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Mental Health team supporting a Syrian refugee woman in a primary health centre in Bekaa

Last week we collaborated with MHPSS.net on a webinar to mark the launch of a new priority research agenda for mental health and psychosocial support (MHPSS) in humanitarian settings. Using a consultative approach, the research prioritisation came up with a list of the 20 most critical research questions needed to support humanitarian MHPSS response for a ten-year period covering 2021–2023.  MHPSS practitioners and researchers, policy makers and funders, all contributed to an initial longlist of questions. This was then further refined through a process of ranking, with inputs from the various stakeholders.  

The research prioritisation, led by PhuongThao Le and Wietse Tol, HealthRight International, used an adapted version of the CHNRI methodology used in 2011 when the first MHPSS research priorities were identified.  This time, an expanded pool of participants was involved.  

This work was commissioned by Elrha, under the auspices of the IASC Reference Group for MHPSS, and was steered by a Funding & Policy Council comprising funders and policy leaders in the field of MHPSS. The findings have been collated into an interactive data-visualisation tool. 

The panellists for the webinar were: 

  • Ananda Galappatti (Chair): Co-director, MHPSS.net
  • Wietse A. Tol: Professor of Global Mental Health, Section of Global Health, Department of Public Health, University of Copenhagen
  • PhuongThao (PT) Le: Research scientist, NYU School of Global Public Health
  • Carmen Valle-Trabadelo: MHPSS Advisor & Co-Chair, IASC Reference Group for MHPSS in emergencies
  • Sarah Harrison: Head of MHPSS Advisors Unit, International Federation of the Red Cross Red Crescent Societies (IFRC) Reference Centre for Psychosocial Support
  • Anne Harmer: Head of Research for Health in Humanitarian Crises (R2HC), Elrha
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Why the need for a new MHPSS research priority agenda?

Co-director of MHPSS.net, and the chair of the panel, Ananda Galappatti, was quick to quiz lead researchers PT Le and Wietse Tol on the need for reassessing humanitarian MHPSS research focus. Wietse explained that the MHPSS research field has expanded rapidly over the past decade, adding that sector demographics have also changed significantly in that period: “The stakeholders have changed, the people working in the field have changed,” he explained, “so we thought it was important to take a fresh look at what the priorities for research may be now; and we wanted to do that afresh with people who are representative of the field as it is right now.” 

PT and Wietse were successful in their goal to improve representation of the current MHPSS sector. They expanded their panel from 114 in 2011 to over 370 professionals in 2021, with particular focus on capturing the voices of implementers and country-level actors in order to move research closer to the field. And it was no mean feat – the increase in panel members meant that around 1,500 research questions were initially proposed. These were then grouped, consolidated, ranked, and eventually boiled down to the top 20. A full methodology report is available to those wishing to learn more about the prioritisation process.

MHPSS Set 2 Study Design and Methodology

What were the key differences between the two agendas? 

Wietse highlighted some of the contrasts between the priority research questions identified in 2011 and those identified in 2021. For instance, in 2011, there was greater emphasis on family and school-based interventions and problem analysis, both of which featured lower on the 2021-2030 priorities. Moreover, four out of the top five questions in 2011 had not even made the top 20 in 2021.  

One of the most notable changes between the two sets, according to Wietse, was a clear shift in emphasis from the effectiveness of MHPSS interventions and services, to questions around implementation and the systems through which interventions are delivered. Ananda queried whether the increase in MHPSS practitioners on the 2021 panel could have contributed to this outcome, but Wietse highlighted that practice-oriented priorities had been a characteristic of the 2011 study too, with both researchers and practitioners ranking those questions highly.  

When looking at differences between the groups of people participating in the prioritisation, Wietse noted that for policymakers, questions on digital interventions, resilience and cost-effectiveness scored higher; practitioners put greater weight on the integration of MHPSS across different sectors; and researchers emphasised questions around stakeholder participation and sustainability.  

Implementation, localisation and dissemination

The shift in priority towards implementation research over effectiveness research ignited several discussions around methodologies and how to turn this new focus into a reality. Carmen Valle suggested that linking the research to the localisation agenda was key, highlighting that these priorities offered a bridge for bringing together in-country implementers and national academic institutions. “It will offer a tool for dialogue for MHPSS colleagues at country level, and a framework for looking together at the challenges of implementation and strengthening the research capacity at country level.” 

While the shift in the agenda was highlighted as a fantastic opportunity to bring practice into research, the panellists all agreed that there are still barriers when it comes to getting research into practice. Wietse raised the point that most research is not geared towards practitioners, both in terms of where it is made available and the format it is available in. Anne Harmer added to this viewpoint, citing two Elrha commissioned reports from 2021 (a review and assessment of MHPSS intervention research in humanitarian settings and a learning paper on evidence use in the humanitarian sector), agreeing that most practice-oriented research is still not fit for purpose. She noted that more work needs to be done to understand the implications of research findings, and to translate them into clear actionable recommendations for humanitarian practitioners. 

How do different MHPSS actors plan to use these findings?  

The webinar panellists represented a range of different humanitarian MHPSS areas and were invited to share how these findings should be used within their field of expertise.  

Practitioners

As a practitioner, Sarah Harrison explained that the results instilled confidence in the IFRC’s existing MHPSS policy, which is already making headway around a number of the priority topics, including strengthening the workforce and sustainability. She noted that it is heartening to see subjects that are important to the organisation being validated. Sarah also mentioned that the results provide a strategy for the IFRC’s research network to approach donors to start getting some of this research underway, or to use existing funding to start addressing these questions in real time.  

Policymakers

Carmen Valle agreed that these questions will be an excellent advocacy tool for donors and believed that the process behind the research was as much an outcome as the results themselves. By bringing in diverse perspectives from professionals in the field and at organisation level, the IASC can advocate for this agenda being a priority for the entire sector. 

Funding bodies

Anne explained that these 20 priority research questions will be a point of reference for all funders and future funders of MHPSS research. Speaking on the benefits of having such a resource available, Anne said: “What’s great is that we now have information that will provide guidance to funders in terms of the really important questions that still need to be answered if we want to provide the best possible MHPSS support in crisis settings.” 

She stressed the importance of addressing evidence gaps identified by practitioners, as it can be easy for research topics to be driven by the interests of researchers and not those who will use the findings. 

Researchers

Wietse suggested that the next steps for researchers hoping to engage with this agenda, would be for them to reflect critically on whether they fully understand where the gaps in MHPSS research are, and if their own work is in-line with these priorities. It would also be beneficial to consider the wider MHPSS research infrastructure and whether that too aligns with these priorities, in terms of both research partnerships and academic teaching.  

Mental health and psychosocial support in humanitarian crises: Setting consensus-based research priorities for 2021-2030

Explore the 20 most critical research questions for humanitarian MHPSS via our interactive tool and a full methodology report.

Read the Report

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