{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:27Z","timestamp":1787027307170,"version":"build-2736575974"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Community-level mental health and psychosocial support (MHPSS) was the first type of MHPSS program launched by the International Committee of the Red Cross (ICRC) back in 2004. Standardized beneficiary-level monitoring was put in place in late 2018. This is the first study to explore whether this type of program correlates, as intended, with reduced psychological distress and increased daily functioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between December 2018 and June 2020, 6,413 victims of violence received MHPSS through 32 community-level projects in the Democratic Republic of the Congo (DRC), Mali and Nigeria. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention and logistical regression models were used to identify predictors of these symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Victims of the violence committed by weapon bearers were more likely to show high levels of anxiety prior to MHPSS (aOR 3.51;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.0001). Also, victims of physical violence were more likely to show high levels of stress (aOR 1.49;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.0001), whereas victims who had witnessed physical violence were more like to report high levels of depression (aOR 2.54;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.0001). The most common perpetrators were weapon bearers (76%) and the most common type of violence was rape (46%). Lack of social support stood out as a predictor of both high anxiety (aOR 2.10;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.0001) and post-traumatic stress (aOR 2.04;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.0001) prior to MHPSS. Following MHPSS, the vast majority of beneficiaries reported a reduction in distress on the DASS21 (96.58%) and the IES-R scales (92.70%) as well as an increase of functioning (82.26%). Adherence to group therapy (seven sessions on average) was stronger than adherence to individual therapy (four sessions on average). A linear trend was found between length of treatment and likelihood of reporting reduced symptoms of depression. Having suffered destruction or loss of property or income predicted less improvement of functioning following MHPSS (aOR 0.90;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Receiving community-level MHPSS is associated with increased wellbeing among the vast majority of beneficiaries. To further enhance the intended health outcomes, it is recommended to increase the length of treatment per beneficiary (30 days minimum) and address, where relevant, the financial consequences of violence. Also, a longitudinal study is recommended to assess longer-term changes in MHPSS symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2022.815222","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T16:42:51Z","timestamp":1648572171000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Community-Level Mental Health and Psychosocial Support During Armed Conflict: A Cohort Study From the Democratic Republic of the Congo, Mali, and Nigeria"],"prefix":"10.3389","volume":"10","author":[{"given":"Ida","family":"Andersen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ives","family":"Hubloue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"B1","unstructured":"Geneva: International Committee of the Red Cross.2021"},{"key":"B2","unstructured":"GenevaInternational Committee of the Red CrossViolences sexuelles au Congo (RDC): les victimes sur le banc des accus\u00e9s2007"},{"key":"B3","volume-title":"Clinical Management of Rape and Intimate Partner Violence Survivors: Developing Protocols for Use in Humanitarian Settings","year":"2020"},{"key":"B4","unstructured":"GenevaInternational Committee of the Red Cross2008"},{"key":"B5","volume-title":"A Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support Programmes in Emergency Settings","year":"2017"},{"key":"B6","unstructured":"GenevaInternational Committee of the Red CrossThe International Red Cross and Red Crescent Movement2021"},{"key":"B7","volume-title":"Monitoring and Evaluation Framework for Psychosocial Support Interventions","year":"2017"},{"key":"B8","volume-title":"International Red Cross and Red Crescent Movement Policy on Addressing Mental Health and Psychosocial Needs","year":"2019"},{"key":"B9","unstructured":"GenevaInternational Committee of the Red CrossGlossary: Distinction2021"},{"key":"B10","doi-asserted-by":"publisher","first-page":"892","DOI":"10.3389\/fpubh.2020.591369","article-title":"Integrating mental health and psychosocial support into health facilities in conflict settings: a retrospective review from six african countries","volume":"8","author":"Andersen","year":"2020","journal-title":"Front Public Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1177\/1044389419841688","article-title":"Is solution-focused brief therapy evidence-based? An update 10 years later","volume":"100","author":"Kim","year":"2019","journal-title":"Fam Soc."},{"key":"B12","doi-asserted-by":"publisher","first-page":"143","DOI":"10.37898\/spc.2019.4.2.0065","article-title":"Solution-focused brief therapy and spirituality","volume":"4","author":"Yakup","year":"2019","journal-title":"Spirit Psychol Counsel."},{"key":"B13","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1093\/aje\/kwf182","article-title":"Socioeconomic inequalities in depression: a meta-analysis","volume":"157","author":"Lorant","year":"2003","journal-title":"Am J Epidemiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3389\/fpsyt.2018.00433","article-title":"Psychiatric disorders in refugees and internally displaced persons after forced displacement: a systematic review","volume":"9","author":"Morina","year":"2018","journal-title":"Front Psychiatry."},{"key":"B15","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.1017\/gmh.2015.26","article-title":"Post-traumatic stress disorder and major depression in conflict-affected populations: an epidemiological model and predictor analysis","volume":"3","author":"Charlson","year":"2016","journal-title":"Glob Ment Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1002\/da.20730","article-title":"Gender differences in depression and PTSD symptoms following combat exposure","volume":"27","author":"Luxton","year":"2010","journal-title":"Depress Anxiety."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11604\/pamj.2018.29.26.7107","article-title":"\u00c9tats de stress en consultation externe \u00e0 l'h\u00f4pital g\u00e9n\u00e9ral de Bangui dans un contexte de conflit arm\u00e9: \u00e9tude transversale descriptive","volume":"29","author":"Mpembi","year":"2018","journal-title":"Pan Afr Med J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1002\/jts.20557","article-title":"Multiple trauma and mental health in former Ugandan child soldiers","volume":"23","author":"Klasen","year":"2010","journal-title":"J Trauma Stress."},{"key":"B19","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1111\/j.1469-7610.2012.02620.x","article-title":"Research review: psychosocial adjustment and mental health in former child soldiers\u2013a systematic review of the literature and recommendations for future research","volume":"54","author":"Betancourt","year":"2013","journal-title":"J Child Psychol Psychiatry."},{"key":"B20","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.puhe.2016.07.019","article-title":"Physical, mental and social consequences in civilians who have experienced war-related sexual violence: a systematic review (1981\u20132014)","volume":"142","author":"Ba","year":"2017","journal-title":"Public Health."},{"key":"B21","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s11524-007-9229-8","article-title":"Witnessing community violence in residential neighborhoods: a mental health hazard for urban women","volume":"85","author":"Clark","year":"2008","journal-title":"J Urban Health."},{"key":"B22","unstructured":"Geneva: International Committee of the Red Cross2021"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-020-00266-0","article-title":"Mental health and psychosocial support for families of missing persons in Sri Lanka: a retrospective cohort study","author":"Andersen","year":"2020","journal-title":"Confl Health."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1016\/j.chiabu.2014.04.003","article-title":"The mediating role of stigmatization in the mental health of adolescent victims of sexual violence in Eastern Congo","volume":"38","author":"Verelst","year":"2014","journal-title":"Child Abuse Negl."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.815222\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T16:43:02Z","timestamp":1648572182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.815222\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,28]]},"references-count":24,"alternative-id":["10.3389\/fpubh.2022.815222"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.815222","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-1049021\/v1","asserted-by":"object"}]},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,28]]},"article-number":"815222"}}