wang","sequence":"additional","affiliation":[{"name":"UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK"},{"name":"Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Kwagala","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Mfitundinda","sequence":"additional","affiliation":[{"name":"Division of Mental Health, Ministry of Health, Kampala, Uganda"},{"name":"Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Abbo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4308-2857","authenticated-orcid":false,"given":"Farhana","family":"Haque","sequence":"additional","affiliation":[{"name":"UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Eaton","sequence":"additional","affiliation":[{"name":"UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK"},{"name":"Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026090905401706000_4.3.e004637.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2009.04.004"},{"key":"2026090905401706000_4.3.e004637.2","doi-asserted-by":"crossref","DOI":"10.1038\/s41398-022-01946-6","article-title":"Mental disorders following COVID-19 and other epidemics: a systematic review and meta-analysis","volume":"12","author":"Leung","year":"2022","journal-title":"Transl Psychiatry"},{"key":"2026090905401706000_4.3.e004637.3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S2213-2600(20)30234-4","article-title":"COVID-19 and the impact of social determinants of health","volume":"8","author":"Abrams","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2026090905401706000_4.3.e004637.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02143-7"},{"key":"2026090905401706000_4.3.e004637.5","doi-asserted-by":"crossref","first-page":"e579","DOI":"10.1016\/S2214-109X(22)00031-6","article-title":"Strengthening global health security by improving disease surveillance in remote rural areas of low-income and middle-income countries","volume":"10","author":"Worsley-Tonks","year":"2022","journal-title":"Lancet Glob Health"},{"key":"2026090905401706000_4.3.e004637.6","doi-asserted-by":"crossref","DOI":"10.1017\/S0950268819002061","article-title":"Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018 - ERRATUM","volume":"147","author":"Mboussou","year":"2019","journal-title":"Epidemiol Infect"},{"key":"2026090905401706000_4.3.e004637.7","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1001\/jamapsychiatry.2022.3109","article-title":"Association of major disease outbreaks with adolescent and youth mental health in low- and middle-income countries: a systematic scoping review","volume":"79","author":"Kumar","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"2026090905401706000_4.3.e004637.8","doi-asserted-by":"crossref","DOI":"10.1017\/gmh.2025.22","article-title":"Effectiveness of psychological crisis interventions during infectious disease outbreaks in low- and middle-income countries: a systematic review of randomized controlled trials","volume":"12","author":"Yirdaw","year":"2025","journal-title":"Cambridge Prisms Glob Ment Health"},{"key":"2026090905401706000_4.3.e004637.9","unstructured":"IASC . The mental health and psychosocial support minimum service package. Geneva, 2022."},{"key":"2026090905401706000_4.3.e004637.10","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19159313","article-title":"Challenges and opportunities for mental health and psychosocial support in the COVID-19 response in Africa: a mixed-methods study","volume":"19","author":"Walker","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026090905401706000_4.3.e004637.11","doi-asserted-by":"crossref","unstructured":"Killewo J , William B , Robinson M . One Health Central and Eastern Africa: historical and future perspectives. In: International encyclopedia of public health. 2017: 342\u20137.","DOI":"10.1016\/B978-0-12-803678-5.00512-9"},{"key":"2026090905401706000_4.3.e004637.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32520-0"},{"key":"2026090905401706000_4.3.e004637.13","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.571342","article-title":"Mental health and psychosocial support during COVID-19: a review of health guidelines in sub-Saharan Africa","volume":"12","author":"Molebatsi","year":"2021","journal-title":"Front Psychiatry"},{"key":"2026090905401706000_4.3.e004637.14","unstructured":"Zhao Y , Kalani K , Yirdaw B , et al . Planning and implementation of mental health and psychosocial support responses during infectious disease outbreak responses in Uganda: a qualitative evaluation of barriers. Cambridge Prisms: Global Mental Health 2025."},{"key":"2026090905401706000_4.3.e004637.15","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s11920-023-01426-8","article-title":"Global mental health: where we are and where we are going","volume":"25","author":"Moitra","year":"2023","journal-title":"Curr Psychiatry Rep"},{"key":"2026090905401706000_4.3.e004637.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance","volume":"350","author":"Moore","year":"2015","journal-title":"BMJ"},{"key":"2026090905401706000_4.3.e004637.17","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000388"},{"key":"2026090905401706000_4.3.e004637.18","unstructured":"Ministry of Health . National health facility master list: a complete list of all health facilities in Uganda. 2017."},{"key":"2026090905401706000_4.3.e004637.19","unstructured":"Kalani KC , Yirdaw B , Zhao Y , et al . Mental health and psychosocial support services in Uganda: mapping existing services and gaps: project report. LSHTM Archives 2025."},{"key":"2026090905401706000_4.3.e004637.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-017-2031-8","article-title":"Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework","volume":"17","author":"Sekhon","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"2026090905401706000_4.3.e004637.21","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyl081"},{"key":"2026090905401706000_4.3.e004637.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.02.002"},{"key":"2026090905401706000_4.3.e004637.23","unstructured":"World Health Organization . mhGAP humanitarian intervention guide (mhGAP-HIG): clinical management of mental, neurological and substance use conditions in humanitarian emergencies. Geneva, 2015."},{"key":"2026090905401706000_4.3.e004637.24","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1037\/pro0000469","article-title":"A systematic review of cultural competence trainings for mental health providers","volume":"53","author":"Chu","year":"2022","journal-title":"Prof Psychol Res Pr"},{"key":"2026090905401706000_4.3.e004637.25","doi-asserted-by":"crossref","unstructured":"Alkasaby M , Philip S , Douba Z , et al . Integrating mental health and psycho-social support (mhpss) into infectious disease outbreak and epidemic response: an umbrella review and operational framework. Infectious Diseases (except HIV\/AIDS) [Preprint] 2023. doi:10.1101\/2023.07.27.23293219","DOI":"10.1101\/2023.07.27.23293219"},{"key":"2026090905401706000_4.3.e004637.26","doi-asserted-by":"crossref","DOI":"10.1186\/s12992-018-0398-x","article-title":"Theory and practice of social norms interventions: eight common pitfalls","volume":"14","author":"Cislaghi","year":"2018","journal-title":"Global Health"},{"key":"2026090905401706000_4.3.e004637.27","doi-asserted-by":"crossref","unstructured":"Barsky BA , Hannah J , P\u016bras D , et al . Redefining international mental health care in the wake of the covid-19 pandemic. In: Stein MA , Mahomed F , Patel V , eds. Mental Health, Legal Capacity, and Human Rights. Cambridge: Cambridge University Press 2021:29-43, 2021: 29\u201343.","DOI":"10.1017\/9781108979016.005"},{"key":"2026090905401706000_4.3.e004637.28","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2018-000924","article-title":"Fear and culture: contextualising mental health impact of the 2014-2016 Ebola epidemic in West Africa","volume":"3","author":"O\u2019Leary","year":"2018","journal-title":"BMJ Glob Health"},{"key":"2026090905401706000_4.3.e004637.29","doi-asserted-by":"crossref","DOI":"10.1017\/S2045796021000056","article-title":"Reducing stigma and discrimination associated with COVID-19: early stage pandemic rapid review and practical recommendations","volume":"30","author":"Gronholm","year":"2021","journal-title":"Epidemiol Psychiatr Sci"},{"key":"2026090905401706000_4.3.e004637.30","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/S0140-6736(20)30634-6","article-title":"Effect of collaborative care between traditional and faith healers and primary health-care workers on psychosis outcomes in Nigeria and Ghana (COSIMPO): a cluster randomised controlled trial","volume":"396","author":"Gureje","year":"2020","journal-title":"Lancet"},{"key":"2026090905401706000_4.3.e004637.31","unstructured":"International Medical Corps UK . Guidelines for remote MHPSS programming in humanitarian settings: implement remote services.2026. Available: https:\/\/internationalmedicalcorps.org.uk\/remotemhpssguidelines\/step3\/"},{"key":"2026090905401706000_4.3.e004637.32","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h4672","article-title":"Understanding the Hawthorne effect","volume":"351","author":"Sedgwick","year":"2015","journal-title":"BMJ"},{"key":"2026090905401706000_4.3.e004637.33","unstructured":"Kalani K , et al . Designing a table-top exercise as a method to evaluate the integration of mental health and psychosocial support into outbreak preparedness and response plans in Uganda. Cambridge Prisms: Global Mental Health 2026."},{"key":"2026090905401706000_4.3.e004637.34","first-page":"37","article-title":"Integration of mental health into primary health care in Uganda: opportunities and challenges","volume":"6","author":"Kigozi","year":"2009","journal-title":"Ment Health Fam Med"},{"key":"2026090905401706000_4.3.e004637.35","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2019-002014","article-title":"Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review","volume":"5","author":"Kamali","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2026090905401706000_4.3.e004637.36","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-024-11704-7","article-title":"Integration of psychological interventions in multi-sectoral humanitarian programmes: a systematic review","volume":"24","author":"Ndlovu","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"2026090905401706000_4.3.e004637.37","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1192\/bjb.2020.35","article-title":"The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review","volume":"45","author":"Cubillos","year":"2021","journal-title":"BJPsych Bull"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-004637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:40:40Z","timestamp":1788957640000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-004637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,9]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjph-2025-004637"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-004637","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}